State announces plan for COVID-19 surge

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By Jarred Meeks

State officials elaborated on their plans to prepare Indiana hospitals for the looming surge of patients expected to be hospitalized due to COVID-19, the disease stemming from the new coronavirus.

Today, state officials reported there were 1,940 critical care beds in Indiana, a 35 percent increase since the beginning of the state’s COVID-19 pandemic planning. State officials also reported there were 1,177 ventilators in Indiana hospitals as of March 1. The numbers of beds are 60 percent full as of this time, according to state officials, but the state is taking measures to double the number of critical care beds and ventilators ahead of the predicted surge. (COVID-19 is a respiratory disease that has taxed many hospital systems worldwide, particularly their availability of critical care beds and ventilators.)

“This is critical not only for the protection of our long-term care residents, but also to ensure that our hospital systems have the capacity, when it’s needed, to care for that wave of COVID-19 patients that we’re expecting,” Indiana State Dept. of Health Commissioner Dr. Kristina Box said at a press conference.

Box predicted today that the surge of patients will come between mid and late April, but state officials said other epidemiological models forecast the surge hitting in early to mid May.

“Indiana already has hospitals that can turn every bed into critical care beds and we have identified those sites as possible surge hospitals for each region,” Indiana Family and Social Services Administration Secretary Dr. Jennifer Sullivan said.

Hospitals are currently increasing their number of critical care capacity by converting existing spaces and beds into critical care beds. This has been made possible by the temporary ban on elective surgeries, turning lower acuity beds into critical care beds, turning operating and recovery room suites into critical care beds and ending outpatient surgeries that are not connected to hospitals and using those facilities for critical care, Sullivan said.

But though state officials have announced plans for doubling the number of critical care beds, they also acknowledge personal protective equipment for healthcare workers have been and will be at a premium. Many hospital systems in the U.S. have reported shortages of personal protective equipment, including face shields, gowns and n95 masks used to prevent the spread of the disease to health workers. Sullivan said, so far, the state has received equipment from the Strategic National Stockpile (from which it has received it’s third and final shipment), by purchasing from Indiana-based vendors, from donations and through the Indiana Dept. of Correction.

Hospitals have worked to double the number of ventilators by reallocating them through additional resources, such as operating rooms, ambulatory surgery centers, EMS and the National Guard, Sullivan said.

“We won’t be able to get everything we want, but we are working to get everything we need,” Sullivan said.

And should these plans fall short of meeting the challenge of the surge, state officials said alternative care centers that could be established within 72 hours would be utilized. Indiana Gov. Eric Holcomb signed an executive order today suspending the necessary provisions to allow for the creation of temporary care facilities.

In an effort to staff more clinicians, a vital third component for preparing for the surge, state officials said they are asking current medical students and retired clinicians and those who have not been working due to the postponement of elective surgeries to help to meet the needs of burdened hospital systems.

Over the weekend, a survey was created asking clinicians to volunteer their efforts, and, as of today, more than 5,300 clinicians have committed.

Holcomb’s latest executive order issued ways for medical students and retired clinicians to obtain temporary authorization to provide health care. The volunteer survey can be found at coronavirus.in.gov.

The moves come in response to the now 1,786 positive cases of COVID-19 in Indiana.

As of today, 35 Indiana residents have died from the disease, of which 65.6 percent have been men. Box said this is likely due to the higher rates of cardiac disease and smoking in men. ISDH data also shows the majority of COVID-19 deaths in Indiana – 68.6 percent – have occurred in people age 70 and older.

Box said the state is testing more than ten times as many people as it was a few weeks ago thanks to ISDH, Eli Lilly and private labs, all of which have bolstered testing efforts, though the tests take at least 24 hours to be performed. Box said Indiana does not have faster testing capabilities at this time.

Also, in response to the pandemic and its effect on the state, Holcomb announced he will send a letter to President Donald Trump asking him to declare a major disaster declaration for the state to free up federal funds for the state to finance its efforts to slow the virus’ spread. Last week, state officials said the state began dipping into its more than $2 billion in reserves to fight the virus’ spread.


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