by James A. Bacon

In my previous post, I laid out the case that Virginia potentially faces a severe shortage of hospital capacity should the COVID-19 pandemic spread in the Old Dominion at the geometric rate of increase as seen in other countries. I estimated that the Richmond region’s acute-care hospitals have only 1,400 un-utilized beds on average. If social-distancing strategies adopted by employers, schools, universities, event organizers and others don’t contain the outbreak, Richmond hospitals will be quickly overwhelmed. I expect that the same can be said of the rest of Virginia.

So, what are hospitals doing to prepare for such a scenario?

I asked the Virginia Hospital and Healthcare Association (VHHA) for data on hospital capacity. None were readily available, but spokesman Julian Walker referred me to a statement that Dr. Michael P. McDermott, CEO of Mary Washington Health Care and VHHA chairman made at a press conference yesterday with Governor Ralph Northam. Said McDermott: “Our message today is that the hospital community is treating this work with the seriousness it deserves to meet the medical treatment needs of Virginia patients and families.”

What, specifically, are the hospitals doing?

McDermott said the following:

While this collaborative work is a significant undertaking, Virginians should know that these planning and preparedness efforts are not isolated to the current COVID-19 situation.

The fact of the matter is that Virginia hospitals and our public sector partners have worked together for many years to prepare for a wide range of public health challenges including natural disasters, man-made incidents, and infectious diseases such as COVID-19.

As Governor Northam noted last week, Virginia is rated as a high performance state in the Trust for America’s Health 2020 Ready or Not report. This report is a national ranking of state emergency preparation readiness. That positive designation is a testament to the shared planning and response efforts, and the infrastructure that has been built up over the years, by the Commonwealth and its partners, including hospitals.

At the hospital level, this work is supported through the Virginia Healthcare Emergency Management Program and the Hospital Preparedness Program in collaboration with our state partners. Through these initiatives, we are monitoring health care system capacity in the event of any potential patient surge challenges, tracking equipment and other resource needs, and we are sharing situational awareness updates on this unfolding situation between the state and our members.

Virginians should know that VHHA and its members remain in daily dialogue with state officials and other health care sector partners through regular conference calls and meetings to ensure our COVID-19 coordinated response strategy is executed efficiently.

To that end, VHHA has established a committee of hospital personnel around Virginia that is meeting twice a week. This committee is focused on mitigating gaps in care by planning for potential community spread of COVID-19, should that occur in Virginia. This committee is creating recommendations for updated facility access standards if needed, work force staffing considerations, laboratory testing, guidance for outpatient care settings, alternate care sites, public awareness and education messaging, and more.

The goal of this committee, and the goal of Virginia hospitals, is to promote clear lines of communication between health systems, state agencies, and other partners as we all work together to meet the health care needs of our fellow Virginians and to keep the health care workforce safe while doing so.

Let me condense that for you: Virginia has bureaucratic structures in place to deal with emergencies. A lot of people are talking to a lot of other people. Moreover, the hospital association has formed a committee focusing on “mitigating gaps in care.” The group is “creating recommendations” about several topics affecting hospital capacity, including workforce staffing, outpatient care settings, and alternative care sites.

The good news is that Virginia hospitals are actively thinking about such things. The bad news is that the deliberations are still in the formulating-recommendations stage. Executing the recommendations presumably will take time.

My wife and I have visited two different hospitals in the past two days on personal business. At the suburban Richmond hospital I visited two days ago, there was a person at the entrance screening visitors to ensure that none were displaying coronavirus symptoms. But few of the nurses and staff we encountered inside the facility appeared to be taking any special precautions, other than two or three who were wearing face masks. At a different suburban hospital that my wife visited this morning, awareness seemed to be heightened but, in my wife’s estimation, confusion reigned. No one was sure what needed to be done.

While Virginia hospitals undoubtedly will devise and enforce new pandemic-fighting protocols relatively quickly, tackling the challenge of finding beds and staffing for a surge in patients is an order of magnitude more difficult. If hospitals are taking active measures, they have not communicated beyond McDermott’s vague rhetoric what they might be.