A week after declaring surge
capacity met, County now says
there aren't enough beds to
reopen Montgomery County
Montgomery County officials attempted to address growing concerns over their lack of defined strategy for ending the coronavirus lockdown yesterday. In a streamed Zoom meeting, County Executive Marc Elrich said he thought the current statistics might point toward reopening the county in one or two weeks. But one number that Health Director Travis Gayles expressed concern about was ICU hospital bed capacity, and that four of the county's hospitals were at-capacity for ICU beds over the last week. This would make it difficult to handle a surge in new patients if a new wave of Covid-19 infections were to break out a few weeks after the Stay-at-Home order would be lifted.
Now, you may remember the county was 500 beds short of the projected need when the coronavirus pandemic began. On April 1, with great fanfare from their friends in the local media, the Montgomery County Council declared it was appropriating $10 million for county hospitals to add those 500 beds. Keep in mind, this is several hospitals' worth of beds.
To those more skeptical than our local press, this sounded like a hefty degree of magical thinking. If you know anything about construction, the regulatory hoops alone would have tied such expansion up for months. Permits would have to be processed, construction work would have to pass inspection. Not to mention that the work would have to be put out for bid, contractors selected, etc. The very expensive beds themselves - and all related equipment that is needed for each bed, particularly in an ICU setting - have to be ordered and shipped.
Just last week, Gayles told Bethesda Magazine in an email that - incredibly - this David Copperfield act had been magically pulled off. In only 41 days, Gayles wrote, Montgomery County hospitals had added all 500 beds. Interestingly, with all of the news cameras hanging out at local hospitals these days, we never saw footage of these new rooms or wings being opened on the TV news.
Ten days ago, we were told we had enough beds to handle a coronavirus surge. Yesterday, still under lockdown before any such surge has even taken place, we were told that a lack of bed capacity is now a primary reason the County cannot reopen its economy.
Something doesn't add up here.
Photo courtesy Hill-Rom
7 comments:
If 500 beds were added, as claimed, why are we still seeing "Blue Alerts" in the past week that our hospitals are near capacity?
There are actually a few ways to add new temporary emergency beds without new construction, which wouldn't require the regulatory issues that you mentioned. Laurel Hospital, for example, which was transitioned from a hospital to an outpatient facility in 2018, was able to utilize the space they already had to add 135 beds. Other options for adding beds could include converting different types of units (e.g. PACU, ED, Outpatient) to ICU, or even adding a second bed in single patient rooms. All of these options have been implemented around the country, and likely here as well.
Beds are not the same as rooms.
My Dad had a heart attack 5 years ago on Christmas evening. Each hospital the ambulance called was Coded for Non Acceptance. . Suburban, shady grove Georgetown medstar etc We waited 15 excruciating minutes for Bethesda Rescue Squad to find hospital who would accept Dad.
Finally the squad took him to Sibley where greeted with all empty beds but a screaming nurse
why did you send him here? So called Code Non accept (Blue?) in the nurses were partying . However, after we learned hospitals in Montgomery County don’t want to accept emergency older than 80 patients as chances dying higher. That is looked as a death on their books lowers ratings. This is why hospitals in NYC sent covid patients to nursing homes and killed all the older people
Fully insured man with loving family by his side
The doctor on call was great but
I do not understand how this system exists where people in a hospital can declare a code non accept if there are empty beds.
Montgomery County needs to address this
Covid has pulled off the screen of a lot of bad practices in this country e.g sending viral patients to elderly nursing homes, and how Code Blue really works
Is it possible that some of the new hospital beds were in areas that were deactivated, off line, or being held for remodeling? I know that the Suburban Hospital recently expanded and opened a whole new addition. I wonder if some of the existing patient rooms were reactivated, and thus appear as new beds to the hospital system. I know that many hospitals across the country have repurposed areas that formerly were used as patients rooms, were for some reason remodeled to other uses, but have recently been re-used as patient rooms to expand non-critical critical care capacity.
A friend of mine spent four days and nights in a Michigan hospital basement hallway for observation as his symptoms of the virus were being watched, but thankfully he didn’t need to be in intensive care, or on a ventilator, just isolated from non-virus patients. He was separated by other patients with curtains, but under frequent monitoring of his condition. Would this qualify as a “new hospital bed”? Certainly not a private room with a view, but better than being at home and in need of professional healthcare and monitoring.
2:58/9:58: I think the fundamental question is, if the 500 beds really were added and were meant to cover a surge, why are the hospitals at capacity before the surge has even started? We should have ICU beds to spare right now, which suggests that the beds were not added.
Code blue applies when _any_ hospital in MoCo goes red (no ECG-monitored beds available). Right now (2:40am), Holy Cross is red but every other hospital is fine. But that causes the entire county to go blue.
Also, the target utilization to end lockdown is 70% I believe.. however utilization is often around 70% even pre-covid, because hospitals aren't built with lots of extra capacity. Someone should look into this -- I think this reopening goal is not easily achievable. The bar is set too high.
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