What 3 hospital leaders are seeing amid COVID-19 surges in Texas, Florida

Florida and Texas are among several states reporting record increases in COVID-19 cases this week as the virus surges in many parts of the South and West.

Below, three hospital executives from these states discuss how their facilities are handling it, including which resources are still hard to secure and what they'd like the public and local health officials to know.

All respondents shared their insights with Becker's via email June 17-19. Responses were lightly edited for clarity and length. They are presented alphabetically.

How would you describe what you are seeing throughout your organization related to COVID-19 hospitalizations, discharges and deaths?

George Ralls, MD, CMO of Orlando Health: The central Florida area began to see significant community spread of COVID-19 in mid-March. Orlando Health experienced a steady but manageable volume of COVID-19 patients that peaked April 8, of which 40 percent required a ventilator. The COVID-19 mortality during this surge was significant, accounting for more than 80 percent of the total COVID-19-related deaths in our system. The second surge of COVID-19 patients has been a different experience. We have again seen a steady increase in COVID-19 hospitalizations, mirroring the new case counts in the community that began in mid-May. Patients have not demonstrated the level of severity and mortality that we saw with the first surge. Eleven percent are being managed in an intensive care unit, and only 4 percent require a ventilator. Although patient characteristics such as age and comorbidities may play a role, the differences in first and second surge outcomes are likely attributable to more effective clinical care, including respiratory management, and use of emerging therapies such as remdesivir and convalescent plasma.

Roberta Schwartz, PhD, executive vice president, chief innovation officer and CEO of Houston Methodist Hospital: Houston Methodist is experiencing a second surge in hospitalizations after the state was reopened. We are hopeful that individuals in Houston will rededicate themselves to masking, social distancing and hand hygiene so that we can, once again, flatten the curve in Houston.

Mark Wallace, president and CEO of Texas Children's Hospital (Houston): Texas Children's Hospital, our employees, medical staff and leadership team are carefully monitoring the ongoing active transmission and increased number of COVID-19 cases in the greater Houston area and across the state of Texas. Our recent testing results are consistent with the number of positive cases regionally, and we, too, are seeing an increase in hospitalizations for patients who tested positive for COVID-19. 

We know COVID-19 continues to pose a risk, so, out of an abundance of caution, Texas Children’s tests every patient admitted to our hospital regardless if they are experiencing symptoms. We are also testing many patients in our outpatient clinic locations. We are doing everything we can to identify any patient who may have COVID-19, and we take every positive result seriously. Texas Children’s has been a leader in testing since the beginning of the pandemic, and we have conducted more than 13,000 tests with our highly reliable testing system both for the virus and antibodies. The health and safety of the patients under our care, and that of our workforce, is our top priority and we will continue to deliver the best care possible.

What resources, if any, are most scarce in your organization and/or market?

Dr. Ralls: Early on, the market struggled with testing capacity, a critical part of responding to this crisis for a health system. We were fortunate to have an ingenious team of pathologists that very early on managed to design and validate our own "in-house" COVID-19 PCR test. This was a game changer and allowed us to manage the COVID-19 testing needs for hospitalized patients without use of outside laboratories.   

Dr. Schwartz: I am very impressed that our organization has turned to supplies that are often reusable. And I am glad that the supply chain has become more stable. We struggle to get quantities of supplies like wipes or drugs like remdesivir. But, we continue to treat our patients safely and with excellent quality in all our hospitals. 

Mr. Wallace: Texas Children’s has a number of infection-control protocols and measures in place to help protect our patients, families, staff and employees. We are very attentive to the challenges other healthcare organizations around the world are facing related to their supply of personal protective equipment. Due to the strong partnership between our clinical and supply chain leadership teams, Texas Children’s currently has adequate PPE supply, and we continue to aggressively source PPE using a global supply chain.

Any recommendations you'd like to share with the greater public or local/state officials?

Dr. Ralls: Throughout this response, we have remained concerned about the medical needs that were being deferred due to unrealistic fears of coming to a hospital out of concern for COVID-19 exposure. We saw many patients suffer irreversible harm by putting off a need to seek care. Our hospitals and practices are safe and ready to meet the healthcare needs of our community on all fronts.

Dr. Schwartz: Society must be diligent with masking, social distancing and hand hygiene.  Unfortunately, our local community has been less diligent than they should be. State officials should assist with not only the messages, but the tools necessary to enforce these actions. 

Mr. Wallace: We know COVID-19 has not gone away. We implore everyone to take responsible actions — practice appropriate social distancing, wear a mask or face covering anytime you leave your home, wash your hands frequently for at least 20 seconds, and avoid touching your face whenever possible. These efforts worked to slow our patient volumes earlier this year, and taking decisive action now will alleviate the pressure on our hospital systems.

More articles on public health:
3 likely reasons Ohio hasn't seen COVID-19 surge weeks after reopening
COVID-19 antibodies may only last 2 months, small study suggests
Where new COVID-19 cases are rising, falling and staying the same — June 18

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