LGH Penn Medicine

Penn Medicine's Lancaster General Hospital in Lancaster city.

With a national model projecting Pennsylvania will run out of ICU beds within a month, Lancaster County health officials are grappling with a fall surge that has sickened direct-care workers and caused at least one to halt visitation.

In a virtual press conference Tuesday, Pennsylvania Health Secretary Dr. Rachel Levine announced “targeted efforts” that include a strengthened mask order, COVID-19 tests and quarantines for out-of-state travel.

“The hospitals and health systems and their chief executive officers need to be working now through our health care coalitions and other partnerships to review and prepare now how they will support one another, should we get to the point that a hospital could become overwhelmed,” Levine said.

Levine also urged hospitals to begin working to move up elective procedures and prepare to reduce non-emergent surgeries, adding she was relying on local health systems to “use clinical judgment” in determining which medical procedures can wait.

Neither WellSpan Health and Penn Medicine or UPMC have plans to limit elective procedures.

In an email to staff Friday, Jan L. Bergen, president and chief executive officer of Penn Medicine Lancaster Heath, said in order to ensure available hospital beds, they were “rescheduling” some elective procedures.

“Patients should not delay important care — scheduled or emergent — due to fears of COVID-19,” Mary Ann Eckard, a spokeswoman with Lancaster General Hospital, said in an email Tuesday to LNP | LancasterOnline. “Delaying medical care could cause serious problems in the long term.”

Earlier in the day, WellSpan Health — which operates eight hospitals in Pennsylvania, including WellSpan Ephrata Community in Ephrata Borough — announced the escalating number of COVID-19 cases had prompted the health system to prohibit visitation except for patients in labor and delivery and those at the end of life.

As the virus takes a foothold in the community, hospitals will increasingly have to battle the novel coronavirus on two fronts: first from without, with patients seeking care, and then from within as staff gets sick and infected.


Health system staff infected

Each of the health systems have had employees test positive for COVID-19.

“Because of the nature of community spread, it is not just frontline staff at WellSpan that have tested positive for COVID-19,” Ryan Coyle, a WellSpan spokesman said in an email.

Kelly McCall, a UPMC spokeswoman, said staff continues to “rise to the challenge” despite these challenges.

Neither WellSpan nor UPMC disclosed how many staff have been infected nor whether nurses and doctors have been sickened with COVID.

In Bergen’s email to her staff Friday, she acknowledged that “some 50 employees were quarantined each day” last week because of exposure in “community settings.”

Dr. Michael Ripchinski, chief clinical officer at Penn Medicine Lancaster General Health, told LNP | LancasterOnline last week that in order to guarantee sufficient staffing the hospital had offered premium pay, overtime and extra shifts to incentivize the workforce.

“An alarming surge in cases of COVID-19 continues to place tremendous demand on hospitals and health systems nationwide,” Bergen wrote in her email to staff Friday.

State data shows health care workers on Tuesday accounted for roughly 5% of all infections. Following the state’s reopening, health care workers in early July represented about 7.5% of all cases.


ICU beds

The University of Washington School of Medicine model used by the White House Coronavirus Task Force projects the rise in cases will drive up the need for ICU beds in Pennsylvania, exceeding what is available in mid-December.

The 14-day average of available ICU beds in Pennsylvania Tuesday was 788, down from 917 on Nov. 1 and 1,284 back on July 1. In Lancaster County, that number was nine, up slightly from about seven on Nov. 1 and down from 21 on July 1.

WellSpan Ephrata Community has 10 ICU beds, which can be expanded, if necessary, to 20 to treat COVID patients, Coyle said.

Lancaster General has 66 ICU beds, Eckard said, but it’s unclear how much the hospital can expand.

UPMC did not provide this information.

None of the health systems serving Lancaster County disclosed whether the increase in cases had hampered their ability to continue accepting COVID patients.