Coronavirus update: Ventilators are the biggest concern in Pennsylvania right now

Pennsylvania hospitals worry they won’t have enough life-saving supplies, workers or cash on hand to survive the outbreak.

The biggest concern in Pennsylvania this week is a looming shortage of life-saving supplies and healthy medical workers needed to treat a surge of coronavirus patients. 

“What we’re worried about here is … the spread of disease will overwhelm the healthcare system,” Gov. Tom Wolf said. 

That’s why he has gradually implemented restrictions across the state. He is trying to keep as many Pennsylvanians home as possible, especially in the hardest-hit areas, to slow the spread of COVID-19. 

On Tuesday, Pennsylvania had enough open beds, medical workers and life-saving ventilators to meet the current needs of patients. 

But doctors and state officials are worried about what comes next — a potential surge that could make Pennsylvania look a lot like New York or Italy.

New York City hospitals have such a shortage of supplies that next week they will be at a point “where people can’t be saved,” Mayor Bill de Blasio said during a CNN interview on Monday.

The supplies most in need are ventilators, the critical machines that help a patient breathe or do the breathing for them. 

The only way to get more ventilators is if the federal government helps, New York Gov. Andrew Cuomo said. The state needs 30,000 ventilators. FEMA is sending 400. 

“Ventilators mean the difference between life or death,” Cuomo said Tuesday.

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New York is not rare and should not be viewed as an outlier, he said. It’s just ahead of other states because it was infected first. The virus took hold there first because of a high number of global travelers and the city being so densely populated. 

Cuomo cautioned other governors and communities to see New York as a test of what’s to come for them.

“Where we are today is where you will be in three or four weeks,” he said Tuesday.

New York is following the path of Italy where there aren’t enough ICU beds and ventilators, forcing doctors to choose which patients get the life-saving devices and who will be left to die. 

If the spread of coronavirus in Pennsylvania follows the path of neighboring New York and there aren’t additional beds and ventilators, hospitals here could also become overwhelmed and forced to decide who gets life-saving equipment and who dies without it. 

“That’s what keeps me awake at night,” Wolf said. 

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Pennsylvania needs more beds and ventilators

Pennsylvania, a state with more than 12 million people, has more than 37,000 hospital beds, including nearly 3,400 intensive care beds and 71 pediatric intensive care beds, according to Nate Wardle, spokesman for the state Department of Health. 

About 40 percent of the ICU beds are available, state health Secretary Dr. Rachel Levine said. 

There are more than 2,000 ventilators in Pennsylvania, and about 75 percent of them are not in use and available as needed, Wardle said. That includes ventilators in healthcare systems, the EMS community and in storage.

That’s enough for normal operations and a normal surge of patients, but officials across the state say it won’t be enough if conditions in Pennsylvania follow that of New York.

Hospitals in hard-hit Philadelphia and surrounding counties have a total of 150 ventilators, according to the Hospital and Healthsystem Association of Pennsylvania. With about 50 hospitals in that southeastern region of the state, that amounts to about three ventilators per hospital. 

Because 148 countries and territories globally are fighting the coronavirus, there’s a competitive market for ventilators. They currently cost between $25,000 and $50,000 each, according to the Hospital and Healthsystem Association of Pennsylvania. 

New York doctors are already experimenting and trying to have two patients use one ventilators, and Pennsylvania caregivers are worried they will face similar choices. 

“There’s no question there are shortages of supplies,” said Craig Skurcenski, vice president of emergency medicine for UPMC Pinnacle. “There’s a shortage of supplies from personal protective equipment to ventilators to test swabs. We’re safe right now, but there’s a limited supply.”

Another critical need in Pennsylvania right now is personal protective equipment for medical workers who are testing and treating coronavirus patients, according to Andy Carter, president and CEO of the Hospital and Healthsystem Association of Pennsylvania. 

Items such as masks to protect doctors and nurses are scarce, and front line health workers have been left vulnerable to being infected. Some medical workers at WellSpan and Penn State Health have already tested positive for COVID-19. 

As of Tuesday afternoon, local hospitals were still waiting on protective gear and other supplies. 

