‘We have to do better’: Health officials warn Linn County hospitals could become overwhelmed if cases continue to increase rapidly

A biomedical equipment specialist conducts maintenance on a ventilator as the Army supports COVID-19 response efforts worldwide. — U.S. Army Medical Logistics Command

During a press conference on Thursday afternoon, health experts warned Linn County residents that if cases of COVID-19 continue to increase as rapidly as they have been, hospitals will become overwhelmed in the next two to three weeks.

Linn County saw its first confirmed cases of the new coronavirus on Saturday, March 21. In less than a week, the number of confirmed cases increased from 3 to 22 on Friday, March 27, according to data published by the Iowa Department of Public Health.

When I talked on Monday, I talked about the rate of increase in cases, how quickly the cases are doubling, essentially,” Dr. Tony Myers of Mercy Medical Center said at the Thursday afternoon press conference. When Myers spoke on Monday, there were six confirmed cases.

“We are doubling too quickly in our first few days,” Myers said Thursday. “The rate that we’re doubling will overwhelm the hospitals in the next two to three weeks. We have to do better.”

“In order for us to prevent and save as many [people] as we can, the hospitals have to have them come in slowly, or slower, even with our increased capacity, so that we can take care of the critically ill people. We have to do better.”

At the press conference, Dr. Dustin Arnold of UnityPoint Health talked about “three buckets” of people — those who are susceptible (“all of us because … it’s a novel virus”), those who are infectious and those who have recovered (“very small amount”).

“For every infectious person that comes in contact with a susceptible, four people get sick, and then that person gets four more people sick,” Arnold said.

Myers, Arnold and Linn County Public Health’s Heather Meador all stressed the importance of social distancing, washing hands and staying home if sick — even if symptoms are mild.

“Through our investigations, we have learned that some individuals with COVID-19 have very mild illness,” Meador said. “Some individuals have not had a fever, and others have not had a cough. We have individuals that have stated to us that their illness was so mild that in the past, they would not have stayed home. For this reason, I want to strongly emphasize that everyone must practice social distancing.”

“COVID-19 is in our community. At this time, you must suspect that every individual that you come into contact with has this virus.”

Meador urged children and adults to use social media and video chat to stay connected with their friends and to not see their friends in person. She acknowledged that it might be difficult, but “it is of utmost importance” to follow this and other recommendations.

“If you do not follow our recommendations, you are putting people’s loved ones at risk for serious illness or death,” Meador said, adding that older adults and people with underlying health conditions are the most vulnerable.

Both the New York Times and ProPublica have created projections based estimates from the Harvard Global Health Institute on how many hospital beds will be needed depending on how quickly or slowly the virus spreads. Public health officials across the country have stressed how important “flattening the curve” is.

The Times noted, “These numbers are not exact predictions. In many ways, they reflect a worst-case scenario, since they do not take into account the efforts hospitals can make to quickly increase capacity during an emergency.”

The projections also don’t take into account how hospitals — including Mercy and UnityPoint Health — have canceled or postponed non-life threatening, non-urgent surgeries and procedures.

In the Cedar Rapids area, the model shows additional hospital beds will be needed in almost every scenario.

Projection of how many hospital beds will be needed in the Cedar Rapids area. Screen grab from ProPublica’s interactive database.

While Arnold or Myers didn’t comment on the specific number of hospital beds available, Myers did say this is something that is continuously being looked at and intensive care capability has “massively increased.”

Myers said having enough staff to care for patients could become a bigger issue than the number of beds.

“We are also just opening up other beds that were used or preparing rooms that have been used for offices in the past,” Myers said. “Dr. Arnold has said this several times and so have I — space is an issue but staff will get to be more of a critical issue, especially if we have staff become ill. It won’t be so much about room availability. It’ll be about whether we have staff to take care of patients in those rooms.”

Another question that has come up is if the state has enough ventilators, which are machines that assist patients with breathing. These have become critical during the pandemic since respiratory failure is a symptom of some COVID-19 cases.

Gov. Kim Reynolds said on Wednesday that the state has 280 ventilators available.

In Linn County, there are “well over” 100 ventilators between the two hospitals, Arnold said on Thursday. He added that UnityPoint Health has requested about 20 more.
However, he said that if the patients all come at the same time, the number of ventilators won’t matter because the system will be overwhelmed.

“Think of all the car wrecks that happen in the United States each year,” Arnold said. “What if they all happen on the same Tuesday? That would just overwhelm the health care system. So think of it from that perspective, that no matter how many ventilators we have, this illness all presented at the same time, it would simply overwhelm the health care system. That’s why we want to socially isolate and slow it down, slow down that spread.”

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