Early this spring, Louisiana officials spent millions of dollars acquiring ventilators and personal protective equipment and building a facility for coronavirus patients at the Ernest N. Morial Convention Center to stave off a predicted overrunning of hospitals in the New Orleans region.
Now, with the virus roiling far-flung corners of the state, some hospital leaders say they are full of patients. And while the steps taken early on to prepare have helped alleviate the strain in some ways, hospitals are facing a whole new set of challenges as coronavirus patients show up in record numbers in several regions, complicating the state’s efforts.
Hospitalizations of coronavirus patients have reached 1,600, the highest point since May 1. But the spikes are happening at different speeds. In New Orleans, for instance, the rise is slow, and comes nowhere close to the previous peak this spring.
Other regions aren’t so lucky. The regions of Acadiana, Lake Charles, Alexandria and Shreveport have seen hospitalizations soar to record levels this month.
Perhaps the biggest problem now, several hospital leaders said, is not beds, but the number of nurses and other health care workers available to care for patients. Many have contracted the virus themselves, leading to dwindling numbers at hospitals, several leaders said. Meanwhile, it has become virtually impossible to recruit nurses from neighboring states like Texas because those states are just as bad off, if not worse.
“Physical space, we can continue to cram patients in the room,” said Dr. Manley Jordan, chief medical officer at Lake Charles’ largest hospital, Memorial Health System. “It’s the human resource we’re worried about. It’s a matter of how long we have to run this hard, and is there more surge coming.”
“We’re feeling a crunch for sure,” said Stephen Mumford, chief operating officer at Baton Rouge General. “Our situation is very similar to our neighboring hospitals in Region 2. Probably for the better part of two weeks now we’ve seen a significant uptick of COVID patients in the hospital.”
The $165 million Morial Convention Center facility in the past week had more beds full, just under 30, than at any point since early May. More than a dozen of those were from a nursing home in Hammond, one from Lake Charles and one from Our Lady of the Lake Regional Medical Center in Baton Rouge, among others.
Gov. John Bel Edwards said it has the staff to handle 60 beds, and the state can bump that to 120 if needed.
But Jordan, from Lake Charles Memorial Health System, said the facility doesn’t help his hospital much. Intensive care unit capacity is what the hospital needs, and patients who need such care can’t be shipped three hours to New Orleans. Dr. Henry Kaufman, chief medical officer at Our Lady of Lourdes in Lafayette, similarly said the hospital doesn’t need the beds provided at the Convention Center; it needs more nurses and other workers.
The Louisiana Department of Health in early July asked hospitals across the state if they would be willing and able to sign a deal with the state to create miniature versions of the Convention Center facility – called medical monitoring stations – in their unused hospital wings or floors. The state would pay for medical equipment needed and other expenses.
Still, it’s not clear whether the endeavor will put a dent in the strain at hospitals, and the Health Department said it hasn’t decided whether to pull the trigger. Spokesman Kevin Litten said the agency has identified three potential sites – down from four after one dropped out because of staffing issues. Ultimately the state could sign two hospitals for 26 beds.
“The main reason is because we wanted to have these options in closer proximity to the facilities that needed them,” Litten said.
In the state’s first wave of infections, in March and April, New Orleans was the biggest hotspot, garnering national attention for the dire situation at its hospitals.
That has changed dramatically since cases and hospitalizations started skyrocketing again over the past two months.
Greg Feirn, the CEO of LCMC Health in New Orleans, said in an email to employees this week that the system had 400 COVID-19 patients at its hospitals on its April 1 peak. As of Friday, the figure was at 57. In fact, 16 of those were transferred from other parishes.
LCMC Health’s Dr. Jeff Elder confirmed in a statement the hospital is taking in patient transfers to “help ease the burden on other regions in the state.” He added that the hospital is operating as normal, and encouraged people to seek out care if they need it.
“There are no plans to cancel elective surgeries at this time, we have the PPE supplies necessary to handle the current situation, and with regard to numbers, we are at less than a quarter as where we were at our peak in early April,” Elder said.
Ochsner Health spokesman Daryl Cetnar said the system had 880 coronavirus patients at its peak on April 7, compared with 224 as of Wednesday. Ochsner also has facilities in Baton Rouge.
New Orleans underwent a massive increase in ICU beds and other resources during the first outbreak in April, but patients from other regions and from Mississippi are already being transferred to New Orleans, said Dr. Jennifer Avegno, the city’s health department director, during a press conference where the city announced they would ban the sale of takeout alcoholic beverages.
"What we're seeing in the hospitals is they're seeing requests for transfers from all over the state and neighboring states because so many of the hospitals in our state are completely full," Avegno said.
At hospitals in other regions – including Our Lady of the Lake and Baton Rouge General in Baton Rouge; Lafayette General and Our Lady of Lourdes in Acadiana; and Memorial Health System in Lake Charles – officials are slowing or pausing many elective procedures amid a rise in patients.
In five of the state’s nine health regions – greater Baton Rouge, Acadiana, Monroe, Shreveport and Alexandria – more ICU beds are in use now than even existed four months ago, when the state was at the start of a stay-at-home order. The state’s data for beds starts in late March.
Baton Rouge hasn’t reached its previous peak for coronavirus hospitalizations, but officials at Our Lady of the Lake and Baton Rouge General say they’re being hit with an influx of non-coronavirus patients who held off getting elective procedures done when the state suspended them during the first wave.
The Baton Rouge and Lake Charles regions both hit a record low number of ICU beds available during the month of July. The Baton Rouge area hit that mark on Friday. Acadiana, Lake Charles and Shreveport all hit record highs for the number of ICU beds in use this month.
Staffing shortages became acute enough for Edwards to ask the federal government for nearly 700 health workers to fill needs at hospitals. Baton Rouge General, which asked for help from the feds as well, got a 33-person strike team from the military that was set to arrive Saturday to help relieve overworked staff and assess needs.
Mumford, of Baton Rouge General, said the hospital shut down three operating rooms at its Bluebonnet campus to create more space, and Mumford said he expects the hospital to surge up to five ICU units, up from two normally.
"I think our plan is sound," Mumford said. "We just have to wait and see how much this escalates. We’re hopeful the mask mandate that went out a couple weeks ago will help."
Staff writer Jeff Adelson contributed to this story.