New Jersey health officials plan to expand hospital capacity by nearly 800 beds in the coming weeks to help prepare for a likely patient surge related to the growing coronavirus epidemic and to keep cases of the resulting COVID-19 disease from overwhelming the state’s health care system.
State Department of Health Commissioner Judith Persichilli announced Wednesday that work was underway to immediately add a total of 260 beds at three acute care hospitals that had recently downsized; while the DOH did not provide specifics, she said 199 beds would be at a north Jersey facility, 11 in central Jersey and 50 in the state’s southern region. Capacity for another 227 patients would be added in the weeks to come, she said.
In addition, the state is working with South Jersey’s Inspira Health to reopen a 300-bed acute care hospital in Woodbury, Gloucester County. Previously known as Underwood Memorial Hospital — and more recently, Inspira Medical Center — the facility has hosted outpatient services, lab space and a satellite emergency room since December, when Inspira opened a new acute care hospital in Mullica Hill.
NJTV News report on challenge of providing care in anticipated surge of COVID-19 cases
Persichilli and Gov. Phil Murphy have repeatedly raised concerns about New Jersey’s hospital capacity if the disease continues to spread here; since early March, 427 residents have been diagnosed with COVID-19, including five who have died. A recent analysis by Rutgers University’s Senator Walter Rand Institute for Public Affairs, in Camden, found that — in the worst-case scenario — the state could face a shortfall of more than 300,000 beds sometime between May and October if the disease continues to spread unchecked.
“As the cases continue to increase in this state, our concern about the health care system’s capacity also grows,” Persichilli said during the state’s daily coronavirus briefing Wednesday. “There are predictions that many parts of the United States will have far too few hospital beds if the new coronavirus continues to spread. That’s why we’re working with our hospitals to develop surge and capacity planning.”
What Murphy asked the president
The governor has taken drastic steps to try and reduce coronavirus transmission by closing schools, movie theaters and restaurants and restricting travel, but the cases continue to climb — nearly doubling since Tuesday — as public health officials have long predicted. That means New Jersey must beef up its hospital capacity immediately to avoid the situation in northern Italy, where doctors are now forced to ration care and equipment, Murphy wrote Tuesday in a request to President Donald Trump for federal assistance.
Murphy said the Trump administration responded late the same day to his letter, which included a request for the U.S. Army Corps of Engineers to help state officials reopen hospitals or repurpose existing facilities. A meeting with regional Army Corps leaders is scheduled for Thursday, he said. The state’s 72 acute care hospitals now have almost 23,000 beds, more than half of which are usually full.
“If we open wings or hospitals and don’t need them, that will be the best mistake we’ve made,” Murphy said earlier this week. “We have to flatten the curve (of new COVID-19 diagnoses) and at the same time build our capacity,” he added.
Bed capacity is only part of the problem, however. Persichilli said there is a particular need for critical or intensive care spots, to care for more advanced cases of COVID-19. The state has nearly 2,000 ICU beds, plus another 1,600 rooms licensed for post-surgical use, which can be converted to critical care; there are also 700 isolation rooms, ideal for quarantine, but experts are concerned this may not be enough.
Public health officials are also concerned about levels of staffing and medical equipment, including the gowns and masks critical to protecting frontline care workers; while the federal government has provided some supplies, Murphy has stressed that much more is needed. Persichilli said Wednesday she is working with nursing leaders to recruit licensed professionals in that field and issued an order that enables hospitals to use mobile intensive care paramedics, who usually staff well-equipped ambulances, for limited duties inside the emergency room.
Acknowledging that pressure will increase
But as more testing sites for COVID-19 come online and a growing number of people are screened and swabbed for the disease, pressure will continue to rise on state hospitals, officials warn. Persichilli said the DOH had considered eight facilities closed over the past decade as possible sites to reopen, but identified challenges in bringing them back into use quickly. While most of these facilities closed prior to 2015, Inspira’s Woodbury hospital was fully operational until late last year.
The commissioner has also said she is in negotiation with four other provider networks about adding beds at existing facilities by reopening rooms that had been shuttered when the need declined or licensing requirements changed. (While specifics were not immediately available, these talks likely resulted in the 260 additional beds the state plans to open in the coming days.)
To address the limited number of isolation rooms — which are designed to contain viruses and other contamination — Persichilli said the state is also examining how to re-engineer the entire wing of an existing hospital to create the same quarantine effect. State officials are also checking out recently closed nursing homes, which could provide additional options, she said. Some hospitals, including Teaneck’s Holy Name Medical Center in hard-hit Bergen County, have opened inflatable annexes to help screen and treat the growing influx of patients.
In most cases these new sites the state is working to create — like the reopened Woodbury hospital — will be equipped to handle less critical cases of COVID-19 or other conditions, but not ICU patients, officials said. This may result in some hospital patients being transferred from existing facilities to these sites to make room for more urgent care needs.
“The surge is going to come in two directions,” Persichilli explained. “One is going to be the COVID-19 patients and then the other patients that come into the hospital through the emergency room that are appropriate for an acute care stay and perhaps a bed is not available,” she added. “That’s where opening up a closed hospital or using an empty nursing home that has the appropriate facilities is going to become really important.”