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Is Fort Worth area ready for a surge of coronavirus patients? Details have been scarce.

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Tarrant County Judge Glen Whitley for the first time Thursday evening provided details about the county’s plans to handle a surge of COVID-19 patients that’s estimated to happen in May.
Whitley said county leaders have scouted locations for a pop-up hospital and have reached out to the congressional delegation to request more protective equipment for doctors and nurses. He said plans are in place to convert unused anesthesia machines into ventilators.
Still, most hospitals in the city have provided few details about their plans in response to questions from the Fort Worth Star-Telegram. Brandon Bennett, the commander of Fort Worth’s Joint Emergency Operations Center, said he’s frustrated with the level of data available to both him and the public.

Whitley defended the hospitals for their lack of transparency.
“I don’t think they want to publicize a whole lot because they don’t want to create a panic,” he said. “Everything they’re doing, they’re doing with a focus of making sure they’re prepared and ready and a lot of that needs to be confidential.”

Asked this week about the hospital capacity, Tarrant County Public Health Director Vinny Taneja said he didn’t have that information handy. He referred questions to the hospitals, which declined to answer that question.

Bennett noted that Dallas County’s Health Department has been more transparent than the Tarrant County Health Department. Dallas County Judge Clay Jenkins has been open since Monday about how the county will operate a pop-up hospital at the request of Gov. Greg Abbott and has routinely discussed hospital capacity and the percentage of patients who have been hospitalized.

For a week, the Fort Worth Star-Telegram asked Whitley, the Tarrant County Public Health Department, the Tarrant County Emergency coordinator, Fort Worth Mayor Betsy Price, the Dallas-Fort Worth Hospital Council and individual hospitals specific questions about staffing, equipment availability and how they plan to treat a surge of patients, expected May 6, according to the University of Washington’s Institute for Health Metrics and Evaluation.
The questions included:
▪ What is being done in terms of a space for overflow patients? Do you have plans to open a facility for a pop-up hospital like the one at the Kay Bailey Hutchison Convention Center in Dallas? If so, how do you plan to staff the hospital and how do you plan to obtain the extra equipment?
▪ What are you doing to ensure hospitals have enough equipment — such as ventilators and personal protective equipment?
▪ What are you doing to make sure we have enough trained medical staff ready?
▪ How many people have Tarrant County tested?
▪ What capacity are the hospitals at currently?
▪ How much of the $150 billion in the coronavirus stimulus package will Tarrant County quality for? What efforts are being made to ensure Tarrant County receives a portion of these dollars? How do you anticipate them being spent?

Until Whitley’s Thursday evening phone call, most hospitals and elected officials who answered the questions, sent via email, kept their responses to generalities.
Whitley, after briefing from Abbott Friday, said he expected the county would be able to more accurately report hospital bed capacity. In his media briefing, Abbott said about of third of Dallas-Fort Worth hospital beds were open. Whitley said the figure was closer to 43% for just Tarrant County.

RESPONSE FROM THE HOSPITALS

Asked how many beds are available at Texas Health Harris in Fort Worth, spokesman Stephen O’Brien wrote: “We are aware of our capacity, and will be using that for anticipated surge case when and if needed. [We will not be releasing capacity.]”

O’Brien said he would give the newspaper an overall response to its questions, but would not go into specifics. A response was not immediately returned when asked to elaborate and a statement was not given.

John Peter Smith Hospital said on Monday that it was exploring additional staff training to help with COVID-19 patients. The hospital said it was developing plans to reopen the Arlington surgical center to house other patients. The hospital declined to release information about its staffing and tactical plans to the newspaper, citing a section of the Texas Homeland Security Act that protects a hospital’s “tactical plan.” It did say that it had ordered more ventilators and should be getting an additional 16.

Asked if Baylor Scott & White has ordered additional personal protection equipment, Media Manager Susan Hall said in an email that the hospital is working to replenish the protective gear. “To ensure we have adequate resources in the weeks ahead, we have implemented conservation guidelines to safely reuse or extend the use of masks using CDC guidance.

“We also have secured agreements with local manufacturers to begin producing reusable gowns and masks out of approved fabrics. In several weeks, we will have enough supply to begin disinfecting gowns and masks daily using an evidence-based cleaning procedure.”

Hall said the hospital is “evaluating opportunities to build additional capacity” in anticipation of a patient surge. That might include using vacant operating rooms.

“Related to the supply of ventilators, we are monitoring the situation and exploring opportunities should the need for additional ventilators arise,” Hall said.

