The number of confirmed cases of the novel coronavirus in Florida continues to jump with each passing day. As of 1 p.m., the state has confirmed 314 cases — more than half of which are in Miami-Dade, Broward, and Palm Beach Counties. State and local officials have begun to take measures to curtail the spread of COVID-19. But will it be enough?
Just yesterday, videos surfaced of slightly drunk and fully idiotic spring breakers reveling in large groups at bars across Miami and Miami Beach. Meanwhile, the Archdiocese of Miami only today announced its churches will stop holding in-person services. The U.S. Centers for Disease Control and Prevention this week recommended against any gatherings of more than ten people, and Miami-Dade County officials yesterday announced an order closing all restaurant dining rooms, bars, and gyms.
But containment efforts are only one side of the coin when it comes to responding to a pandemic. Testing, economic stimulus, and hospital expansion are all imperative if a crisis is to be met head-on. It's that last one — hospital capacity — that has public health experts most worried. A certain amount of viral spread is inevitable, but it's important that everyone doesn't become infected all at once, or hospitals risk running out of beds.
New data gathered by the Harvard Global Health Institute provides some tentative insight. Researchers plugged in the number of hospital beds available in regions across the nation, along with the average occupancy rate of those beds. Then journalists at ProPublica took that data and created a model with a handy search tool, which allows users to look up projections for their city. The results for the Miami area aren't exactly heartening.
If 20 percent of Miamians contract COVID-19, Harvard researchers estimate, roughly a fifth of them will require hospitalization. If those cases are spread out over the next year, Miami might be able to meet the demand for hospital beds. However, if those hospitalizations happen within the same six months, the system will be pushed well beyond capacity, requiring 50 percent more beds than those available right now. That's why slowing the rate of infection through social distancing and isolation, known as "flattening the curve," is so important.
And that's the best-case scenario. In the Harvard team's "moderate" scenario, 40 percent of the adult population in the United States — or nearly 99 million Americans — would contract COVID-19. In the Miami area, a 40 percent infection rate would push hospitals past capacity even if infections were spread out over 18 months. If 40 percent of Miamians were to become infected in the next six months, hospitals would require more than 200 percent of their existing bed capacity to meet the demand.
In the Harvard researchers' worst-case scenario, the Miami area would need three times as many hospital beds than it has now if COVID-19 hit 60 percent of the local population in six months. And it would need two times as many beds if 60 percent of people became infected over 12 months.
The dangers of running up against bed capacity cannot be overstated. In northern Italy, doctors have been forced to make the kinds of difficult life-or-death decisions no physician would ever want to make, including treating only patients with a high chance of survival. Rationing care in this way is the darkest of scenarios, to be sure, but even in more positive projections, hospitals under strain will still be forced to limit the number of unnecessary treatments and surgeries unrelated to the novel coronavirus.
"If we don't make substantial changes, both in spreading the disease over time and expanding capacity, we're going to run out of hospital beds. And in that instance, we will not be able to take care of critically ill people, and people will die," Dr. Ashish Jha told the New York Times in an interview. (Jha is the director of the Harvard Global Health Institute, which produced the estimates that ProPublica compiled.)
The Harvard team's numbers should be taken with a grain of salt, though. As the Times notes, the projections do not consider any efforts hospitals might make to increase capacity during an emergency, such as sending home patients with conditions that aren't life-threatening. The Times conducted interviews with various hospital executives who predicted they could increase capacity between 20 and 70 percent if necessary. But looking at the Harvard study, a 70 percent increase still might not cut it if the curve of infected patients isn't flattened.
Reached for comment by New Times, a state spokesperson said the Florida Division of Emergency Management has requested that the federal government send 5,000 hospital beds, five mobile intensive care units, and 5,000 ventilators. Those supplies will be delivered to Florida cities on a rolling basis. Additionally, one temporary field hospital is on its way to Broward County.
"The state is preparing for any potential impact to our hospitals throughout the state and will continue to monitor bed capacities and provide any necessary assistance," the spokesperson wrote in an email.
Local hospital organizations, including the University of Miami Health System and the Jackson Health System, say they are ready to handle a surge in coronavirus cases, according to reporting by the Miami Herald . The hospitals say they are fully stocked with ventilators and protective gear needed to treat sick patients, but they did not disclose the bed capacity in their intensive care units.
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