As COVID-19 patient counts continue to soar in Brevard County — swamping local hospitals to near breaking point — some in the medical and emergency management sectors paint an increasingly dire picture of the situation.
All three hospital systems in the county are over capacity, and are continuing to deal with a strong surge in patients, Brevard County Emergency Management Director John Scott said.
Brevard County Communications Director Don Walker said county officials are now working with the hospital systems to identify potential sites outside the hospitals to house patients, should the surge reach a level at which they run out of space and can no longer handle the patient counts.
Already, Brevard’s hospitals have halted many of their elective surgeries, and have converted some of their general patient beds for use as intensive-care-unit beds or for COVID-19 patients.
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In addition, medical surge tents have been set up outside some local hospitals, and are being used for patient care.
“Everybody’s being stressed to their limits, with the hospitals at or above capacity,” said Dr. Adam Fier, president of the Brevard County Medical Society. “But everybody’s banding together and doing what we can to keep people as healthy as possible.”
Latest-available data from the U.S. Department of Health and Human Services shows how much hospital ICU facilities are getting filled in recent weeks, even as they are increasing the number of available ICU beds.
During the week of July 30 to Aug 5, Brevard had a total of 189.3 ICU beds at its seven general hospitals — with 176.6 ICU beds occupied on average.
In comparison, during the week April 2 to April 8, there were 172.4 ICU beds, with 140.6 beds occupied.
Among the increases:
- At Holmes Regional Medical Center in Melbourne — Brevard’s largest hospital — 73 of the 78 ICU beds were occupied during the week of July 30 on average. That compares with 55.7 of the 68 ICU beds occupied during the week of April 2.
- At Palm Bay Hospital, 15 of the 17.1 ICU beds were occupied during the week of July 30 on average. That compares with 6.7 of the 12 ICU beds occupied during the week of April 2.
- At Steward Health Care’s Melbourne Regional Medical Center — 9.3 of the 12 ICU beds were occupied during the week of July 30 on average. That compares with 6 of the 12 ICU beds occupied during the week of April 2.
The surge in COVID-19 cases also prompted Brevard County Fire Rescue Chief Mark Schollmeyer to urge residents to stop calling 9-1-1 for non-emergency calls, so as to leave hospital emergency room staff and facilities — and BCFR crews — to handle the urgent medical emergencies.
“Our BCFR ambulances are seeing an increase in hospital times due to not being able to turn patients over to hospital staff,” Schollmeyer said, referring to ERs filled with patients suffering from COVID-19 symptoms. “We continue to ask that people use 9-1-1 sparingly for non-emergent issues and to save the ambulances and ER trips for those who urgently need those services.”
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So far the increase in hospitalized COVID-19 patients shows no signs of abating any time soon.
Health First, for example, reported Tuesday that 316 patients with COVID-19 were at its four Brevard County hospitals — a 39% increase from 227 just a week ago.
That includes 137 at Holmes Regional Medical Center (up from 93 a week ago), 71 at Palm Bay Hospital (up from 46 a week ago), 56 at Viera Hospital (up from 49 a week ago) and 52 at Cape Canaveral Hospital in Cocoa Beach (up from 39 a week ago).
In a memo to other county officials, Scott said emergency rooms “continue to be full and are experiencing very long wait times, resulting in periods where multiple ambulances are out of service for prolonged period of time,” as ambulance crews wait with patients before the patients can be examined by hospital medical staff.
“Additionally, urgent-care centers are also beginning to experience long wait times, as they are seeing an increase in patients who didn’t want to wait at an ER,” Scott said.
Scott noted in his memo that Parrish Medical Center in Titusville “had to go on ‘full divert’ (excluding cardiac-related items) for approximately 10 hours” on Friday, “while they created additional COVID spaces.”
That means that ambulance crews were directed to go to other hospitals, rather than coming to Parrish’s emergency room.
The hospital only recently stopped diverting all but the worst-off patients due to a heavy influx of people suffering from the effects of the novel coronavirus.
Outside Parrish Medical Center on Tuesday, an emergency medical tent stood waiting in case of a surge of COVID-19 patients.
Just inside the emergency room doors, a handful of patients and visitors stood waiting in a socially distanced line to be checked in accordance with the hospital’s emergency protocols.
At Parrish, the surge emergency overflow tent is operational. In addition to Parrish’s main 12-bed intensive-care unit, a secondary overflow ICU unit has been established. Nearly 50 patient rooms have been converted to function as “negative pressure rooms” geared for COVID-19 patients.
As of Tuesday, Parrish had 71 COVID-19-positive patients, including 14 in the ICU and 17 in the Emergency Department.
Non-emergency surgeries continue to be postponed until further notice to allow staffing resources to be deployed to areas of greatest need. Visitation continues to be restricted.
Health First, meanwhile, on Tuesday announced it was imposing stricter limits on visitors to its four hospitals, effective Wednesday.
