A team of 10 critical nurses flew from Arizona to Colorado on Sunday to help a Greeley hospital with its coronavirus response. USA TODAY Handout
Even as Northern Colorado hospitals scramble to find more intensive care beds, they know efforts could fall short if a surge of coronavirus cases hits Larimer and Weld counties, as expected. They’re casting a wide net, looking at every available space from western Nebraska and eastern Wyoming to Denver.
Gov. Jared Polis estimates Colorado could need up to 5,000 ICU beds — it has 1,800 now — depending on how successful the state’s stay-at-home order is in tamping down a potential surge.
“I see and hear different projections, but most of them appear that we are light on ICU beds if we really get the full brunt of what could occur in these communities,” said Kevin Unger, CEO of UCHealth Northern Colorado, which includes Poudre Valley Hospital, Medical Center of the Rockies and UCHealth in Greeley.
According to a Coloradoan analysis of Colorado Hospital Association data, Larimer and Weld counties have 65 ICU beds and another 47 that could be used as intensive care rooms among UCHealth and Banner Health’s five area hospitals. There are a total of 840 hospital beds.
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UCHealth’s Longs Peak Hospital and Yampa Valley Medical Center in Steamboat Springs provide another 15 ICU and critical care beds and 90 beds overall to the system’s capacity closest to Larimer and Weld counties.
If national estimates are correct and about one-third of all coronavirus hospitalizations will require ICU-level care, Northern Colorado could find itself hundreds of beds shy of what it needs.
The infection rate of COVID-19 is still unclear. But using infection rates of 7.4% from a mild flu season, Larimer and Weld — with a combined population of 664,823, according to 2018 census data — could see more than 49,000 coronavirus cases.
If only 10% of those require hospitalization — China had a 15% hospitalization rate — Northern Colorado hospitals could see 4,900 patients in a service area with fewer than 850 total beds and 112 ICU or critical care beds.
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Those projections do not account for the impact social distancing efforts could have on flattening that so-called curve. They also don’t take into consideration that intensive care units this time of year — in peak flu and trauma season — are typically full without a pandemic.
Larimer County is preparing to convert part of The Ranch into a medical unit if the need arises. The county has enough equipment for a 160-bed facility, which would be staffed by UCHealth and Banner.
State officials have contacted Larimer County and other communities across the state about the possibility of establishing a 500-bed facility if one were needed, said Lori Hodges, emergency manager for Larimer County.
The state would provide medical staff for that facility.
How UCHealth is preparing
Banner and UCHealth systems are increasing ICU bed capacity however and wherever they can. Like most health care facilities, both have canceled elective and non-essential surgeries to free up space, equipment and staff.
UCHealth has moved its infusion center at Poudre Valley Hospital from the new emergency department to the old ER, mothballed in 2017 when the new wing opened, creating more treatment and triage space for COVID-19 cases.
It’s converting ICU rooms at Poudre Valley Hospital, Medical Center of the Rockies and Greeley to double occupancy, plans to shift critical patients throughout UCHealth’s vast network as space dictates, and is setting up tents outside its emergency departments for COVID-19 triage if needed, said Chief Operating Officer Ryan Rohman.
The benefit of a vast system like UCHealth is that “command centers” can manage patient flow in Northern Colorado between Longmont, Greeley, Fort Collins, Loveland and Yampa Valley Medical Center in Steamboat or farther, Unger said.
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“We wouldn’t rule out patients going to Denver,” he said. “Plans are to get patients to wherever we have capacity.”
As of Friday, UCHealth had COVID-19 cases at four of its five Northern Colorado facilities but had doubled up only one ICU room in Greeley, Unger said.
Northern Colorado can also access bed capacity at Orthopaedic Center of the Rockies and surgery centers on Prospect Road and the Harmony Campus if needed.
“We need to continue to evaluate bed capacity and supplies,” Unger said. “The ventilator shortage is real.”
New York Gov. Andrew Cuomo has pleaded for thousands more ventilators to cope with the deadly surge in his state and in New York City, in particular, “striking fear in all of us” for what might come our way, Unger said.
Currently, UCHealth Northern Colorado “is very well positioned” on ventilators thanks to partners, like CSU’s veterinary hospital, that have loaned supplies.
“We just don’t know what reality holds for the next few weeks,” Unger said.
What’s happening at Banner?
Like UCHealth, Banner is analyzing different spaces and looking at every room that could be used as a critical care room, said Margo Karsten, president of Banner Health’s Western Region that includes eastern Wyoming and western Nebraska.
“We’re looking at every room that would have medical gases and evaluating what rooms have telemetry capabilities and what rooms could accommodate ventilators,” Karsten said.
As Weld County becomes a hot spot for COVID-19 cases in Colorado, with more than 215 cases and nine deaths as of Monday, Banner’s data analytics team is studying March trends and extrapolating “what the demand could look like in Northern Colorado.”
Karsten said she has asked UCHealth Northern to join in a united attack against the virus.
If there can be something positive coming from a global pandemic, COVID-19 has compelled UCHealth Northern Colorado and Banner Health to actively cooperate for the first time.
Both are working on their plans for a spike in cases and plan to share their data so they can “work together to serve Northern Colorado,” Karsten said.
“We plan to sit down with our doctors and chief operating officers and work together on capacity and how best to serve the community,” she said.
That means UCHealth patients might end up at a Banner hospital and vice versa as one runs out of room.
Karsten and Unger are in a “unique position” to partner, Karsten said. The two have known each for two decades since they worked together at Poudre Valley Hospital when Karsten was CEO.
This story has a correction: One-third of all coronavirus hospitalizations, not cases, could require ICU-level care.
Northern Colorado ICU bed capacity
Hospital ICU beds CCU beds* Total beds
Banner Fort Collins 23
Estes Park Medical 25
McKee (Loveland) 11 115
Medical Ctr Rockies 20 12 174
NCMC (Greeley) 16 10 225
Poudre Valley Hosp 12 25 225
UCHealth Greeley 6 53
Yampa Valley 4 5 39
TOTAL 69 52 879
*Critical care beds in specialty units such as cardiac care or neurology ICU.
Source: Colorado Hospital Association (2018)
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