I’m originally from Houston, and still have a lot of family there. The Texas Medical Center in Houston (where I was born, incidentally) is the largest medical complex in the world, with 106,000 employees, 9200 patient beds, 21 hospitals and eight specialty institutions, four medical schools, seven nursing schools, and comprises the 8th largest business district in the world.
The idea that you are going to start shipping patients out of the largest medical complex on the planet because they are at capacity makes no sense whatsoever. The TMC dwarfs the capacity of any other medical complex in the region. If they’re overwhelmed, you can bet the smaller hospitals in the region are, too.
The hospitals at the TMC aren’t the only hospitals in Houston, either. My sister works for a smaller satellite hospital 15 miles to the west (still within city limits) with 1700 employees and 444 hospital beds, and she reports they are overwhelmed, too.
Finally, back when my father (a physician) got sick, he got moved from the hospital in Lufkin, Texas to the TMC in Houston because he needed care he couldn’t get in Lufkin. Nobody gets moved from the TMC to Lufkin.
Gotta agree. When I was living in Houston, I met a surprising number of people there who were “medical tourists”. Houston has way more medical capacity than it generally needs. If they are swamped, shit is bad.
What I read is that they were not even very good at having overwhelmed hospitals finding local excess capacity. From the NYT -
Meanwhile there is a good tracker for Texas. It looks like for Harris county COVID-19 patients in ICU beds is pretty flat, in the 700s mostly. Total ICU bed usage is upper 1500s, near operational capacity with another 400 ICU beds on stand by for surge capacity. As the article points out the biggest issue is not the beds but staffing them.
I"m sorry but that’s complete nonsense. Complete. If the Houston Hospitals exceed capacity that’s exactly what is going to happen. They will be relocated to other facilities.
Houston is not only the largest city in the region, but also happens to have far more excess medical capacity relative to its population than the other smaller population centers in the region. If the Houston hospitals (with their excess capacity) are overwhelmed, the other hospitals in the region will be, too.
Also, do you have any idea how spread out the cities in Texas are? The distance between Houston and the three closest large cities (San Antonio, Dallas, and Austin) are comparable to the distance between NYC and Boston.
When the hospitals in NYC were overwhelmed, how many patients got shipped up to Boston?
With all that being said, if things got bad enough, I could see them bringing a hospital ship into the Houston Ship Channel.
The big difference here is that the crisis was much worse in NYC than in the other cities mentioned in the article (like Albany). Also, relatively speaking, only a handful of patients were moved, mainly because one NYC hospital was having problems with its oxygen system.
The current spike in hospitalizations in Texas (and throughout the South) is very bad In multiple areas simultaneously, not just Houston.
WHAT other facilities? Please provide some details here. I’ve linked above the Texas ICU capacity numbers; what region in the state do you think has enough excess hospital beds to soak up a couple of hundred patients? In the case you cite, Albany didn’t have a big outbreak of COVID at the same time; in fact, Albany County has had fewer than 2400 confirmed cases during the entire outbreak. (For comparison, there are about 2900 COVID cases in Harris County [Houston] hospitals right now.)
Now, Dallas has an outbreak, San Antonio has an outbreak, Galveston has an outbreak, Corpus Christi has an outbreak, etc., etc., etc. In New England in April, you could find cities that had significant excess hospital/ICU capacity to move patients do; what cities in Texas do you think have significant excess capacity here in July? Don’t just hand-wave away the question with “oh, there’ll be room somewhere”; tell us where you think it is.
A medical chopper has a maximum speed in the 150-170 mph range; actual flight speed is usually significantly less, and once you add in time to prep the patient and transfer to/from the chopper, you’re lucky to average 100 mph. That makes a flight to Dallas from Houston work out to about two hours; Oklahoma City (414 miles) is around 3 1/2 hours, Lubbock (454 miles) about the same. Even San Antonio is 190 miles, or about half again the distance from NYC to Albany (135 miles).
Hmmm. NYC was having about 20,000 regular beds occupied and nearly 4600 ICU beds occupied at peak capacity. Sounds like from the linked article at one critical moment they evacuated maybe a hundred … total?
