Southeast Michigan hospitals overwhelmed by COVID-19 cases have begun sending some of those patients to hospitals with spare beds. These transfers to relief hospitals are part of the state health department’s so-called load-balancing plan.
Dr. Joneigh Khaldun, the chief medical executive of MDHHS, explained the plan in a live address on Thursday morning.
“The only way we are going to be able to effectively handle this outbreak is by coming together and coordinating our healthcare resources as a state,” she said.
Under the plan, any hospital in Michigan with capacity may be asked to open 10% of its total number of beds to COVID-19 overflow patients.
However, according to MDHHS spokersperson Lynn Sutfin, hospitals are not yet required to open that space.
Dr. Jenny Atas, the medical director for Michigan's Region 2 South healthcare coalition, said some hospitals have already rejected COVID-19 patients, either on the grounds that they don't have the resources to manage a possible surge of their own or that the virus has yet to spread through their community.
The Region 2 South coalition — which encompasses Wayne, Monroe, and Washtenaw counties — is one of eight healthcare coalitions responsible for, among other things, coordinating resources and transport between Michigan hospitals. They keep tabs on key statistics like number of available ICU beds, ventilators and negative-pressure rooms so they can anticipate a hospital reaching overflow.
Hospitals are supposed to report those numbers to their regional coalition daily. "We've done it for many, many years," said a nurse at one of the Beaumont hospitals, whose name we're not using, to protect her job. "Now it actually counts."
The virus’s wide footprint in Southeast Michigan means it’s been harder to find relief hospitals just a short drive away. On Wednesday, according to Atas, four patients from a Southeast Michigan hospital were transferred to a hospital in Marshall, 100 miles west of Detroit.
“We’re finding the majority of beds outside of where the focus of infection is right now,” she said.
On Wednesday, the Region 2 South coalition launched a tab on its dashboard dedicated to overflow relief, which allows hospitals to indicate their willingness to accept COVID-19 patients.
“Before that,” said Atas, “I was calling around to ask every hospital, every CEO, to see whether their healthcare system was able to take and offload some of these patients that were down here in southeastern Michigan.”
Referring to those hospitals that have rejected overflow patients, Atas said, “it’s a slow buy-in.”
The coalitions speak directly with both sending and receiving hospitals to arrange a transfer, and connect the sending hospital with emergency medical transport.
The coalitions, which receive funding from the CDC and the United States DHHS (specifically, the Office of the Assistant Secretary for Preparedness and Response), are also responsible for identifying alternative overflow sites, like hotels and dormitories. In the live address Thursday, Khaldun said officials are still drafting plans for use of those big empty spaces.
“We don’t at this time have details on those alternative sites,” she said. “However, we are actively working with our state leaders on developing and implementing plans for these sites should we need them.”
Atas said all of Michigan’s eight coalitions have identified those sites, and that hospital networks do need them. These locations must have negative-pressure rooms, the ability to supply oxygen, food services, laundry, break rooms for staff, and space for ambulances to unload.
On Thursday Atas inspected and approved a site for 1,000 patients.
To start using the spaces, however, Governor Gretchen Whitmer must request permission from federal officials. That request has been made to FEMA, which plans to set up a field hospital at TCF Center (the former COBO Hall) and has also investigated the Detroit Pistons Performance Center and some dormitories at Wayne State as possible overflow locatations as well.
The North American International Auto Show, scheduled for June in the TCF Center, has been canceled so FEMA can use the facility.
Once it has, said Atas, the overflow sites could be operational in two to three weeks.
“The patient load is not going down,” she said. “It would not be a bad move to lean forward and start doing this.”
UPDATE: This story has been updated to reflect that Governor Whitmer has asked federal authorities for assistance and FEMA plans to use the TCF Center as an overflow field hospital.