Harvard study suggests New Hampshire needs to rapidly build up hospital bed count to prepare for virus

Monitor staff
Published: 3/19/2020 10:31:02 AM
Modified: 3/19/2020 10:30:52 AM

New Hampshire officials are racing to build up a health care response that can absorb further incursions of the COVID-19 virus.

One area of concern: hospital beds.

A national study by the Harvard Global Health Institute indicates that hospital systems across the country will need to dramatically boost the number of regular and intensive care unit beds should the virus intensify – and New Hampshire is no exception. 

Depending on how severe the virus becomes, hospitals in central New Hampshire will need to dedicate anywhere from 124% to 373% of its current hospital bed capacity to just coronavirus patients, the projections found. 

That means in order to accommodate a surge, the state will need to free up and even build beds that are not currently available. 

Exactly how dramatically hospitals and providers need to expand capacity depends on a number of factors. 

In the study, the Harvard researchers gamed out three scenarios for how many Americans the virus could unfold: one in which 20% are infected; one at 40% and one at 60%.

They used those scenarios to compare 304 geographical regions on hospital preparedness. 

New Hampshire included two regions: one based in Manchester, with 714,679 adults, and another based in Lebanon, with 320,499. 

In general, the Manchester area would need to create proportionally more beds than Lebanon, the site of Dartmouth-Hitchcock Medical Center, the analysis shows.

For instance, if the virus infected 20% of people across the country – a conservative estimate based on the pattern in other countries – the central New Hampshire area would see about 143,000 people infected, with 30,000 people needing hospitalization and 6,500 needing ICU care. 

That would mean the number of available hospital beds at any one time would need to jump from 582 to 1,992 in the first six months – according to the analysis. But if health care officials can free up “potentially available beds” by moving at least 50% or current non-COVID-19 patients out of it, the need leap reduces down to 124% in six months. 

Either way, the situation necessitates building more beds. 

And it indicates a reality where large portions of hospitals are cleared to focus exclusively on virus patients.

The ICU situation is even more urgent for the Manchester area, the analysis shows. In all, 811% more ICU beds would need to be made available than are presently available. Even by tapping into “potentially available ICU beds” the Manchester area needs 314% of the ICU capacity it has now. 

And that’s at a 20% infection rate. The numbers increase proportionally at higher infection rates of 40% and 60%.

Nationally, New Hampshire’s hospital system is under-resourced compared to other systems. 

The Manchester area is ranked 265th out of the 304 geographical regions in terms of how prepared its bed capacity is for the crisis, proportionally speaking, the study shows. 

The Lebanon area fares slightly better at 177th.

New Hampshire officials and hospital leaders say they are doing what they can to prepare. 

Each hospital already has its own “medical surge” plan in place for pandemic situations, according to Vanessa Stafford, vice president of communications for the New Hampshire Hospital Association. 

And the state has its own guidelines. 

Among the considerations: Using temporary beds in clinical units, moving inpatient care into non-inpatient spaces, using clinics and urgent care for patients who don’t need hospital care, putting off elective surgeries, discharging patients home, ramping up telemedicine, and expanding the hours for outpatient care facilities, according to Stafford.

“New Hampshire hospitals are collaborating and taking important steps to ensure maximum capacity is available for those that are severely ill as a result of Coronavirus disease,” Stafford said.

And Sununu suggested this week that the state was exploring new options beyond what is already outlined in its pandemic response plan to boost bed counts. 

“When it comes to health care providers and hospitals, we’re already building contingency plans if we were to need more beds,” Sununu said at a press conference Tuesday. “Where would they go, how would they be expanded. We’re working on that right now and we feel comfortable we can provide a lot of that new excess capacity that may be needed if this crisis were to really hit true epidemic levels.”

 

(Ethan DeWitt can be reached at edewitt@cmonitor.com, at (603) 369-3307, or on Twitter at @edewittNH.)




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