ICUs are completely full in at least 50 Texas hospitals from the COVID-19 peak

Ivan Melendez, the health authority of Hidalgo County, says that getting to COVID-19 units today feels like a non-linear version of the five stages of grief: denial, anger, negotiation, depression, and acceptance.

“You’re crying,” he said to the stands. ‘There is a lady that I take care of who I have known since I was a child. … We grew up together, and I know she’s dying. … It’s the same: “We got together for Christmas.” Now we see its consequences. “

Across Texas, hospital intensive care units are being battered as COVID-19 cases continue to rise at a peak after the holidays. Dozens of facilities have reported that their ICUs have been at or above 100% capacity for weeks, leaving staff overworked and thin.

More than 50 hospitals in Texas are currently reporting their ICUs are 100% or higher, and a dozen of them have been full for more than half the 24 weeks since hospitals began reporting that information in July, according to a Texas Tribune analysis of data released by the United States Department of Health and Human Services.

For example, Rio Grande Regional Hospital in McAllen and HCA Houston Healthcare Medical Center in Houston are over 100% for 23 and 22 weeks, respectively.

While statewide hospital admissions appear to be stabilizing as a result of COVID-19, there is still cause for concern, said Chris Van Deusen, a spokesman for the Texas Department of State Health Services. Across Texas, there are about 600 available intensive care beds – a fraction of the few thousand that were open in the spring when the pandemic started.

Van Deusen said the pandemic appeared to hit different regions in waves. Currently, the Dallas-Fort Worth, Houston and San Antonio areas are seeing significant spikes in COVID-19 cases, according to DSHS data.

Health officials in Laredo have sent emergency alerts begging residents to stay at home as local ICs have reached capacity in the past month. Currently, COVID-19 patients occupy nearly half of the hospital capacity in that region, according to DSHS data – the highest percentage in the state.

Many cities have had to divert patients to other hospitals because their local ICUs overflow, in addition to expanding and converting available beds to treat ICU patients.

Melendez said counting available ICU beds does not provide the full picture in Texas hospitals as they are constantly adapting to accommodate more patients. If an IC unit is technically full, he said, many hospitals can still convert some available beds or units outside of that unit to provide IC care to patients.

Stephen Lowry, Hendrick Health’s chief of staff, said his hospital in Abilene has used both diversion and bed conversion. Currently, the facility is operating at 160% capacity, which is below a peak of 180%, he said.

Hendrick Health is the regional referral center for 24 surrounding counties, but Lowry said the hospital was unable to meet the needs of the area because they no longer have room for new patients; they created all the new space they could in the spring before the pandemic hit.

“It’s really frustrating,” said Lowry. “You hear stories from outside the community, or relatives who have relatives in one of these remote towns, and they are struggling to get their loved ones into a higher level of care because not only Hendrick, but many other facilities across the state are full and cannot accept the transfers. “

Texas Health Fort Worth, one of Tarrant County’s busiest hospitals, reported reaching 100% ICU capacity on Jan. 8, according to data from HHS. The president of the hospital, Joseph DeLeon, said, like many other medical centers, the Texas Health Resources network has tried to relieve pressure by canceling non-critical outpatient procedures.

But so far, measures that helped during the summer COVID-19 spike haven’t worked so well in winter, DeLeon said.

“We were like, ‘Well, okay, now that we have some experience from July, we kind of know what it’s going to look like.’ But the second wave was different. There were many more critically ill patients this time, “DeLeon told the Tribune.” This time we’ve had a lot more stress on the staff, a lot more stress on the doctors … it was just a test of endurance. “

Cynthia Simmons is the Arlington Public Health Authority and physician in the Medical City of Arlington emergency room, who has been at or near 100 percent capacity for weeks. She said Texans need to understand that if they have car accidents, heart attacks, or other non-COVID-19 emergencies, a full ICU at the nearest hospital could mean that there may not be enough resources available.

“We’ve now reached a point where we have so much COVID in our community, it’s spread so easily, that the same things we’ve talked about from day one of public health measures are now really important,” said Simmons. “I am aware that people are tired of that. But it’s really, really important right now that we continue with those measures to help save capacity in our hospitals. “

Simmons added that people shouldn’t delay care if they need it because the emergency department is good at treating both COVID-19 and non-COVID-19 patients, even when they are full.

Simmons and other Texas health professionals have expressed hopes for the future after the Texas vaccination process began on Dec. 14. Tens of thousands have already received a second dose, although millions of eligible people are still waiting for Texas to receive enough. doses to vaccinate the health professionals, long-term caregivers, the over-65s and those with certain health conditions including groups 1A and 1B.

But the crunch in the ICU is far from over. While hospitalizations are not currently increasing at December’s higher rates, a more contagious COVID-19 variant, identified in Harris County on Jan. 7, could cause hospitalizations to increase more strongly as it spreads. While it may not make people sicker or affect the death rate, the mutation means the virus can spread faster and infect more people, said Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council.

“The result is more hospital admissions, more capacity problems,” said Love. “For the next three to four weeks [it’s] absolutely crucial for us to check and try and get the word out to people to please do what they need to do to stop the spiral. “