A dip in the number of open ICU hospital beds driven by the surge in COVID cases in Lancaster County means health care systems may need to repurpose other spaces that could strain the capacity of current staff.
On Wednesday, seven ICU beds were open in Lancaster County out of the 80 available, a review of state data showed.
The majority of the beds were occupied by non-COVID patients. The seven-day rolling average Wednesday was 11.
October and November saw more than two weeks of days in which the beds available in the county’s intensive care units dropped into the single digits, unlike the summer months that had significantly more.
Health officials track a variety of factors to gauge viral spread — from the number of daily cases and hospitalizations to patients occupying ICU beds.
ICU capacity is central to implementing more aggressive interventions such as using ventilators that “breathe” for the patient placed in a chemically induced coma.
National models project Pennsylvania hitting 22,000 COVID cases a day this month and running out of ICU beds. If Lancaster County’s percentage of cases holds at 5% of the state’s infections, those 22,000 daily cases would translate into 1,100 COVID patients here.
Local health care systems have touted their ability to shuffle patients, supplies and staff between facilities as the answer to worrisome increases in COVID cases that threaten to overwhelm hospitals.
The health care sector already routinely did this pre-pandemic, sharing the load from higher level care patients, typically from smaller and rural hospitals to larger, academic institutions in urban areas.
But this third wave of COVID infections could threaten patient transfers as health systems weigh their own capacity, said Amesh Adalja, an infectious disease physician and senior scholar with the Johns Hopkins Center for Health Security.
“The system may break down in a pandemic,” Adalja said.
‘If we need to grow … we can’
To date, UPMC Pinnacle has been able to accept COVID patients, Lou Baverso, chief operating officer, said Wednesday.
UPMC Pinnacle has roughly 100 ICU beds across the seven hospitals it operates, which includes UPMC Lititz. The Lititz hospital is licensed for 12 ICU beds.
“We do have plans that if we need to grow above 100, we can,” Baverso said.
That, Baverso said, could mean repurposing the Post-Anesthesia Care Unit or reviving older ICUs currently being used for other purposes.
The average ICU stay for a COVID patient — and this is bit of a moving target depending on the complexity of the case — is more than seven days. It’s less for non-COVID patients. Given this, the ability to expand a hospital’s ICU will be critical as the pandemic intensifies.
But even this would address only part of the problem.
“We’re going to have to find a way to augment the workforce,” said Adalja. “It may not be an issue of space, but of the workforce.”
LNP | LancasterOnline reached out to officials at WellSpan Health and Penn Medicine Lancaster General Hospital about their health system’s contingency plans should COVID cases outpace their ability to respond to patient needs.
Ryan Coyle, a WellSpan spokesman, said the health system was “finalizing some things” and would not be able to respond before LNP’s press deadline. Mary Ann Eckard, a spokeswoman for Lancaster General, did not provide specific details. “With months of experience and continued daily planning efforts, Penn Medicine Lancaster General Health continues to maintain and identify opportunities to expand our capacity to care for patients of all kinds,” she said, “and we are committed to ensuring that patients can access both routine and emergency care during the COVID-19 pandemic.”