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Hospital system leaders reveal 'surge capacity' plans

Mar 27, 2020

Monroe County Adam Bello speaks Friday about 'surge capacity' plans.
Credit Screenshot from Monroe County news briefing

Monroe County and hospital system officials detailed their plans Friday morning for what they will do if an influx of COVID-19 patients overwhelms local hospital capacity.

County Executive Adam Bello said the "surge capacity" plan would add more than 2,000 hospital beds, which would potentially double the number currently available.

The plan would add more beds in hospitals and ambulatory clinics. It also would double up rooms, add beds in nonhospital spaces and create a field hospital if leaders determine those steps are necessary.

Bello said the county has identified four possible locations for the field hospital. He'll start touring them Friday afternoon, he said.

The county executive would not identify the four sites, but said he expects each would fit 500 to 1,000 beds. 

He said continued physical distancing will mitigate the need for these surge capacity measures.

"The results really are in our hands," Bello said. "If you do not need to be outside your home, you need to stay home."

(Video of today's briefing begins at 3:51) 

COVID-19 continued to spread in Monroe County, with a dozen new cases confirmed overnight. That brought the total number of known cases in the county to 160, officials said Friday morning.

Of those 160, 31 people were hospitalized, 20 in an intensive care unit.

County public health commissioner Dr. Michael Mendoza has said that ICU capacity is an important component of hospital systems’ ability to treat serious COVID-19 cases because they house ventilators. COVID-19 patients whose condition deteriorates often require a ventilator. 

Health officials said there were about 640 ventilators in Monroe County, split between the two local hospital systems. The University of Rochester Medical Center system had 400 ventilators, and Rochester Regional Health had about 240, officials said.

Dr. Michael Apostolakos.
Credit Screenshot from Monroe County news briefing

Dr. Michael Apostolakos, the chief medical officer at two URMC hospitals, said URMC was using about 70 ventilators on Friday morning.

Kathleen Parinello, the chief operating officer at Strong, said the hospital had placed an order for 20 more ventilators, which she believed were being shipped. She said the hospital had also requested an additional 30 ventilators from New York state.

New York Gov. Andrew Cuomo has said the state will need thousands more ventilators to treat the number of patients he anticipates will be seriously ill with COVID-19 in the coming weeks.

But ventilators are a last resort for treatment. Local hospital leaders also spoke about their plans to increase capacity for patients without life-threatening COVID-19 cases.

Apostolakos said URMC’s surge plan would add more than 1,000 beds to the URMC system and shift less critical surgeries to Highland and F.F. Thompson hospitals to free up capacity at Strong.

Apostolakos also stressed the importance of social distancing.

"The public plays a huge role in what happens in the future," he said. "This is not simply about capacity."

The more people heed the advice to stay home, the more hospitals will be able to "care for everyone and reduce mortality," he said.

Reducing the spread of the coronavirus also reduces the rate at which health care workers burn through the protective gear -- masks, gowns and gloves -- that they need when they are near patients with respiratory symptoms.

Hospital administrators outlined plans to double up COVID-19 patients in a single hospital room. That would increase patient capacity and also decrease the amount of protective equipment that workers need to discard as they move from room to room. 

New York City hospitals have been employing this strategy as the number of cases there rises into the thousands.

Dr. Robert Mayo.
Credit Screenshot from Monroe County news briefing

Dr. Robert Mayo, chief medical officer at Rochester Regional Health, said his system had a similar plan.

External treatment facilities were set up at the Wilson immediate care center, Unity Hospital, United Memorial Medical Center in Batavia, and Clifton Springs Hospital.

Outpatient physicians were learning inpatient skills so they could help out with COVID-19 treatment if needed, Mayo said.

The hospital system was also determining nontraditional areas where they could establish hospital beds for treating COVID-19 patients, Mayo said. Rochester Regional might room patients together for a variety of shared conditions, not just COVID-19, in an effort to free up floor space for additional capacity.

Officials said they were well into the first phases of their surge plan: adding more beds in hospitals and ambulatory clinics. They remained hopeful that aggressive social distancing would stave off the need for more drastic measures like grouping patients for treatment and establishing a field hospital.