Local, state and federal officials have taken unprecedented steps to control the spread of coronavirus. School and churches are closed. Restaurants can only serve to-go meals and bars are shuttered. “Social distancing” has become a part of our lexicon.
These are all steps to “flatten the curve” of coronavirus cases, meaning to avoid sharp increases over a short period of time that could overwhelm the health-care system and endanger lives.
Projections from the Harvard Global Health Institute demonstrate why flattening the curve is so important in El Paso and southern New Mexico. A sharp rise in coronavirus infections in coming months could overwhelm the number of hospital beds and intensive-care unit beds in the region’s hospitals.
ProPublica and the New York Times this week published the data on how hospitals in communities across the country could be impacted by COVID-19, the illness caused by the novel coronavirus.
How coronavirus could strain El Paso hospitals
Hospitals can’t rapidly add beds in the midst of a pandemic. Instead, they could have to ration care, which has been happening in Italy and China as COVID-19 has ravaged those countries. Health professionals could have to make difficult choices about who gets treatment and, in some cases, who gets to live.
“A simplistic way to think about it is, imagine that a thousand people showed up at the emergency department on one day. That emergency department could not handle a thousand acutely ill patients. But if you could spread that out over a month, it would be 30 patients a day and an emergency department could do a much better job handling that,” said Dr. Ashish Jha, director of the Harvard Global Health Institute.
The El Paso “hospital referral region” — which includes Las Cruces, Deming and Alamogordo in addition to El Paso — had 2,086 hospital beds and 274 intensive care beds in 2018, according to the Harvard data. Many of those beds would be filled at any given time by people with conditions other than COVID-19.
This scenario looks at what hospitals would face if the coronavirus infection rate among adults in the region reached 20 percent, 40 percent or 60 percent, and whether those levels were reached at six months, 12 months or 18 months.
By comparison, studies show that influenza virus affects about 9 percent of adults annually. But unlike the flu, there is no vaccine for coronavirus, which also has a much higher mortality rate than seasonal flu. The Harvard public health experts said a 20 percent infection rate would be a conservative estimate, based on prior pandemics.
In this scenario, El Paso Matters is assuming that hospitals would open up half the hospital beds and ICU beds that normally would be occupied by people with other illnesses or health conditions, a form of rationing care to prioritize COVID-19 infections. If hospitals continued to treat other illnesses without change, the stress on medical infrastructure from a coronavirus outbreak would be even greater than shown in this scenario.
If 20 percent of the region’s adults contracted COVID-19 over the next six months — about 168,000 people — area hospitals would have 63 percent more patients needing care than available hospital beds, according to the Harvard estimates.
But if 40 percent of adults fell ill with COVID-19 over six months — about 336,000 people — regional hospitals would have three times more patients needing care than available hospital beds.
On the other hand, if current efforts like widespread closures and social distancing can flatten the curve and spread cases over 12 or 18 months, area hospitals would have a more manageable situation.
How El Paso-area ICUs could be overwhelmed
The picture is more stark for intensive-care unit beds, which provide critical care and life support for acutely ill and injured patients.
If the El Paso region reaches a 20 percent infection rate among adults over the next six months, hospitals would see three times as many people in need of intensive care than ICU beds for them. If the infection rate reached 40 percent, regional hospitals would be dealing with six intensive care patients for every available ICU bed.
But if the El Paso region flattens the curve to spread a 20 percent infection rate over 18 months, the Harvard data indicate the area would have just enough ICU capacity.
Dr. Jha of the Harvard Global Health Institute said Italy has shown what happens when COVID-19 overwhelms hospitals.
“What we saw were reports of hospitals becoming completely overwhelmed by the number of coronavirus patients. ICUs having to turn critically ill patients away, hospitals having to turn critically ill patients away. And a rapid rise in the number of deaths across Italy,” he said in a media conference call on Tuesday.
Dr. Ogechika Alozie, an infectious disease specialist in El Paso and chief medical officer at Del Sol Medical Center, said El Pasoans must practice aggressive measures to slow the spread of coronavirus. He didn’t immediately know the number of ICU beds in El Paso, but used 200 as a hypothetical example to illustrate the problem. (The Harvard data said El Paso and southern New Mexico have 274 ICU beds.)
“Just a little back of the envelope math tells us that if we have 800,000 people living in El Paso and only 5 percent get coronavirus, that’s approximately 40,000.” If 15 percent of those people needed intensive hospital care, which is lower than what happened in Italy, “that gives us 6,000 people who will need some some sort of high-level hospital care: 200 beds, 6,000 people. “
“That’s where the importance comes; we need to flatten this curve as long as possible. There’s no way anybody in this city can take in 6,000 people in a month or two months or three months. That’s where the concern is,” Alozie said.
How you can slow the spread of coronavirus
The Centers for Disease Control and Prevention recommends a series of steps that individuals can take to reduce the risk of coronavirus spread.
- Clean your hands often. Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
- Avoid close contact with people who are sick. Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
- Stay home if you are sick, except to get medical care. Learn what to do if you are sick.
- Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash. Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60 percent alcohol.
- Wear a facemask if you are sick and around other people. If you are not sick, you don’t need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
- Clean and disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. If surfaces are dirty, clean them.
El Paso Matters multimedia editor Angela Kocherga contributed to this story.