Rex Hospital uses tents to expand emergency room amid unrelenting stream of COVID patients

Rex also is among the growing number of hospitals across the region that are canceling or delaying non-emergency surgeries because they don't have enough available beds for those people to recover afterward.

The tents outside the emergency entrance will initially provide space for family and friends of patients waiting to be seen. Hospital officials said the tents can expand into treatment areas as needed, as some patients are now waiting up to 12 hours for an available bed to be admitted.

"You can imagine, with the hospital being so full and still people coming to the emergency department, it can take longer to get a bed space upstairs. So, people end up being in the emergency department longer than they would have been otherwise," said Jeff Hammerstein, Rex's emergency preparedness coordinator.

Triangle hospitals in crisis: UNC Rex has more patients than beds

Rex had 45 patients with COVID-19 on Monday, including 20 in intensive care. Across the UNC Health system, 415 patients were being treated for COVID-19, officials said.

"I think what we're seeing now is a more rapid increase in numbers, like we're seeing across the nation," Hammerstein said. "So, it's so important to be able to have that capacity there, assuming numbers continue to grow as they do for right now, so that we can accommodate and have the space to take care of people the way we need to."

Rex also put up tents during the early stages of the pandemic a year ago, but they were taken down as vaccines became widely available and the number of infected patients subsided.

"We were so hopeful in June that we wouldn't have to do this again, and here we are," said Kim Boyer, Rex's emergency services director and a nurse. "We have to separate the COVID and non-COVID patients, and, at times, that's hard to do within the walls here."

The tents, which are heated and air-conditioned, will stay up as long as they are needed.

"We're treating people and seeing people in the hallways, whether in a stretcher or a chair," Boyer said. "If it gets to the point that we have to put our waiting [area] in our tent, we will open up our waiting room and make it a treatment area."

"We have had to make the difficult decision to delay elective surgical procedures that require an inpatient bed," said Lori Dove, interim chief operating officer at UNC Health Southeastern, in Lumberton. "Sometimes, 72 hours prior to their surgical date, we're saying, 'I'm sorry. We can't do that surgery today,' and then we're not giving them a date. So, you know, we're not canceling it, but we're not able to say, 'Well, this is the date we're going to go ahead and do your surgery.'"

Rex has postponed about 20 percent of elective surgeries indefinitely, officials said.

UNC Medical Center in Chapel Hill has "purposely reduced" non-emergency surgeries that require an overnight stay by about 30 percent, Chief Operating Officer Rowell Daniels said.

"We're absolutely prioritizing the emergent surgeries," Daniels said, noting that a team of physicians decides which operations are the most pressing each day. "We're letting the surgeons make those decisions so that we're best serving the patients."

Duke University Health System and WakeMed officials said their respective hospitals also have cut back on elective surgeries in recent weeks.