How rising COVID-19 numbers are impacting central North Carolina hospital capacity, emergency rooms

RALEIGH, N.C. (WTVD) -- For months, North Carolina Department of Health and Human Services Secretary Dr. Mandy Cohen has warned residents that the state's hospitals are feeling strained due to the COVID-19 pandemic.

"Our hospitals are feeling the strain and this is really worrisome," Cohen said in a news briefing Thursday.

New data from the federal department of Health and Human Services shows the extent of that strain on individual hospitals, and the Triangle is not immune.

During the week of November 27 to December 3, Duke University hospital had 55 adult patients with confirmed or suspected COVID-19 in in-patient beds on average each day, including 19 in the ICU. On average, 91% of the hospital's 687 available adult beds were occupied each day, and just two of the hospital's 113 staffed ICU beds were empty.

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In the same week, University of North Carolina at Chapel Hill's hospital had, on average, 50 adult patients with confirmed or suspected COVID-19 in-patients beds each day, 46% of which were in the ICU. On average, 81% of the hospital's 726 adult beds were occupied each day, with 26 ICU beds available.

WakeMed's Chief Medical Officer Dr. Chris DeRienzo explained that the winter is already a busy time of year for hospitals, with viruses like the flu circulating in addition to COVID-19.

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WakeMed's Chief Medical Officer Dr. Chris DeRienzo explained that the winter is already a busy time of year for hospitals, with viruses like the flu circulating in addition to COVID-19.



"In the ICU and across the hospital, we are certainly very busy," DeRienzo said, adding that the hospital system has about 10% more patients in beds than during the summertime peak in cases and hospitalizations.

Last week, WakeMed reported on average 86% of adult inpatient beds were occupied each day at its Raleigh facility, with just five available ICU beds on average. On average, 68 of those beds were occupied by a COVID-19 patient each day, including 22 in the ICU.

DeRienzo said about 25-30% of COVID-19 patients at WakeMed are in the ICU, and unlike in the summertime, most patients are only in the hospital for a short amount of time.

"As a community we're doing a better job protecting those at higher risk," DeRienzo said. "We've learned a lot about how to treat this condition, but I can't emphasize enough that the rise that we're seeing across the state and here at WakeMed is absolutely concerning."

One indicator of that rise is the number of patients going to the emergency room with COVID-like symptoms. Last week, 1,348 people visited WakeMed's Raleigh emergency room for that reason, 38% of all emergency room visits. Duke reported 88 emergency room visits and UNC reported 250 in the same week.

"We're seeing numbers going up each and every day, and as a state we need to begin taking the steps necessary to try to get our arms back around this pandemic," DeRienzo said.

But he added that hospitals are used to expanding and contracting their number of beds in order to best serve the community, and that this is nothing new for hospital staff.

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Intensive units across the state, including UNC Health, are feeling the strain of staffing as the number of COVID-19 cases begins to outnumber available nurses.



"It's helpful to know even during normal times we are opening bed areas and closing bed areas based on community need," DeRienzo said. "When I think about our ICUs specifically, we create additional ICU capacity when and where we need it."

But he added that the most precious resource for health care is the staff.

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"It's been a very long 9 months for folks within our COVID unit, for folks across our hospital and frankly for everyone in North Carolina," DeRienzo said. "COVID has done nothing other than challenge us with something new and different almost on a weekly basis."

He added that giving staff enough time to rest and recharge is important, but as more and more hospitals need to surge their capacity, it's getting harder to balance staffing. But he emphasized that because North Carolina took steps early on to create additional hospital capacity, he doesn't see staffing or bed shortages becoming a critical issue in the state any time soon.

"And I pray we never see that," DeRienzo said.

Right now, DeRienzo said he isn't worried about the number of patients in his facility, but if current trends continue, he said WakeMed and other hospitals could run into trouble.

"We certainly have the capacity we need right now to treat our patients who are presenting with COVID and the hundreds upon hundreds who we care for that don't have COVID. And we've got more rounds that we can go, but we've got to get our arms back around this now," DeRienzo said.

As North Carolinians wait for a vaccine, DeRienzo emphasized what state health leaders have repeated again and again: wear a mask, wash your hands, and stay physically distant from people not in your home.
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