Weeks ago, Texas officials were scrambling to expand the state’s hospital capacity, seeking out external facilities that could house coronavirus patients and banning all nonessential procedures in an effort to preserve resources. Now, with many major cities saying their facilities seem prepared for the outbreak, some of those restrictions will be rolled back and some backup plans may prove unnecessary.
State leaders are projecting cautious optimism about the state’s medical capacity, including hospital beds and personal protective equipment like masks and gloves, suggesting measures taken weeks ago to conserve resources have borne fruit.
“It turned out in hindsight that we have a great number of hospital beds that are vacant, that appear that will not be needed to treat COVID-19 patients,” Gov. Greg Abbott said at a Friday afternoon press conference when he also announced plans to gradually reopen the state economy. “Because of the hospital bed vacancy and because of a new supply chain for PPE, we feel that we can begin allowing some more procedures.”
A prohibition on medical procedures that are not “immediately medically necessary” will be loosened starting next week, allowing hospitals that have struggled financially without those lucrative procedures to begin recouping losses. Starting Tuesday night, health care facilities may perform a limited number of nonessential surgeries, so long as they preserve at least 25% capacity available to treat COVID-19 patients and don’t deplete medical resources.
Of course, local officials and medical experts cautioned, for coronavirus levels to remain manageable in Texas hospitals, Texans must continue taking precautions like social distancing.
Major hospital overflow centers in Houston and Dallas — where most Texas cases of the new coronavirus are centered so far — may not end up serving patients after all.
In Houston, where medical experts say the curve is starting to flatten, the makeshift hospital under construction at NRG Stadium may not prove necessary.
“We do have a good handle on it,” SouthEast Texas Regional Advisory Council CEO Darrell Pile said of hospital capacity in the 25-county region he leads in the Houston area. Over the last several days, he said, he has seen a steady number of coronavirus-related hospitalizations, all below the area’s capacity. “It would appear that our current system can manage demand.”
In Dallas County, local officials stalled a plan to set up a pop-up hospital in a convention center — about a week after the county judge said they “need that asset” for coronavirus patients.
The decision came as a regional hospital council said social distancing was having a “positive impact” and that local health care facilities would be able to handle a surge in patients on their own.
“When we look at our numbers, we could not justify moving forward setting up 240 beds,” county Commissioner John Wiley Price said Friday.
Ahead of Abbott’s announcement, lawmakers and the Texas Medical Association had called on him to loosen the restrictions on elective procedures, raising concerns about patients’ access to needed care.
“Decisions that are reasonable and prudent today may not be so in a week or two weeks,” said David Fleeger, the association’s president, in an April 13 letter to Abbott. “At the same time, not every community will face the same challenges of a surge at the same time.”
Officials across the state said hospitals have seen lower-than-normal patient populations since the order went into effect. The bar on elective procedures coincided with public health warnings that urged Texans to stay home and to delay appointments and medical care if possible.
“In our area right now, they’re sending nurses home because there’s no patients in the hospital,” said Grant Madden, chair of the Big Country Regional Advisory Council, which services 16 counties. “I would say hospitals around here are 15% to 20% [full]. … They’re not allowing any noncritical surgeries to happen. They’re just waiting for the surge of COVID patients.”
Danny Updike, executive director for two regional advisory councils in West Texas, said facilities in his area have “plenty of bed space,” estimating most are between 30% and 50% full.
“Nursing staff and housekeeping staff and nurse aides, and even executive leadership, are all having to take days off — they can use PTO or just take time off without pay — just because they don't have work,” said Updike, whose service area includes 31 counties. “I don’t think out here right now we really see a need for any of the freestanding hospitals or anything like that.”
The loosening of the restrictions was some “good news,” he said Friday.
Brian Weis, chief medical officer for the Northwest Health Care System hospital in Amarillo, said his hospital has the resources it needs to treat the region’s coronavirus patients. The challenge, he said, has been having to furlough hundreds of staff members due to the decreased number of patients coming in for care.
“People are not coming to the hospitals,” he said. “We literally don’t need the staff we have right now.”
The picture looks different across the state.
In El Paso, where the coronavirus case counts continue to climb, hospitals have worked together to prepare for a potential surge.
“Right now, we are looking OK,” said Ryan Mielke, director of public affairs for University Medical Center El Paso. His hospital has constructed isolation tents in front of the building to prescreen potential COVID-19 patients. “However, we are seeing a very strong uptick in patients. We made a plan — whether or not that is more than enough or not enough is still yet to be seen. We’re dealing with an unknown.”
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