A wave of new coronavirus cases in the US is threatening to crush hospital systems in a string of southern and western states, which are struggling to cope with a surge in patient numbers.
More than 15,000 patients are being treated for coronavirus in hospitals in California, Texas, Florida and Arizona, according to a Financial Times analysis of figures from state health departments. A surge in hospitalisations tends to act as a precursor for a rise in deaths.
The strain on hospital systems comes at a time when the number of new coronavirus cases is increasing in several US states, primarily those that have quickly reopened their economies.
Intensive care units are filling up with the sickest patients, who require around-the-clock care and access to respiratory equipment including ventilators, forcing state officials and hospital executives to activate contingency plans to boost capacity.
In Arizona, health officials reported on Monday that 88 per cent of the state’s ICU beds were occupied. Qaali Hussein, a trauma surgeon and critical care specialist who works in Phoenix, said ICU units at several hospitals in the city were already full and they were refusing to admit patients arriving by ambulance to the emergency room.
“We’re essentially saying we’ve reached capacity. When we reach that limit, patients who should be in the ICU are held in the [emergency room] and we cannot accept any new patients,” she said.
Dr Hussein said hospitals were trying to recruit new ICU nurses but that there was a statewide shortage. She added that some patients who should be in an ICU were being treated in other parts of the hospital, such as wards that are intended for people who are recovering from surgery.
The Houston-based Texas Medical Center, the largest hospital system in the US, said its ICU system was running at 95 per cent capacity.
Cindy Zolnierek, chief executive of the Texas Nurses Association, said: “When you get to the level of spare capacity of 10 per cent or less, it means you are really tight. Rarely do you have a patient leaving the ICU at exactly the right moment when someone new needs to go in.”
Ms Zolnierek described the situation in Texas as “scary” and said there was a lot of anxiety among nurses. “The stress and exhaustion is really taking its toll and we are going to be in this situation for a while, until there is a plateau.”
She said some hospitals were poised to activate contingency plans that would result in sick patients being treated in “step down units” that are normally used to treat people who have recently left intensive care.
Ms Zolnierek also predicted that some cities in Texas would be forced to find extra hospital capacity, such as Austin, which has drawn up plans to turn its convention centre into a 100-bed hospital.
The deteriorating picture in Texas and Arizona has echoes of the situation in New York in March and April, when the hospital system came under immense strain. However, at that time New York had a strict lockdown in place, resulting in a dramatic decline in the number of non-coronavirus patients, whereas hospitals in the south and west are still treating people for accidents and other illnesses.
Florida’s hospital system is not yet reporting the acute shortages occurring in Texas. As of Monday, about a fifth of its ICU beds were still available. But the situation varies depending on the area: in Broward County, the state’s second most populous county, just 15 per cent of ICU beds are available.
Healthcare workers in California said some pockets of the state’s healthcare system were also experiencing a shortage of ICU beds. In Los Angeles County, health officials warned local hospitals could reach capacity within a fortnight.
Chad Ricks, a nurse practitioner who runs a facility in Riverside County, said all of its 42 intensive care beds were full.
Mr Ricks said young people in particular were not adhering to social distancing rules or wearing masks, adding that his facility had treated patients as young as 29 years old.
In Arizona, people under the age of 44 accounted for about a fifth of all coronavirus hospitalisations. Air-conditioned bars have been identified as a major source of infection, leading to an uptick in the number of young people becoming seriously sick. On Sunday California ordered the closure of bars in Los Angeles and six other counties, following similar moves in Texas and Florida.
According to the most recent figures available on Tuesday morning, there were 5,956 people hospitalised with coronavirus in California, 5,913 in Texas and 2,691 in Arizona. Florida does not report active hospitalisations, but the cumulative number — which includes people who have been discharged — was 14,540 on Monday.