With the number of patients with COVID-19 symptoms in McHenry County hospitals climbing, local health care leaders say they’re prepared to create additional capacity in their facilities if needed, but they haven’t had to activate those contingency plans.
Although McHenry and Lake counties, the health region identified by the Illinois Department of Public Health as Region 9, has seen the number of patients climb every day for the past 50 days, the number of intensive care unit beds available remain above the warning thresholds set by the state.
The region had 43% of the region’s 250 ICU beds and 86% of its 293 ventilators open, both higher than the state as a whole, according to the state’s data, which tracks capacity in terms of three-day rolling averages updated each day.
Part of what could be causing fewer patients entering the hospital who need intensive care unit beds compared with the spring is that many of the outbreaks in the spring occurred in senior living and care facilities among older populations especially susceptible to developing severe symptoms from the virus, said Dr. Irfan N. Hafiz, an infectious disease specialist with Northwestern Medicine, which operates hospitals in McHenry, Woodstock and Huntley.
He said he believes facilities catering to seniors are better prepared with information, personal protective equipment and testing capability than earlier this year.
“We are seeing a considerable rise in the numbers,” Hafiz said. “So far we’re not seeing as many maybe go to the ICU, but they are requiring a lot of care still, and they may need to be in the hospital for a number of days.”
People with underlying health conditions, such as diabetes or otherwise, are among those driving the increase in hospitalizations, as severe symptoms of COVID-19 continue to be more common in those with such issues.
“We’re seeing a lot of patients coming from the community who are independently living, active adults. The reality is they’re coming in with respiratory issues, fever, cough, shortness of breath that have become so unbearable that they have to come to the emergency room. They may have had diabetes for 30 years, but they have never had breathing issues until now. We’re seeing a lot of those folks come in,” Hafiz said.
Mercyhealth, a regional health system with seven hospitals, including one in Harvard and another planned for Crystal Lake, also has seen cases rise, said Barb Bortner, the system’s vice president.
“COVID-19 hospitalizations at Mercyhealth hospitals have continued to increase,” she said. “At the same time, the volume of non-COVID patients has increased in much higher numbers. These are patients with chronic conditions and serious acute conditions such as heart failure, stroke and cardiac.”
Across the state, 29% of total ICU beds were open and 23% of medical and surgical hospital beds, closer than the county’s region to the 20% warning thresholds the state has set for when to recommend additional mitigation orders to slow the viral spread. The state had 73% of its 5,755 ventilators open, according to state health department data.
It is a better situation in terms of available ventilators now than in mid-April, when about 57% of ventilators in the state were open as 800 COVID-19 patients were using a ventilator and another 520 patients with other ailments were using one, according to the state health department data.
But the 1,089 ICU beds available statewide on Tuesday was reported at its lowest since May 19. The same is true for total open hospital beds in the state – that number dipped below 10,000 on Tuesday for the first time since at least mid-April, according to the state data.
COVID-19 is not the only ailment eating up hospital space: The number of patients on ventilators statewide who have not tested positive for COVID-19 has outnumbered the COVID-19 patients on ventilators since early May, the state data shows.
But the 404 patients with COVID-19 on ventilators as of Tuesday in Illinois is the most since June 8 and the number has been steadily rising since September, the data shows. An additional 1,100-plus patients without COVID-19 were on ventilators in the state as of Tuesday.
Analyses of state health department data on the outbreak by the Illinois Medical Professionals Action Collaborative Team, a group formed earlier this year, project Illinois will surpass its intensive care unit bed capacity by Thanksgiving, and deaths per day will peak mid-December, the group said in a Monday statement.
“We are better at identifying and treating this disease, and survival rates are improving slightly in COVID-19 patients since the start of this pandemic,” the group said in a statement. “This is good news, but has not changed the overall trajectory and danger of the pandemic. COVID-19 hospitalizations in Illinois have doubled over the last three weeks, a very dangerous trend.”
The group warned that if hospitals are overwhelmed, those who suffer heart attacks, appendicitis and other common medical issues could be more at risk for dying as a result.
Both Northwestern and Mercyhealth have hospital capacity now and the capabilities to expand capacity if needed. Hafiz suggested this winter could be mild in terms of influenza cases because the social distancing and mask-wearing should help reduce spread of that ailment.
So far, although it is very early in the flu season, Hafiz said he is unaware of any local hospital admissions because of influenza.
“We are very cognizant of the fact that there are people who are still admitted to the hospital with non-COVID-19-related issues, as well,” Hafiz said. “We do want to be able to continue surgery as safely as possible. I think what we are doing with all the planning that is going on, we do have contingencies of being able to expand some of our capacity and be able to continue to serve those patients that need those admissions locally.”
The fact that COVID-19 cases are on the rise in a much wider swath of the country than in the spring and summer, when there were concentrations of cases in cities such as New York and then Sun Belt states, respectively, complicates the sharing of medical resources such as ventilators, Hafiz said.
“Pretty much every state is seeing an uptick. It’s very much across the U.S., which makes resources quite a bit more difficult to ship across states when everyone is feeling that pain. Within the state some areas are harder-hit than others. We look at resources at a regional and local level,” he said.
To help limit the surge in serious COVID-19 cases and keep hospital space available, the IMPACT group’s Monday statement suggested to enforce universal masking requirements, including by adding steeper penalties for those who do not wear face coverings; emphasizing there should be no indoor gatherings, even in private homes, especially during the holidays, and that anyone with symptoms of COVID-19 must get tested and anyone with no symptoms but with exposure or travel to a high-risk location must quarantine for 14 days.
It also suggested continuing to support work from home employer policies, and that county and state governments should require stronger surveillance and mitigation efforts at all private and public grade schools and universities in the state, which remain sources of COVID-19 transmission, according to the statement.
“Right now, it’s more important than ever to help keep our hospitals from needing to activate surge plans by working together to continue wearing masks, practice good hand hygiene, use social distancing measures, keep gatherings small and seek medical care when needed so we can once again, decrease the rise in cases,” Bortner said.