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Bill Lee talks hospital bed capacity, COVID-19 surge on April 1




Here is the daily Tennessee Health Department report:

Tennessee has 2,683 confirmed cases, the Tennessee Department of Health said. There have been 24 deaths, up from 23 deaths reported Tuesday.

The state is now reporting recoveries: There have been 137.

There have been 200 hospitalizations since the pandemic began.

A total of 32,452 tests have been processed in the state.

Here is a summary of Gov. Bill Lee’s press conference comments from Wednesday:

Together we can fight COVID-19.

“We’ve lost 24 Tennesseans in this pandemic. All the more reason why Tennesseans need to be vigilant.”

The state leads peer states per capita in testing. The more tests are done, the more officials will know about the virus.

Wednesday is first day of the National Child Abuse Prevention Month. Schools are closed and children are outside of that structured environment. Each person is a mandatory reporter of suspected child abuse. Call the child abuse hotline of any suspicion or tn.gov/dcs.

Health care workers are on the front lines.

Over 18 million items of personal protective equipment (PPEs) were acquired in last several weeks. Every county got a shipment from the Unified Command Group into its region. “We are providing PPEs to every county, to rural communities as well.” The state is working to provide for the PPEs. Counties may contact TEMA to make sure the region is prepared. “There is not a large supply of PPE but we’re are finding it everywhere we can.”

The state reached a critical threshold on face shields. Last week I mentioned TCATs are printing them. We produced 10,000 face shields through 3D printing at higher education institutions.

The U.S. Army Corps of Engineers is doing surge planning to bring on online thousands of hospital beds in every major city in the state. The plans are being assessed. “Action is already being taken.” This is a partnership with hospitals and hospital association. The state will need thousands of new beds as the surge takes place in coming weeks. More information on numbers of beds and sites will be coming soon.

We are issuing an urgent call to unemployed health care workers. Unified Command will have a website to have you join the surge planning. “We’re going to need every available health care worker.” The state lifted restrictions on licenses.

Possible strain on health care safety net. TennCare got a waiver for flexibility and funding to serve Medicaid population. We are providing more services to our safety net. There are providers in nearly every county … for uninsured who need testing and care. We have partnerships with hospitals.

“There is a storm over out state. It is intense. We are doing everything we can to protect the citizens of Tennessee … there will be a day where these clouds break. Do your part – stay apart. We implore and we encourage Tennesseans to be part of this.”

Dr. Lisa Piercey of the Tennessee Department of Health:

Coronavirus is in virtually every county. Shelby leads in cases. Then Davidson. That’s not unexpected – they have the most population.

Yesterday we mentioned reporting by county. That information is now on TDH’s website. We did over 32,000 tests and “we are pulling away from other states.”

We monitor assets at each of the hospitals. In aggregate form, we have 32 percent of inpatient beds available, 32 percent of ICU beds available and 69 percent of all traditional ventilators available (that does not include new or alternative ventilators).

TDH continues to “watch” the vulnerable populations.

Answers to questions:

Has there been a shift in tracing of patients’ contacts? There are reports that tracers are overwhelmed in certain communities. Piercey: I would point to the Wsahington State experience, that is something Tennessee is dealing with. As the number of cases grows, the ability to do detailed tracing diminishes in a timely fashion. We will continue to trace every case, but like with testing, we will prioritize it to the most vulnerable. Each patient could have had 100 contacts.

A reporter told Lee he had mentioned to lawmakers this morning there are shortages of beds and ventilators. When will the shortage begin? Is the state doing anything besides telling people to wash hands and get tested and stay home? Will there be anything like curfews and roadblocks? Lee: There is a wide range of efforts around the country, none of which have given much real data or evidence to what is most effective in social distancing. We think what we did will make a significant impact. When you close all non-essential businesses in every corner of the state it liimts the movemet of people.

We have fewer beds than will be needed at the height of the surge. WE are working on models, including the University of Washington’s Institute for Health Metrics and Evalutation. We are trying to get a more Tennessee-specific model. We are working with Vanderbilt on that and we have part of that model; we are trying to meld the models. The current model shows a shortage in 3.5 weeks, April 19 or 20, I think. Every health care provider is putting in place additional beds. We hope the shortage will be met, but no idea what that shortage will be. We have not seen an exponential rise in cases, but the surge will increase based on models.

Question: The Tennessee medical community has asked why is there no shelter in place; it’s a matter of life or death. Lee: I heard from the medical community all over the state. I heard from one organization today that supports the efforts I am doing. There are different opinions on the right strategy on social distancing. Discernment is difficult when there is so much information.

A reporter asked for numbers of the surge and beds. Lee: Assuming the worst case, we need 7,000 more beds. We have a partial plan with the Army Corps and will receive more information tomorrow. Some of that need has been met as elective surgeries have been cancelled. Private providers already are putting in extra bed capacity, but we don’t have the numbers yet. We are coordinating with the hospital association. We are finalizing plans for the overflow.

Follow-up question: Could overflow capacity come from hotels and convention centers? Lee: Yes. The Corps also is looking at dorms.

Question: What is the projected surge? Lee: “I don’t have that number in front of me. There are a number of models, you know. Our strategy is to plan for the worst.”

Question: How many beds are there right now, and studies show we need 1,800 ventilators. Lee: We don’t know the number. It changes by the hour as patients occupy beds or clear the beds.

Piercey: I have specific numbers with me. There are 3,414 inpatient beds available, which is 32 percent of overall capacity, so 68 percent are taken. There are 534 ICU beds available. There are 838 ventilators available. These are traditional numbers of units. Hospitals have plans for surge capacity and can ramp up. We have more supplies ordered, and alternative supplies can be converted.

Lee: We have licensed, unstaffed beds not included in these numbers. Also, we will announce financial assistance for rural hospitals to bring on capacity which is not currently being used.

A reporter asked about having enough tests for everyone and said health care workers are waiting weeks to get results because they are caught in a backlog and are self-isolating. We learned yesterday the TDH labs can return results in 24 to 48 hours but no one told them. Is there a concern health care workers cannot work?

Lee: We don’t have enough tests for everyone to take tests, we have enough for those who need to test. Tennessee does more tests than other states. Weeks ago, I told our team to be aggressive and we were one of the first five states to start testing with remote testing centers. We are waiting on a one-hour turnaround test, the whole nation is waiting.

Piercey: The state lab does issue a priority for health care workers and the vulnerable populations and can process them in 36 hours; we have no backlogs. We don’t have the capacity to run all the tests in Tennessee. Most private labs are not in the state. Today I learned a 45-minute test is coming, sites are getting parts of it, and it may be available at the end of the week.

Lee: We’re aware that test turnaround time is challenging for us with health care workers. If we can get a quick turnaround before the peak of the surge hits in 3-4 weeks…

Question: Health care worker are upset they are waiting two weeks to get results. Was an opportunity missed to get them quickly tested? Lee: We said multiple times the state lab is providing priority testing for health care workers.

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