Report: Triangle could run out of hospital beds in six weeks

The report, compiled by researchers at Duke University's Margolis Center for Health Policy and the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, shows North Carolina overall has slightly more "runway" to work with in terms of hospital capacity, running out of beds in a little more than six weeks.

Intensive care beds across the state could be maxed out in about 4½ weeks under current conditions, according to the report. Triangle hospitals have enough ICU beds to last 5½ weeks.

North Carolina set its 12th consecutive daily record for COVID-19 hospitalizations on Tuesday, at 2,373 people. Hospitals are at 75 percent capacity, with ICU beds 82 percent full. By comparison, the North Carolina Healthcare Association said the average hospital occupancy rate in 2018 was 61 percent.

"We are setting records both for the number of people hospitalized with COVID-19 and the number of people in the intensive care unit. We are seeing increases across the state. Hospitals are feeling the strain," Dr. Mandy Cohen, secretary of the state Department of Health and Human Services, said during a Tuesday afternoon news conference.

The Duke and UNC-Chapel Hill researchers noted that the state's seven-day average of new cases has risen by 30 percent in the last week, leading to a 19.9 percent growth rate in virus-related hospitalizations.

"Cases that are infected today are going to be in the hospital two or three weeks from now, so the next week to two is already sort of predestined," said Mark Holmes, director of the Sheps Center.

Lowering that growth rate to 14.9 percent would give North Carolina hospitals an extra couple of weeks before they reach capacity, while a surge of new hospitalizations – similar to what many other states are seeing – could shorten the runway to four weeks, the report states.

As for ICU beds, the current growth rate for COVID patients is 13.8 percent. If that increases to 16.1 percent, all ICU beds statewide could be full within four weeks, the report states.

Previous models showed the state had 15 or 16 weeks before reaching hospital capacity, Holmes said.

"You’re seeing a much shorter window, much shorter time to turn the ship, so to speak, especially as we continue the holiday season and we will likely have more family gatherings," he said. "One the things that we’ve seen with this pandemic, like all pandemics, is a series of waves. We saw the initial one in April, we saw one this summer, and now we are in another large one. What we never really know is when the wave tips over and starts to subside."

Triangle hospitals have the second-shortest runway for available beds, trailing the Charlotte and Asheville regions, which are forecast to run out in 4.9 and 5.3 weeks, respectively, under current conditions. The Fayetteville region has nearly seven weeks before it maxes out, and the Wilmington region has the longest runway, at almost 12 weeks.

Dr. Thomas Owens, president of Duke University Hospital, said the hospital has seen an increase in admitted patients in recent weeks, but only about 6 percent are virus-related on an average day. Similarly, WakeMed spokeswoman Kristen Kelly said COVID-19 admissions are up about 10 percent from a July peak but still represent "a small proportion" of the hospital system's patients.

UNC Health is treating about 300 COVID-19 patients and is "cautiously optimistic" about its capacity, spokesman Alan Wolf said.

"We are increasingly worried about our staffing levels, as more co-workers contract COVID in the community or are required to go out on isolation because they’ve been in close contact with someone who has tested positive for COVID," Wolf said in an email.

"We opened up an entire floor at the end of Thanksgiving to take on more of the coronavirus patients. There will be a limit to the number of floors that we can have, and there is also a limit to the number of staff we can have to take care of those patients," said Chief Medical Officer at UNC Rex Hospital Dr. Linda Butler.

"I'm honestly very nervous and scared for how it's going to turn out in the hospitals," said Stefanie Wisda, physical therapist at UNC Rex. "The turnover -- when we get someone discharged, it's not long before that bed is filled up again with someone from the emergency room."

Wisda said she thought the surge in coronavirus cases now "might be worse than the one [in the] beginning of spring."

"'[There's] patients of all ages, severity of symptoms. It's intense, both physically and emotionally for patients and health care workers who are caring for them," she said.

Fayetteville-area hospitals are in a more dire situation regarding ICU beds, with less than four weeks until reaching capacity, according to the report. The Asheville region is the worst off, at three weeks, followed by hospitals in Greenville and northeast North Carolina. Once again, hospitals in the Wilmington region are in the best condition, with almost nine weeks until they max out.

"Although very near-term trends are largely unchangeable, we can change trends in the medium term," the researchers wrote in the report. "Indeed, when North Carolina has faced the prospect of large case counts in the past, we have managed to slow case growth and reduce pressure on hospitals. While we hope we can achieve another reduction in case and hospitalization growth, the recent rapid growth in cases and high testing positivity ratios makes us less optimistic than in the past."