As public officials take drastic measures to slow the spread of COVID-19, Wisconsin’s health care providers are preparing for an influx of critically ill patients.
Statewide efforts to “flatten the curve” are aimed at preventing a sudden spike in coronavirus cases that could overwhelm the state’s health care system, as has happened in countries like Italy. Still, health care and public officials have warned of a potential shortage of intensive-care unit beds, ventilators and other critical supplies in Wisconsin.
Dr. John Raymond, president and chief executive officer of the Medical College of Wisconsin, presented a scenario in which 5% of Wisconsin’s 6 million residents contracted the virus, which he said is a conservative estimate. With about 20% of COVID-19 patients requiring hospitalization, the state could potentially have 60,000 patients in need of hospital beds, with only 12,300 beds currently available across the state.
“If that happens, we’re going to overwhelm the capacity of our health systems to be able to accommodate that number of critically ill patients,” Raymond said during a webinar hosted by the Metropolitan Milwaukee Association of Commerce for business leaders.
State public health officials have said they are still determining how many beds and ventilators are available statewide, but have also warned of a shortage.
“We have a finite number of ICU beds and ventilators,” said Dr. Ryan Westergaard, chief medical officer of the Bureau of Communicable Diseases for the Wisconsin Department of Health Services. “In a pandemic situation the real risk is that the number of critically ill patients will grow too large too quickly and we may not have enough resources to save everyone who needs critical care.”
Advocate Aurora Health, which has a network of hospitals and clinics stretching from Green Bay to downstate Illinois, continues to assess its ICU bed and ventilator supply, while watching the pace at which the virus spreads nationally and locally, said Dr. Nkem Iroegbu, chief medical officer of Aurora St. Luke’s Medical Center in Milwaukee.
“I feel that we are ready for what we anticipate we will see, but again we will keep reassessing that on a daily basis,” he said.
At press time, there were 416 confirmed coronavirus cases in the state, 204 of which were in Milwaukee County. Despite social distancing efforts, state public health officials said community spread – meaning the virus is being transmitted to people who do not have relevant travel history or exposure to another known patient with COVID-19 – is occurring in several counties, including Milwaukee, Dane, Kenosha, Brown and Waukesha.
Area health systems have tightened visitor guidelines, with many banning visitors altogether, and canceled all non-time-sensitive surgeries, procedures and appointments to mitigate the spread of the virus.
Children’s Wisconsin was the first health care organization in the region to report a positive test in one of its providers. The system said it identified and contacted 48 patient families, plus staff members that could have been in contact with a doctor who has the virus. The doctor was exposed to an individual who later tested positive for the virus in connection with domestic travel outside Wisconsin before travel restrictions were in effect, according to Children’s Wisconsin. Among the tests that had been processed, all had returned negative for the virus at press time.
Meanwhile, national shortages of testing supplies have stymied efforts to accurately measure how many people in the state have the virus.
While the Wisconsin State Laboratory of Hygiene – the state’s public health lab in Madison – has ramped up its operations to test as many as 400 specimens a day, the volume of specimens received far exceeds its daily capacity. To conserve supplies, DHS has prioritized specific tiers of cases, including those who are critically ill, those who have knowingly been exposed to a confirmed COVID-19 patient and health care workers. Test requests that don’t meet those criteria are sent to other labs in the state and country, which will have longer wait times.
Several commercial laboratories and hospitals, including Children’s Wisconsin and Wisconsin Diagnostic Laboratories at Froedtert Hospital, have increased the state’s capacity by completing on-site testing, rather than sending samples to one of the two public health labs in the state. At press time, ACL Laboratories, which is owned by Advocate Aurora, was in the process of finishing testing validation and training for COVID-19 to be able to perform at least 400 tests daily once operational.
Some health care facilities are offering drive-thru testing sites in their parking lots, in an effort to increase testing capacity while mitigating concerns of exposure to the virus within clinics and hospitals.
Froedtert South offers drive-thru testing at its Pleasant Prairie hospital. After planning to establish drive-thru testing operations at most of its locations, Advocate Aurora later paused those plans as a result of national test kit shortages. Waukesha-based ProHealth Care said it is considering opening drive-thru testing sites once supplies and lab capacity increases.