Oklahoma public health officials are finalizing new contracts for hospital surge plans as the number of positive cases and hospitalizations of coronavirus patients have spiked in recent weeks.
The contracts expand the number of hospitals for COVID-19-only treatment for the Oklahoma City metropolitan area and keep an existing contract in place at Oklahoma State University Medical Center-Tulsa. In all, 335 beds will be available under the contracts to treat COVID-19 patients.
Interim Health Commissioner Lance Frye said the new surge contracts are a better deal for the taxpayer and allow the state to respond quickly to more localized outbreaks of the virus. The earlier contracts were with Integris-Baptist Medical Center-Portland Avenue in Oklahoma City and OSU Medical Center-Tulsa. Money from the federal CARES Act will again be used to pay for the renegotiated surge contracts.
Hospitalizations for COVID-19 in Oklahoma on Friday reached their highest point since late March. There were 499 people with confirmed or suspected cases of COVID-19 in the hospital, according to the state’s executive order report. That’s up 52% in the last two weeks.
Frye, in an interview on Saturday with Oklahoma Watch, acknowledged the increase in hospitalizations but said hospital executives have told him the state’s overall bed capacity was still in good shape.
“I know the numbers are up as far as hospitalizations, but they’re all saying that they’re doing fine,” Frye said of his conversations with hospital executives. “They’re not to the point that they’re concerned enough to where they want to discuss any alternatives such as limiting elective surgeries or anything like that. They’re still fully functioning, fully open and seem to be doing well. But we wanted to assure that we had a backup insurance plan basically for these patients if the hospitals start to get full.”
Under the new contracts, a total of 120 beds will be available in the Oklahoma City metro area to treat COVID-19 patients at Mercy Hospital, SSM-St. Anthony Hospital, OU Medical Center, Norman Regional Hospital and AllianceHealth Midwest in Midwest City. OSU Medical Center-Tulsa will continue with its earlier arrangement to have 120 COVID-19 beds available. In addition, the Oklahoma State Department of Health will retain an option for the next eight months to reserve 95 beds for COVID-19 care at Integris-Portland Avenue in Oklahoma City.
Since the state embarked on its reopening in late April, the pandemic entered a new phase in Oklahoma with consistent community spread and localized hotspots. That’s in contrast to the first two months, where much of the state was locked down and the virus was spreading fast in nursing homes but there were few instances of community spread.
State public health officials have consistently said the number of cases will rise amid the reopening. Most of the newer cases are among young and middle-aged adults, age groups that typically are able to weather the virus better than those with compromised immune systems or older patients with underlying health conditions. The average age of those with confirmed cases fell to 39 by July, down from 49 in early May.
Frye, an obstetrician/gynecologist who is the State Air Surgeon for the Oklahoma Air National Guard, credited hospitals and the Oklahoma Hospital Association for their help as the state continues to refine its hospital surge plan. The earlier version of the plan, released in mid-April under former Health Commissioner Gary Cox, involved several tiers.
The first tier called for hospitals across the state to increase their capacity by 40%, while the second tier involved the reservation of hospital beds to treat COVID-19 patients in Oklahoma City and Tulsa. The last tier involved temporary hospitals built by the U.S. Army Corps of Engineers in locations like convention centers and fairgrounds to treat non-COVID patients.
“When we first went into this, we were considering that every community and every hospital in the state of Oklahoma was going to be inundated with these patients and at capacity,” Frye said. “It just didn’t happen. We really have hotspots that have popped up here and there. Everywhere has community spread. We’ve got cases and hospitalizations up, but it hasn’t happened the way we thought it was going to. So that allowed us to kind of relook at our plan.”
Frye said the original surge plan might now work in reverse, so as COVID hospitalizations increase in the Tulsa and Oklahoma City metro areas, non-COVID patients could be sent to nearby regional hospitals for treatment.
“The great thing about our hospitals is they’ve been in the business for a long time,” Frye said. “The truth is, if we left them alone, they’d figure out the same thing on their own. If they start to get too busy, they’d stop elective cases if they’ve got an ER full of COVID patients.”
Along with hospitalizations, the share of those COVID-19 patients needing intensive care has also grown. Statewide, the number of COVID-19 patients rose to 217 on Thursday. That was the highest level since early April.
Frye said ICU bed availability is always tied to staffing and the state’s hospitalization data also depends on hospitals voluntarily reporting their capacity each week day. The level of compliance with that has ranged from 80% to 90% in the past several months. A snapshot of daily ICU capacity by hospital accidentally was published on the state’s data dashboard earlier in the week, alarming some people on social media.
“We know what the total capacity is, but what’s reported through that system everyday basically is their staffing,” Frye said. “Hospitals are used to calling in staff as their (patient) numbers go up. They staff based off what they feel like the need is going to be for that day. So in an ideal world, they all want to be functioning at a 100 percent capacity every day.”
Frye said treating COVID-19 patients is different than responding to a tornado or other natural disasters. Generally, there won’t be a large surge of COVID-19 patients arriving all at the same hospital at one time.
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