“This is the Number One need today,” Carter said.

What is Pennsylvania doing to solve the problem?

State health officials say they are working “to ensure that should the system be severely taxed, we have access to more ventilators,” Wardle said. 

“We hope that the mitigation efforts taken in Pennsylvania will prevent us from needing more ventilators than we have, but we are taking steps to get more if needed,” he said. 

By mitigation efforts, he’s talking about Wolf ordering thousands of non-life-sustaining businesses to close across the state and issuing stay-at-home orders for residents in the seven most affected counties in Pennsylvania. 

“We are working with manufacturers. We also are seeing if there could be Pennsylvania companies who may be able to make them,” Wardle said.

The state health department on Thursday shipped N95 masks, gloves and gowns to 40 counties, Wardle said. But he would not say how many of each were sent and to where they were sent. 

More items are still needed by medical facilities, he said. 

The Pennsylvania Department of Health is also looking at other sectors for help. To meet the need for N95 masks, health officials are reaching out to miners to obtain their protective masks, Wardle said.

Mining is one of the Pennsylvania businesses deemed to be nonessential during the outbreak, and health officials say protective supplies could be shared.  

State health officials have also reached out to the federal government and asked for some of the ventilators in the national stockpile, Wardle said. That request has not yet been answered. 

The stockpile has more than 10,000 ventilators, Vice President Mike Pence said during a news conference Wednesday. 

New York alone needs 30,000, and Cuomo criticized the federal government for sending 400. But 

“You want a pat on the back for sending 400 ventilators?” Cuomo said Tuesday. “What are we going to do with 400 ventilators? You pick the 26,000 people who are going to die.”

Cuomo was so mad about the 400 ventilators that he misspoke and said 26,000 instead of the the 29,600 New York patients who would be in peril without the life-saving equipment.

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While not getting enough help from the feds, Cuomo called on all New York hospitals to increase their surge capacity and bed capacity by 50 percent, ideally by 100 percent. 

Is Pennsylvania doing that? 

“Absolutely we want more beds,” Wolf said. “We need more beds.” 

State health officials and hospital leaders say they are working together to add beds across Pennsylvania. 

“Beds are opening up on an hourly basis,” Carter said. 

But he said he could not give specific plans at specific locations. 

“I can’t speak authoritatively on exact plans for the surge. Members across the state are moving 24/7 to be ready for a surge in the next week or the next few weeks,” Carter said.

Senior leaders of Geisinger, Penn State Health, UPMC and WellSpan were meeting last week to discuss what to do together if worst-case scenarios hit the central Pennsylvania region. The health systems would collaborate to manage shortages and space. 

“They are dedicated to providing what’s necessary,” Skurcenski said. 

He couldn’t say what they are looking to do or where, but he said they are ready to meet the challenges of fighting this virus.

“Nothing is ruled out,” Skurcenski said.

Coronavirus could close hospitals

The deadly coronavirus is not just threatening patients and the medical workers who care for them. It’s also threatening hospitals across the state. 

Without an emergency response package from state or federal officials soon, some Pennsylvania hospitals could go under, Carter said Tuesday.

“It’s a legitimate, credible threat that some hospitals will close,” he said. “We would see closures. I can’t tell you how many.”

How did we get to this moment of no supplies and no money when some hospitals are logging billions in revenue every year and hundreds of millions in charitable giving? 

While hospitals have money and supplies today, the coronavirus could deplete all that, Carter said. The potential scope of the pandemic could put hospitals completely out of business.

“The closure of a hospital in the middle of this would be devastating,” he said.

Pennsylvania hospitals are facing significant challenges. A third of Hospital and Healthsystem Association of Pennsylvania members lose money in a given year. A fifth lose money up to three years in a row, Carter said. 

“These aren’t normal times,” he said. “We need the (emergency fund) to maintain stability and financial demands of all this overtime and emergency health care facilities.”

“Emergency planning did not prepare for this.”

Candy Woodall is a reporter for the USA Today Network. She can be reached at 717-480-1783 or on Twitter at @candynotcandace

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