CORONAVIRUS

University of Iowa hospitals enacts first stage of surge plan as COVID-19 cases skyrocket

'These changes are designed to keep our services available to all Iowans who need us'

Medical assistant Shannon Jensen (right) carries a swab for a coronavirus test taken from a patient in their car back to
Medical assistant Shannon Jensen (right) carries a swab for a coronavirus test taken from a patient in their car back to her colleague Katrina Rogers to be bagged and sealed at the Family Medicine Clinic of the University of Iowa Hospitals and Clinics in Iowa City on Monday, April 20, 2020. (Andy Abeyta/The Gazette)

IOWA CITY — On a day when Iowa shattered its record for new COVID-19 cases — reporting 4,706 in 24 hours and a highest-ever 44-percent positivity rate — the University of Iowa Hospitals and Clinics announced it is officially activating the first stage of its coronavirus surge plan.

That involves, among other things, adding 16 intensive care unit beds to its current 100; expanding testing capacity; and doubling staffing at its influenza-like-illness clinic, which on Wednesday reported 1,089 visits — its highest to date.

Although Iowa has been through other COVID-19 peaks and valleys since the virus arrived in March — prompting UIHC to halt elective procedures, shift to remote work, and impose visitor restrictions — UIHC CEO Suresh Gunasekaran said this is the first time his team has enacted a concerted phase of their three-tiered surge plan.

The campus, he said, is committed to dialing up the changes by Nov. 16 and maintaining that surge level through Jan. 3.

At the highest surge stage three, UIHC would have 200 total ICU beds, doubling its current capacity. Gunasekaran said administrators haven’t developed scenarios for demand above that.

“I assume by the time that we have been overwhelmed, or we get to that stage, it would be pretty dire,” he told reporters. “Truthfully, we expect Iowans to help us out before we get to that stage because I think that would be a pretty difficult thing for us to manage as a single facility.”

In addition to Iowa’s exploding new case counts, its hospitalizations have been breaking records for 11 straight days — jumping from 777 to 839 Thursday. The state has 188 patients in the ICU and 60 on ventilators. The state reported 20 new deaths Thursday, bringing its total to 1,801.

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Gunasekaran said UIHC’s ICU is about 88 percent full — with mostly non-COVID-19 patients. Although UIHC was reporting 39 coronavirus patients Wednesday, some of those are not in the ICU, Gunasekaran said. Although many are.

Among the main stressors on the UIHC system facing a COVID-19 surge is staffing. An additional 27 UIHC employees tested positive for COVID-19 on Wednesday, bringing the total since the pandemic began to 801.

That’s why the hospital is enacting new employee quarantine procedures that allow workers who have been exposed but who have no symptoms and who test negative to continue coming to work.

“One thing that is very, very important to understand is if a staff member is COVID-positive, they are not at work,” Gunasekaran said. “On the other hand, we have had a significant population of workers who have been exposed to someone who is COVID positive and have been out on quarantine for 14 days.”

Those workers should continue quarantine measures — not socializing and staying home when possible.

“But if they are asymptomatic, and they are COVID negative — we will test them — and if they are COVID negative, we would like them to come back to work,” Gunasekaran said.

Those changes jibe with federal guidance and practices at other health care centers. And they’ll greatly aid the university in meeting patient demands.

“There are a significant number of health care organizations, hospitals, nursing homes, long-term care facilities that have all used this so that they don’t have significant disruptions to clinical services,” he said.

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UIHC has been looking to boost its staffing ranks with temporary and permanent hires, but Gunasekaran said that’s been a struggle.

“During a pandemic, recruiting additional staff to be on the team has proven to be a challenge because there’s so much demand for health care workers,” he said.

Changes to visitor restrictions — which already limit the number of people who can see adult patients and accompany pediatric patients — also are forthcoming. Gunasekaran said additional limitations could include hour modifications and changes for patients undergoing procedures.

Stressing UIHC is prepared to handle a surge and is “built for this,” Gunasekaran said his campus might also have to decrease clinical volumes “as needed.” But patients are encouraged to keep appointments, “as the added capacity and staff reassignments are designed to keep as many UI Health Care services open as staffing allows.”

“We’re taking action now because this is a critical moment in the pandemic,” Gunasekaran said. “If COVID numbers in the state continue to rise unchecked, these may be only the first of many difficult decisions we will need to make over the coming weeks.”

He urged this is the year to skip traditional holiday gatherings. Avoid typical indoor group events. Wear masks, he said. Make sacrifices. UIHC and its workers are setting the example and ramping up preparations, but they need help, Gunasekaran said.

“All of these changes are designed to keep our services available to all Iowans who need us,” Gunasekaran said. “It is not good when people put off the care they need, and we are being intentional about our changes to ensure we can continue to serve the entire state even during this surge.”

Comments: (319) 339-3158; vanessa.miller@thegazette.com

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