University Hospital will begin limiting the amount of visitors allowed inside due to the recent spike in COVID-19 cases.
Because of the growing number of coronavirus cases, University Hospital will begin limiting visitors again. Credit: Bonnie Arbittier / San Antonio Report

San Antonio and Bexar County has “plenty of capacity right now” to treat hospitalized patients diagnosed with COVID-19, according to the head of the network that coordinates the regional emergency health care system.

Of the 168 local residents who have tested positive for coronavirus, 42 were hospitalized as of Monday and 13 were in intensive care units, said Eric Epley, executive director of the Southwest Texas Regional Advisory Council, a network of hospitals and first responders across 22 counties that maintains the regional trauma and emergency health care system.

In total, Bexar County has about 7,100 licensed hospital beds and approximately 950 intensive care unit (ICU) beds at 24 area hospitals, Epley said.

This indicates San Antonio is in good shape for coping with the coronavirus pandemic, he said Monday.

“If we flatten the curve, hopefully we stay at the edge of capacity,” said Epley, referring to the need to keep the daily number of coronavirus cases at a level medical personnel can handle through measures such as the local Stay Home, Work Safe order.

Of the 42 hospitalized patients, 13 patients were treated in ICU, and 11 needed ventilators. Bexar County has nearly 700 ventilators available for use on a given day, Epley said.

As the number of coronavirus patients grows locally and nationally, concerns have grown about whether local hospitals will be able to handle a sudden spike in patients needing to be hospitalized. Also of concern is whether there is enough equipment and staff available to treat seriously ill patients.

The University of Washington’s Institute for Health Metrics and Evaluation (IHME) has constructed real-time projections of the coronavirus outbreak in each state. The model provides forecasts of when the outbreak will peak in individual states, how many hospital beds will be needed at that time, including ICU beds, and what kind of specialized equipment, such as ventilators, would be required.

The maximum use of hospital beds and other health care resources (peak resource use) in Texas is 34 days away, on May 5, according to projections published March 26. To treat patients statewide during this peak would require 16,538 hospital beds, 2,469 ICU beds, and 1,975 ventilators.

While Texas was projected to have plenty of regular hospital beds when they are needed most, the IHME model showed the state would require 210 more ICU beds than currently exist.

Epley said IHME’s statewide projections are based on what can happen if Texas doesn’t mandate certain social distancing measures necessary to flatten the curve by April 2. Gov. Greg Abbott has largely left stricter measures, such as stay-at-home orders, up to county-level officials to decide but has ordered schools closed until May 4 and implemented restrictions on travelers from outside the state.

In addition to various measures implemented to reduce the spread of coronavirus, area hospitals have agreed to stop performing elective surgeries, such as joint replacement and bariatric surgery for weight loss, to keep beds available for coronavirus patients, Epley said.

While Bexar County appears to have enough hospital beds and equipment available to handle a surge in coronavirus cases, local officials have designated Freeman Coliseum as the site of a pop-up hospital if such a facility is needed.

The pop-up hospital is scheduled to be ready in a matter of days, Bexar County Judge Nelson Wolff said Monday, noting that additional pop-up hospital sites will be identified by the end of the week to accommodate a total of 1,000 overflow beds in the county.

As of midday Tuesday, Texas health providers have administered more than 42,992 COVID-19 tests, according to the Department of State Health Services. Of those tests, 3,266 came back positive, and 41 people have died.

The IHME model predicted there would be 155 coronavirus-related deaths per day come May 6 if Texas does not implement statewide measures such as stay-at-home orders and travel bans.

Epley told the Rivard Report that while San Antonio is in a good position to treat the inevitable influx of coronavirus patients, “it’s more complex than what is the number of ventilators that you have on hand.”

While there are 700 ventilators available for daily use locally, utilizing the equipment needed to treat coronavirus patients requires hospitals to have adequate staff available to provide treatment, Epley said.

For severely infected coronavirus patients, a more specialized machine called an Extracorporeal Membrane Oxygenation (ECMO) is used when a ventilator won’t work. The machine pumps and oxygenates blood outside the body in an effort to let patients with severe heart and lung failure heal.

“That takes special cardiac doctors to attach the ECMO,” so the availability of specialists also is a factor in handling a dramatic increase in the number of severely ill patients, Epley said.

For their part, hospital systems are communicating daily with STRAC’s hospital command center, located at the San Antonio Office of Emergency Management on the city’s South Side. Hospital officials report how many patients test positive, are hospitalized, and are discharged to ensure a correct count of available beds and equipment.

“We have some of the best health care providers in the state working for us, so we all need to do our part to keep people out of hospitals,” Epley said.

Roseanna Garza

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.