No this does not mean that capacity elsewhere was meaningfully able to utilized.
If the hospital beds are all full of covid patients, what happens to the person with acute appendicitis? the one having a stroke? the one having a heart attack? the one with a ruptured placenta? the three people with severe trauma from that car accident?
Any of them might die on that trip to San Antonio; or suffer permanent damage that would otherwise have been avoidable. Even if San Antonio’s not also full up.
Back in mid-April, the Southwest Texas Trauma Service Area (22 counties, stretching from tightly-packed San Antonio [population 1.5 million in the city limits] to not-so-populous Brackettville near the Mexican border [population ~1700]) routinely had 300 to 350 ICU beds empty out of the ~760 in the region. The number of available beds dropped below 250 briefly in late April before climbing back over 300. Then it started sliding again, dipping below 200 at the end of May, below 150 in the latter part of June, and below 100 on July 8. For the last two weeks, it’s been floating between 60 and 100 (78 on 7/22). Having around twice as many people needing the most advanced and labor-intensive care the hospitals can provide must be taking an enormous toll on the staff. Running at “only” 88 or 90 percent capacity in your ICU for any length of time is not a good thing.
Similarly, total available beds of all types in the region usually numbered around 2500 back in April; the number has been around 600-700 for the past ten days (638 on 7/22). That’s for all of the hospitals spread across those twenty-two counties. Stretching staffing tighter and tighter means more people are exhausted, emotionally drained, overworked, and/or working in unfamiliar areas; those are recipes for mistakes and failures.
Yikes! I was just looking at total hospital capacity (I think). That is starting to trend down. Cases are all over the place because I think they get data dumps from a while ago. I can’t see trend. Hospitalization and EMS calls seem the most consistent and they’re trending down.
The ICU has NOT been decreasing as you said. Luckily not increasing but definitely not going down. That’s to be expected since most people are in the ICU for a while (unless they die right away).
Long story short, we’re barely keeping up with our own patients. San Antonio seems to be doing worse than Dallas and Houston per capita.
New Jersey was having the same problems as New York and exceeded NY in per capita deaths.
Putting that aside, what’s your point? We have layer upon layer of medical transport aircraft available. If necessary the aircraft will be brought in as needed and the patients transported to available ICU beds as needed.
that’s a non-question. Whatever hospital has space closest to the hospital that needs to move patients out.
I’ve already cited the process in action. It’s not up for debate. It’s a simple process to engage. what seems like a long distance to you is not for a chartered jet.
I’ll give you a simple example. I had a workmate with a seriously ill child who needed transport 2 states away for emergency specialized surgery. it was set up with a phone call and his child was transported 461 miles. It was an hour flight and transport to the airport on either end would have been 15 minutes. This was done through a volunteer pilot’s group. Nothing unique or spectacular was brought into the process.
The system to do this is already in place and has many layers to it. We have a large commercial and private network of aircraft. That’s backed up by military aircraft with units who can outfit and launch modified cargo aircraft for mass transport. Again, this was done in NY but they only needed to moved doctors to NY. They weren’t utilized for patient transport.
Ships and assembled emergency stations are a another layer of protection but they require more lead time than aircraft do.
It sounds to me like you are saying that because some other hospitals moved a few patients as a last resort due to overcrowding, that we should just make that our primary action. Or that, since there are some hospitals that specialize in things, we sometimes transport patients to them.
It’s like saying you don’t need brakes because the airbag saved your life last time.
One question. Say they move a whole bunch of Texans to Cincinnati because we have spare capacity. Then we get a big wave in Cincinnati and need those hospital beds. Do we send the people from Cincinnati to Indianapolis, or transport the Texans a second time to Indianapolis?
What happens if Indianapolis isn’t open to take patients? Can we just kick the Texans out so that we Cincinnatians have room?
You’re starting a what-if for the sake of argument. Since I know the area I’ll play along. Ohio has a military base with a hospital, A VA hospital, A huge facility at Ohio State University (with it’s own airport) and major hospitals all over the region.
Seriously, what part of a process that is used on a regular basis to transport patients are you having problems understanding?