Surveying the state's number of available hospital beds amid the coronavirus crisis, Gov. Andrew M. Cuomo said Tuesday that "the numbers are daunting."
They're daunting in Western New York, too.
Cuomo said the state will need between 55,000 and 110,000 hospital beds because of the COVID-19 pandemic. Adjusting those numbers based on population, that would mean that metro Buffalo could need as many as 6,358 hospital beds – when it only has 2,844, many of which are occupied at any one point in time.
For intensive care beds, the numbers look even worse. Hospitals in Erie and Niagara counties might need upwards of 2,150 ICU beds – when they have only 208.
Those are only projections based on state and federal data, and health care experts say the area will not be in such short supply of hospital beds if metro Buffalo avoids the worst of the pandemic.
Still, Erie County Executive Mark C. Poloncarz said Tuesday that he's preparing for the hospitals to run out of space – overwhelmed with COVID-19 victims with serious respiratory issues – at some point in a crisis that's expected to peak in the state in about 45 days.
To provide extra hospital space, Poloncarz is considering trying to find a way to reopen TLC Lakeshore Hospital in Irving, a Chautauqua County facility that closed in January. In addition, the county is exploring closed nursing homes and hotels, as well as a portion of the closed Erie County Home, as makeshift hospital sites.
"We're going to need more beds with regards to ICU beds, as well as general beds," Poloncarz said. "I can't give an answer on how many we need; it's all based on hypotheticals. And our goal is to try to get as many and open up as many beds as possible."
Poloncarz is not alone in thinking such thoughts. Also on Tuesday, Niagara County agreed to use the shuttered Newfane Intercommunity Hospital to house quarantined individuals who may have been exposed to the coronavirus but who cannot quarantine at home.
Buffalo, like every community in the country, has enough hospital beds to cover an influx from a run-of-the-mill emergency like a snowstorm – but not enough for a nationwide pandemic, said Mark A. Sullivan, president and CEO of Catholic Health.
"If we had 700 ICU beds in this community right now, there wouldn't be a health system open because we'd be bankrupt," Sullivan said.
That's because intensive-care beds – typically equipped with ventilators to help patients breathe – are hugely expensive to maintain because they are much more fully staffed than regular hospital beds, Sullivan said.
That means hospitals only keep as many ICU beds as they need – and it's a surprisingly small number. Erie County Medical Center, the region's largest hospital, has 573 beds in total, but only 38 of them serve intensive-care patients. Buffalo General Hospital has 484 beds, but only 53 for the most critically ill or injured. Mercy Hospital in Buffalo has 30 ICU beds, and most other hospitals in the region have fewer than 20.
While there's nothing unusual about the region's low number of ICU beds, it's a matter of concern during a pandemic, said Dr. Anne B. Curtis, chair of the Department of Medicine at the University at Buffalo.
Most COVID-19 patients will be able to recover at home and would have no need for a conventional hospital bed, Curtis said. Most of those that will need to be hospitalized, though, will need the kind of treatment they can only get in intensive care.
"I really would worry about the ICUs – and not only that, but the number of respirators that we have," Curtis added.
Also called ventilators, these devices deliver oxygen to patients who are struggling to breathe. And both in Buffalo and nationwide, they are startlingly scarce.
Catholic Health has 75 to 100 ventilators spread across its five hospitals. Erie County Medical Center has 70, and the Buffalo VA Medical Center has 60. Kaleida Health, which operates Buffalo General and three other hospitals, has 954 hospital beds, including 204 ICU beds.
If a hospital runs out of ventilators, its first step will be to call the state, said Charlene Ludlow, a registered nurse who leads infectious control efforts for Erie County Medical Center and Kaleida.
“Any hospital in New York State though has access to a stash that has been put it away by the state for emergencies," Ludlow said.
But the New York State Task Force on Life and the Law found only 2,800 ventilators in that state stockpile in 2015. According to the New York Times, that panel found 7,250 ventilators in New York hospitals and about 1,900 in nursing homes – far short of the 18,600 that would be needed at the peak of an outbreak like the 1918 Spanish Flu pandemic that killed 675,000.
That being the case, Cuomo has been insisting that the federal government should aid with a coming respirator shortfall.
"An ICU bed has additional equipment, most notably ventilators, and that's why you hear on the news ventilators are very hard to get globally," Cuomo said Tuesday. "Why ventilators? Because we're all talking about acutely ill mainly senior citizens who have an underlying illness. They have emphysema, they're battling cancer, they have heart disease, and then they get pneumonia on top of that – that's (from) the coronavirus."
It's possible that COVID-19 will never hit metro Buffalo with the ferocity with which it seems to be hitting New York City, where there were already 814 cases as of Tuesday afternoon. After all, metro Buffalo essentially shut down when the number of reported cases was still in the single digits, meaning there is a chance that the region stopped or slowed the contagion's spread far better than New York City did.
Only one of the Buffalo area's 20 patients has been hospitalized so far, and the fast action to shut the region and the state down may show the pathogen's progress, said Dr. Nancy H. Nielsen, senior associate dean for health policy and medicine at UB.
"I think what what has happened with the county health commissioner and the county executive and the governor has been really quite extraordinary and and really has gotten people into the right mindset," said Nielsen, a former American Medical Association president.
Then again, Nielsen warned that there are actually many more Buffalo-area residents with COVID-19 who just haven't been tested yet.
"We could see a dramatic rise – and that's what other places have seen," she said.
And that's what Poloncarz is preparing for in seeking more hospital beds.
"We are planning to address the worst and hope for the best," he said.
News staff reporter Scott Scanlon contributed to this report.
Story topics: Covid-19