When the newspaper sent questions to Hall on March 12 about how it was preparing to quarantine patients, Hall referred questions to the DFW Hospital Council. Stephen Love, chief executive officer, answered questions specific about testing. When asked questions this week about preparing for a patient surge, spokesman Chris Wilson said Love couldn’t answer the questions and referred the paper to Whitley, who answered the questions on Thursday.
Bennett said he is confident in hospitals’ ability to handle a patient surge, though he lamented that hospital data had been hard to sort and was not readily available.

He was the only public official who spoke with a reporter at length about these questions until Whitley’s interview Thursday evening. Earlier in the week, Taneja hosted Q&As with reporters but did not offer detailed answers or referred reporters elsewhere for answers. Brian Swift, the chief executive officer of the Tarrant County Medical Society answered questions Tuesday, saying hospitals are low on personal productive gear and that retired and specialty doctors have been called on to help patients.

As the city’s health officer and code compliance director, Bennett leads Fort Worth’s emergency response to the virus and coordinates almost daily with hospitals, he said.
“Probably every hospital system out there said, ‘We’re ready for this,’ right, including the ones that got overwhelmed,” Bennett said. “Here we have hospital systems that were able to see what has happened in other cities, and they’re able to make changes to their operating plans.”
Though Bennett was frustrated with the level of information given by the hospitals, Whitley said he was satisfied with what he’s been told.

“We are very closely communicating, just about every day,” Whitley said. He said the hospitals are coordinating with each other, which is enough.

RESPONSE FROM THE CITY, COUNTY

During a news conference on Monday, Taneja, the Tarrant County Public Health director, referred questions about the hospitals to individual hospitals. Asked about a pop-up hospital that would provide additional bed space, he deferred to city leaders.

Price responded to the newspaper’s questions with the following statement: “I am in regular communication with leaders of the area hospitals, alongside Judge (Glen) Whitley and (Arlington) Mayor (Jeff) Williams, regarding capacity and preparedness in regard to COVID-19. Their requests for equipment and supplies are coordinated through the County and JEOC (Joint Emergency Operations Center). Hospital surge capacity planning is underway, including reviewing surge plans from hospitals and potential facilities.”
Whitley said on Thursday the county is receiving estimates from hospitals on their capacities, a number that won’t be made public.

“We’re gathering data together to do modeling, and we’ve got a couple locations identified that we might use,” he said.

To make sure any additional hospital is staffed, Whitley said, officials have been talking about training nurses who might not usually work in hospitals. JPS said last week it was considering the same.

“We might spend the next 30 days or so training them to bring them back up to speed so we have the staff ready to go in one of those facilities,” he said.

To help coordinate resources, Price in mid-March established a health care committee led by Councilman Brian Byrd, who is a physician.

Byrd said the committee met once and was disbanded after hospital officials informed him that they believed they were already coordinating well and another phone call checking in on them would add to their burden.

BED CAPACITY, EQUIPMENT

Hospitals have built a shared network so that if one reaches capacity, patients can be tranferred to another with more space, Bennett said. Each hospital has the ability to set up facilities in tents for patients with minor ailments who are not coronavirus-positive, he said.
Federal and state officials have identified at least one field hospital in DFW: The Kay Bailey Hutchison Convention Center in Dallas, which could hold 250 beds.

Gov. Greg Abbott’s decree allowing hospitals to place two patients per room has allowed hospitals to nearly double their bed space. Meanwhile, at least one hospital has closed clinics and reallocated resources to coronavirus-care, further increasing capacity, Bennett said, though he would not name the hospital.

Increasing bed space does not immediately boost patient capacity. Medical professionals and equipment are in short supply, Bennett said, though hospitals have assured him they are not running out.

Bennett did not have specific numbers, but said county hospitals have “thousands” of protective masks and “hundreds” of ventilators. He said there is constantly a call for more equipment, but much of that is being allocated to harder hit regions like the New York City area.

However, Swift, the chief executive officer of the Tarrant County Medical Society, said facilities are running out of personal protective equipment like masks.

“Nobody has enough PPE right now,” he said. “It’s coming in, but slowly. PPE is just a huge huge issue everywhere. There is a shortage of PPE, period.”

Whitley said he’s asked hospitals to take inventory of their supplies. He said leaders have been talking with those in Congress to make sure supplies are replenished.

Some small things are being done to alleviate the burden on health care resources.

The Fort Worth Fire Department has been washing and reusing N95 respirator masks, which help block airborne particles from being inhaled, Bennett said. MedStar, the regional public ambulance agency that serves Fort Worth, is assessing patients through telemedicine to determine if they need to be taken to an emergency room or if they can be treated at home.

“Not everybody has to be in the hospital,” Bennett said. “Just because you test positive, COVID-19 doesn’t mean you’re going to be hospitalized.”
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Source - https://www.star-telegram.com/

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