Among the exceptions to the no-visitor policy, a single visitor will be allowed under these circumstances:
- Legal guardian or power of attorney (must execute transaction, and then exit the facility).
- Obstetrical delivery: Father/partner and doula are allowed.
- A minor child may have one parent visit (parents may switch out).
- Patients at “end of life.”
ER wait time fallout
Titusville resident Charlene Melcher this week experienced firsthand the fallout from long wait times for emergency room care.
Melcher’s 78-year-old father has a series of health issues, including Parkinson’s disease and cardiac concerns, and has recently suffered falls. Melcher, a Realtor, is heavily involved in his care, as well as her mother’s health problems.
When Melcher arrived at their house Monday morning, her dad couldn’t get out of bed, and complained of severe back and neck pain.
“He has a medic alert system,” she said. “And he’s just so heavy, I couldn’t get him up. So I pushed this little button and called them. … Titusville responded, and they did vitals, and then Brevard, who transports, because Titusville doesn’t transport.”
The vital signs were good, she said.
But “as soon as (Brevard) came in the house, a paramedic said, ‘We can’t transport him. … If we transport, he will sit on my gurney for at least eight hours before being seen,’ ” Melcher said.
“He told me, ‘We are being encouraged not to transport anybody that doesn’t have breathing or cardiac problems.”
With the help of the paramedics, her father was loaded into Melcher’s car. She contacted his primary-care physician and took him to Parrish’s Port St. John clinic, where a security guard helped her get her dad into a wheelchair. He was seen and released, and “got fabulous care,” she said.
But Melcher is worried about news that hospitals are filling with COVID cases.
“It’s frightening,” Melcher said, especially for someone whose parents’ medical woes could precipitate a health crisis at any time.
“We’ve been keeping them home and trying to keep them safe. … We already live in fear of something like (this) happening. It’s hard enough to get help as it is,” said Melcher, who’s 58 and has had open-heart surgery herself.
COVID makes it “even more frightening,” said Melcher, whose father was vaccinated.
“I knew the hospitals were filling up, and I knew it was changing … that visitors couldn’t come in and stuff like that,” she said.
“But I never dreamed that, if I called them, they would not be able to transport my dad,” Melcher said. “I wish I could say better things. … I honestly don’t blame the paramedics. What they’re facing is a lot. But it makes it difficult to know what to do and how to take care of my dad now.”
Elective surgery issues
The curtailment of elective surgeries to keep hospital beds available for COVID-19 patients is having wide-ranging effects, too.
Health First and Parrish have stopped all elective surgeries. Scott said Steward Health Care — which has hospitals in Melbourne and Rockledge — has stopped any elective surgeries that require an overnight stay.
The curtailment of surgeries concerns Fier, who is a cardiac anesthesiologist with Brevard Physician Associates.
“Unfortunately, we’re having to defer elective surgery for folks because of the staffing issues,” Fier said. “So this includes people that need a total knee replacement. It’s also people who may have colon cancer or breast cancer, because, in the county and the state, a lot of these hospitals don’t have the capacity to take care of both sets of patients,” Fier said.
“Valve surgery. Colon surgery. Orthopedic surgery. Even something as simple as getting a colonoscopy screening has been deferred at this time because of the record number of patients,” he said.
Push for vaccinations
Fier encouraged Brevard residents to get vaccinated. He said statistics are showing COVID-19 death rates can clock in roughly 100 times greater for unvaccinated people than for vaccinated people.
As of Thursday — the latest-available Florida Department of Health data — 323,175 Brevard County residents have received a COVID-19 vaccine. That’s 53% of the overall population and 60% of the population ages 12 and up, the age group eligible for vaccination.
Medical experts say 70% to 80% of the overall population needs to be vaccinated to slow the spread of the virus.
During the week of July 30 to Aug. 5, there were a record 3,836 new COVID-19 cases reported in Brevard. The count has steadily increase during the last five weeks, rising from 693 to 1,443 to 2,166 and to 3,516 before hitting 3,836. In all, 55,378 Brevard residents have had confirmed cases of COVID-19 — nearly 1 in every 11 county residents.
With the rising case counts, there has been some renewed interest in unvaccinated Brevard residents getting vaccinated, with 7,610 people vaccinated during the week of July 30 to Aug. 5.
“Increasing vaccine rates among our residents remains the best path to stabilization, and while the small uptick experienced … is encouraging, the high level of hesitancy continues to plague any substantive progress,” Scott wrote in his memo.
Fier said politics should stay out of the vaccine debate.
“This is not a Republican or a Democrat virus. This is not a Republican or a Democrat vaccine,” Fier said. “Republican leaders and Democratic leaders alike have been vaccinated. So this isn’t a political issue. This is a health — and death — issue.”
North Brevard reporter Tyler Vazquez contributed to this report.
Dave Berman is business editor at FLORIDA TODAY. Contact Berman at [email protected]. Twitter: @bydaveberman.
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