Texas Hospitals Are Running Out Of Drugs, Beds, Ventilators And Even Staff

Edgar Walters, Shannon Najmabadi and Emma Platoff

A coronavirus patient in Anahuac was flown by helicopter to a hospital in El Campo — 120 miles away — because closer facilities could not take him.

Ambulances are waiting up to 10 hours to deliver patients to packed Hidalgo County emergency rooms.

And short-staffed hospitals in Midland and Odessa have had to turn away ailing COVID-19 patients from rural West Texas facilities that can’t offer the care they need.

As the tally of coronavirus infections climbs higher each day, Texas hospitals are taking extraordinary steps to make space for a surge of patients. Some facilities in South Texas say they are dangerously close to filling up, while hospitals elsewhere are taking precautionary measures to keep their numbers manageable.

Doctors warn of shortages of an antiviral drug that shows promise for treating COVID-19 patients. And epidemiologists say the state’s hospitals may be in for a longer, harder ride than places like New York, where hospitals were stretched to capacity in the spring and some parked refrigerated trailers outside to store bodies of people who died from COVID-19.

“It used to [be that] if one hospital got kind of overwhelmed … you would start transferring out ICU patients to other facilities that had ICU beds available,” said Dr. Robert Hancock, president of the Texas College of Emergency Physicians. “And there really is none of that now, because everybody’s in the same boat and they’re struggling to get their own patients admitted.”

Cases of the new coronavirus have surged in Texas since Memorial Day weekend at the end of May, one month after Gov. Greg Abbott allowed a phased reopening of businesses. In June, Abbott scaled back parts of that plan, first pausing elective procedures in the state’s biggest cities in an attempt to conserve hospital capacity for COVID-19 patients, then ordering bars to close and capping restaurant occupancy at 50%.

Last week, he expanded the ban on elective procedures to more than 100 counties across broad swaths of the state, a sign of the increasing urgency of the virus’ toll on Texas hospitals. Then he warned that if the trend continues, he might order another economic lockdown.

Hospital beds in use in Texas

The Texas Tribune is tracking the percentage of hospital beds in use for each trauma service region, which shows how the virus is currently impacting hospitals in different parts of the state. These regions are administered by Regional Advisory Councils (RACs). (To view map graphic see at https://www.texastribune.org/2020/07/14/texas-hospitals-coronavirus/)

Dr. John Zerwas, the executive vice chancellor for health affairs at the University of Texas System and a former state representative who is advising Abbott on coronavirus response, forecasted that July “will be a month for peak activity related to the epidemic.”

“Probably toward the end of the month, we’ll be seeing ourselves get into a bit more comfortable place,” he said.

Local officials in urban centers throughout Texas say more restrictions are needed now to slow the virus’ spread and keep hospitals from being overwhelmed in the future. On Sunday, Houston Mayor Sylvester Turner called on the governor to shut down businesses for two weeks.

Many Texas hospitals have stopped accepting transfer patients in order to maintain space for a surge that’s expected to come. In the Rio Grande Valley, that moment has already arrived, with hospital beds in short supply.

“The tsunami is here,” Hidalgo County Judge Richard Cortez said last week.

DHR Health, based in Edinburg, the county seat, is creating a third special COVID-19 ward in a facility normally used for physical therapy — after spending more than $9 million to convert a hospice center and rehabilitation facility into COVID-19 units.

“We’re full to the gills,” said Dr. Carlos J. Cardenas, chairman of the board at DHR Health.

In neighboring Cameron County, all of the hospitals were at or above capacity and holding patients in their emergency departments Monday, said Dr. James Castillo, the county health authority. Some were converting or eyeing areas not typically used for patient care, like conference rooms or lobbies, he said.

At Valley Baptist Medical Centers in Brownsville and Harlingen — which keep opening new units to care for critically ill patients — there were people waiting in the emergency room hallways for treatment this week, said Dr. Jamil Madi, medical director of the ICU in Harlingen. The hospitals are nearly out of ventilators and are starting to consider older models and disaster ventilators that are less optimal for treating the virus, he said.

“There’s nothing else other than COVID. … You treat COVID, you look at COVID, you see COVID, you smell COVID, you hear COVID. Everything’s COVID,” Madi said. “There are two parallel worlds: The world inside the hospital and the world outside. … We need people to understand that it is a dire situation going on inside the hospital.”

Ambulances are sometimes waiting hours to deliver patients to the emergency rooms, said Mack Gilbert, chief operating officer of Med-Care EMS, which services most of Hidalgo County. Normally, the wait is less than 30 minutes, he said.

“You can’t blame the hospitals for being full. The ICUs are full,” Gilbert said. But “the longer [the patients are] with us, the longer it takes to get them the care they need. We’re not really set up for long-term care like that, for four to six to eight hours.”

The extended delay also leaves medics in the confined space of an ambulance with a COVID-19 positive patient for longer, increasing their risk of exposure to the virus even though they wear full protective gear, Gilbert said.

The state sent hundreds of medical personnel to South Texas earlier this month to alleviate staffing shortages. It also deployed a fleet of 10 ambulances to Hidalgo, of which Med-Care can use two for 12 hours a day.

Gilbert is grateful — “these guys are doing a great job.” But in a 12 hour shift, “they’re only able to do three calls, because each call is taking four hours,” he said.

In Houston, major hospitals have had to treat hundreds of COVID-19 patients in their emergency rooms as they await space in intensive care units. Data shows the dozen busiest hospitals in the area are increasingly telling emergency responders that they cannot safely accept new patients.

Ripple effects can be felt throughout the region, including at El Campo Memorial Hospital, about 75 miles southwest of Houston.

Under normal circumstances, hospitals in Houston’s world-renowned Texas Medical Center would accept transfers of medically complex patients from smaller regional hospitals that are less equipped to handle them. But with many Houston hospitals diverting patients away, smaller facilities like the 49-bed El Campo Memorial Hospital have taken them on.

This story was originally published by Texas Tribune.