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Local hospital systems push state to allow earlier reopening

Apr 23, 2020

With a surge in COVID-19 cases yet to materialize, many hospital beds in Monroe County and the surrounding region are empty.

The push for physical distancing has been successful, hospital leaders and public officials said. Closing businesses and shutting down schools averted a crisis, at least for now.

Golisano Children's Hospital has been largely empty, and even Strong Memorial Hospital has excess capacity, officials say, as an overwhelming surge in COVID-19 cases failed to materialize in Monroe County.
Credit File photo

Three weeks ago, county public health commissioner Dr. Michael Mendoza said every projection in use at the time showed the county running out of ventilators.

"There’s no model that we have that has us being able to treat everybody," he said.

This week, Mendoza said the county had reached a plateau. The number of people hospitalized and in intensive care for treatment of COVID-19 has leveled off at a rate the health care system can easily handle -- though Mendoza and other public officials continued to stress the outbreak could easily get out of control if those distancing measures are not continued.

On Wednesday, the University of Rochester Medical Center’s chief medical officer said Strong Memorial Hospital had about 80 total people on ventilators -- some for COVID-19 treatment, some for other conditions. The hospital could handle about 200 people on ventilators, said Dr. Michael Apostolakos.

Numbers for Rochester Regional Health were not immediately available, but doctors there said they, too, had excess ventilator capacity.

As hospitals across the state prepared for the yet-unrealized surge in COVID-19 patients, they shut down other parts of their operations. "Our children’s hospital, except for the neonatal intensive care unit, is almost empty … and the same thing is happening in our cancer center," Apostolakos said.

New York state should allow upstate hospitals to admit non-COVID-19 patients sooner than planned, says Dr. Michael Apostolakos, the chief medical officer at the University of Rochester Medical Center.

That was good when the region was trying to stave off a surge, he and other local hospital officials said. But now, with COVID-19 cases in a plateau well below the health care system’s capacity, local officials are looking to restart some of the procedures doctors had put on pause.

New York Gov. Andrew Cuomo said earlier this week that some upstate hospitals will be able to resume elective outpatient procedures. But Rochester-area health systems said the regulations governing when they can begin admitting more patients were too strict.

Hospitals can resume those procedures if they are in a county with fewer than 10 COVID-19 hospital admissions over the last 10 days, and if more than 25% of hospital beds in the county are unoccupied.

"The problem is that that doesn’t fit our county," said Apostolakos. Monroe County’s hospital discharge rates for COVID-19 have kept pace with admissions for the last 10 days, he said, but they are still well above the 10-in-10-days threshold.

That’s preventing people who should get medical care from receiving it, he said. 

"Some surgeries that are elective now will become urgent in two weeks," Apostolakos said. "If you have an injury, you might be able to wait it out for some time, but when you start postponing it indefinitely is when you start running into problems."

And while they are closed to elective procedures, hospitals are hurting financially. Several in New York state have furloughed staff even as the pandemic smolders.

Neither Rochester Regional nor URMC have taken that step, spokespeople said, but Apostolakos said it "is a real concern."

"Quite frankly, each month, we’re losing money, and we can only tolerate that for a relatively short period of time," he said.

Both hospital systems acknowledged that admitting more patients for elective procedures does increase the risk of coronavirus transmission. Still, officials said, the danger is tolerable.

"We believe that small risk is being far outweighed now by the non-COVID illness that patients are accumulating because of not getting the treatments that they need," Apostolakos said.

Further exacerbating the problem, he and officials at other local hospitals said, is a public wariness of health care facilities. In some cases, doctors said, the fear has gone too far.

"All of our hospitals have reported patients that have presented to the emergency room much later than they would have" if not for the pandemic, Apostolakos said.

In some cases, people with heart failure have tried to stay home, turning a chronic condition into an emergency. "We could have turned things around, and they wouldn’t have needed admission," he said.

Officials at URMC and Rochester Regional said their institutions were safe for patients.

"If you need medical treatment, get it. Don’t ignore your symptoms," said Veronica Chiesi-Brown, a spokesperson for Rochester Regional Health.