Hospital: We can handle ‘surge’ – LKMC and county talk daily about capacity

At the July 15 BOCC meeting, County Administrator Roman Gastesi and Administrator and Health Officer for the Florida Department of Health in Monroe County Bob Eadie took a realistic look at the rising number of cases and hospitalizations in the county, but gave an encouraging update on hospital capacities.

Gastesi started out with an update from the Lower Keys: “I just got a call from David Clay, the CEO of Lower Keys Medical Center. There are 19 cases (of coronavirus) in hospitals (in the Keys, as of July 15). That’s a doubling of cases in the last week or so. If we get the same doubling going forward, we’ll have about 40 cases when the thousand-or-so people are down here for mini-season.”

Clay told the Weekly that his hospital’s capacity changes based on current patients and staffing availability. The “very fluid situation” also allows for expansion of different areas of the hospital for additional COVID-19 units, if needed, and use of its behavioral health campus as necessary.

Gastesi confirmed this at the BOCC meeting. 

He said, “The good news is, the hospitals have the ability to surge. They feel well-equipped to handle surges in cases by pulling resources from their networks in other states.” 

It’s a similar process to that which Miami-Dade used to get nurses when they were short at Jackson Memorial, Gastesi noted. 

Sharon Weiner, the county emergency management director, echoed the staffing concern for hospitals as the real test, but noted that all Keys hospitals have contracts in place (sometimes multiple) for surge contracting of personnel. 

“Seeing the hospitalizations rise is definitely nerve-wracking,” Gastesi said, “but the color-coded system makes me feel a little better even if the numbers don’t look favorable.”

Gastesi is referring to a “stoplight” monitoring system for the hospitals wherein “green” means they have seven or more days of supplies and personnel, “yellow” means under seven days and “red” means under three. 

If hospitals run out of room to treat COVID-19 patients, they can stop doing elective procedures to free up space and personnel, Eadie added. 

“Right now we’re at green, and there’s elective procedures being done,” Eadie said. “There’s almost a way to have instant capacity for COVID-19 patients if necessary and that’s by cutting off elective procedures.”

Earlier in the meeting, Gastesi also noted that the time will be “evident” if and when the Keys need checkpoints again. 

“I talked to the DOT about checkpoints, and they weren’t happy,” the county administrator updated the public and the BOCC. “If we are totally compromised or getting to that point, that’s the time to have the checkpoint discussion.”

He also noted that there are still other protective measures that the county can strengthen, and that he has been in constant contact with Miami-Dade, Palm Beach and Broward counties, which all believed they’d “seen the worst” and “already peaked.”

Of the capacity at hospitals, he assured everyone, “Believe me, we’re talking on a daily basis.”