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How could COVID-19 potentially impact hospital bed capacity in Iredell County?

How could COVID-19 potentially impact hospital bed capacity in Iredell County?

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A patient's room at Iredell Memorial Hospital.

With 504 cases of COVID-19 confirmed by the North Carolina Department of Health and Human Services as of Wednesday morning, health officials are concerned about hospitalizations putting local healthcare systems over bed capacity.

How would this directly impact Iredell County?

Iredell Memorial Hospital is licensed for 247 beds and 16 intensive care unit beds, said John Green, president and chief executive officer of Iredell Health System.

Green said that the occupancy rate of those beds frequently changes but that the hospital is not over its bed capacity currently and that IHS is working to remain within that range.

“We are working on a daily basis to ensure that patients are being treated at the correct level of care for their illness,” Green said. “This includes use of critical care, acute care and skilled nursing beds and sending patients home with independent instructions or the use of our home health agency.”

Green urged people to follow the Centers for Disease Control and Prevention guidelines to slow the spread of COVID-19 and limit the burden on healthcare systems such as IHS.

“Follow the CDC guidelines regarding social distancing and avoiding groups at this time. Follow the CDC’s recommendations regarding appropriate hand washing and covering your cough. If not feeling well, contact your healthcare provider for advice and direction with respect to staying home or going to a facility for potential treatment,” Green said.

Lake Norman Regional Medical Center did not give a bed count but Public Information Officer Leigh Whitfield said that they have plans in place to increase bed capacity if needed.

“Lake Norman Regional Medical Center is prepared to support patients and staff in response to coronavirus,” Whitfield said. “We have well-established infection control and emergency response protocols in place, including contingency plans for additional bed capacity as needed. Our clinicians and emergency department team are skilled in caring for respiratory illnesses and equipped to provide necessary medical attention.”

Davis Regional Medical Center did not give a bed count either, but Public Information Officer Janie Stikeleather said that Davis has plans in place to increase bed capacity as well.

“Davis Regional Medical Center continues to be prepared to respond to COVID-19,” Stikeleather said. “We have a local hospital team actively working through contingency plans that includes potential additional bed capacities. Our emergency department and hospital stand prepared and ready to provide necessary medical care.”

Regional bed capacity

Around 20% of the people infected will require hospitalization, a report from the Harvard Global Health Institute indicated.

To flatten the curve or keep the healthcare system at or just over capacity, the hospitalizations would generally need to occur over a period of 18 months as opposed to a shorter time span, the Harvard report indicated.

In order to calculate the bed capacity of specific regions in the country, the Harvard Global Health Institute divided the country into hospital referral regions, which it defines as a regional market where people generally go to the same hospitals.

Iredell County is in two regions. Statesville and the surrounding area is in the Winston-Salem region. Mooresville and the surrounding area is in the Charlotte region.

The data that the Harvard study collected is from 2018, the most recent data available.

The study uses the data to give models of what a COVID-19 pandemic would look like in each region if 20%, 40% or 60% of the population were infected in six-month, 12-month and 18-month intervals.

In the Winston-Salem region, there are 2,870 beds and 499 ICU beds. There are 1,857 beds potentially available and 269 ICU beds potentially available, the Harvard data reported.

If 20% of the population were infected in six months, hospitals would be over capacity in a six-month interval, then have regular beds available once more at the 12-month mark, while still having a shortage of ICU beds. At six months the region would potentially need 36% more regular beds and 105% more ICU beds. In 12 months, the region would be at 68% capacity for beds outside of ICU, but need 3% more in that area. In 18 months, regular beds would be at 44% capacity and ICU beds would be at 67% capacity.

If 40% of the population were infected in six months, hospitals would be over capacity in six- month and 12-month intervals, then have regular beds available once more at the 18-month mark, while still having a shortage of ICU beds. At six months the region would potentially need 172% more regular beds and 310% more ICU beds. In 12 months, the region would potentially need 36% more regular beds and 105% more ICU beds. In 18 months, the region would be at 89% capacity for beds outside of the ICU, but need 34% more in that area.

If 60% of the population were infected in six months, hospitals would be over capacity in six-month, 12-month and 18-month intervals. At six months the region would potentially need 309% more regular beds and 516% more ICU beds. In 12 months, the region would potentially need 104% more regular beds and 208% more ICU beds. In 18 months, the region would potentially need 33% more regular beds and 101% more ICU beds.

In the Charlotte region, there are 4,873 beds and 770 ICU beds. There are 3,169 beds potentially available and 510 ICU beds potentially available.

If 20% of the population were infected in six months, hospitals would exceed capacity in a six-month interval, then have regular beds available once more at the 12-month mark, while still having a shortage of ICU beds. At six months the region would potentially need 76% more regular beds and 133% more ICU beds. In 12 months, the region would be at 88% capacity for beds outside of ICU, but need 16% more in that area. In 18 months, regular beds would be at 57% capacity and ICU beds would be at 76% capacity.

If 40% of the population were infected in six months, hospitals would exceed capacity in six-month, 12-month and 18-month intervals. At six months the region would potentially need 252% more regular beds and 365% more ICU beds. In 12 months, the region would potentially need 76% more regular beds and 133% more ICU beds. In 18 months, the region would potentially need 15% more regular beds and 52% more ICU beds.

If 60% of the population were infected in six months, hospitals would be over capacity in six- month, 12-month and 18-month intervals. At six months the region would potentially need 428% more regular beds and 598% more ICU beds. In 12 months, the region would potentially need 164% more regular beds and 249% more ICU beds. In 18 months, the region would potentially need 72% more regular beds and 128% more ICU beds.

“Each and every choice we are making is intended to flatten the curve and provide our healthcare system the ability to treat the sickest patients in the coming months,” Gov. Roy Cooper said in a press release Monday where he announced extended school and business closures.

“This is what we need to do to slow the spread of this illness and protect the health and safety of North Carolinians.”

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