The burden is uneven, but Philly hospitals are holding up under the strain of coronavirus, officials say

Though Philadelphia-area hospitals have been strained by coronavirus cases, city and state health officials said Friday, so far none are out of room for new patients. Still, some hospitals are bearing a greater load than others.

Clinical workers are exhausted and overworked at Temple University Hospital, said Francine Frezghi, president of the Temple University Hospital Nurses Association, a local of the nurses’ union PASNAP. Temple has more COVID-19 patients than any other Philadelphia institution, according to data shared by city hospitals.

There’s a slow trickle of nurses who are themselves becoming victims of the coronavirus, she said.

“Every day I’m hearing about another nurse who’s positive,” Frezghi said. “They’re scared. They’re anxious. They’re dedicated, though.”

Temple University Hospital and Einstein Medical Center are especially strained. Both are in low-income areas in North Philadelphia and serve many African American residents, who appear to be disproportionately affected by the virus, data suggest.

Temple’s Boyer Pavilion, which is being used as a COVID-19 hospital, had between 30 and 40 beds available Friday morning, including 5 to 10 ICU beds, said Jeremy Walter, a Temple Health spokesperson. “These numbers change hour to hour,” he said.

In the hospital’s critical care wards, nurses are finding their workloads in some cases doubled over the norm. In intensive care units, nurses accustomed to caring for no more than two patients per shift are now responsible for up to four, Frezghi said. In the less-acute medical surgical units, she said, each nurse is assigned to six to seven COVID patients.

The hospital is not turning patients away, she said, but one day in the last week it did request emergency medical teams divert patients away from an overwhelmed emergency room.

Adding to the hospital’s challenges, she said, is the number of beds being occupied by COVID patients who have recovered enough that they don’t need hospitalization and "could be home, but they don’t have anywhere to go.”

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Temple was the only hospital that would provide the number of available beds. The city health department relies on the Hospital and Healthcare Association of Pennsylvania (HAP) for data, said department director Thomas Farley, but does so with the stipulation that the information not be shared publicly. HAP would not comment.

Pennsylvania Secretary of Health Rachel Levine said Friday afternoon that 2,524 people are hospitalized across Pennsylvania with COVID-19, adding that hospitalizations were up in the southeastern and northeastern portions of the state. She said she has received no reports of hospitals at capacity.

The state reported an additional 49 coronavirus-related deaths on Friday, bringing its total to 756, and reported 1,706 new confirmed coronavirus cases. As pressure builds to ease social distancing requirements so people can return to work, that’s among the highest daily tallies in the last month and an abrupt change from recent daily declines.

Levine said the increase is due in part to “a significant number of results from LabCorp and Quest,” labs that have experienced backlogs.

Farley said his department is watching for signs of uneven burdens among the city’s hospitals.

“We’re encouraging any hospital near capacity or at capacity to transfer patients so every patient gets optimal care,” he said. “I can’t talk about specific hospitals, and some are closer to capacity than others. The overall region has adequate capacity, and the best way to manage that is through transfers."

Hospitalizations in Philadelphia, which lag the discovery of new cases, continue to increase as they have across the state, he said at an afternoon news conference on Friday. There were 852 coronavirus patients in city hospitals Friday, and 1,633 in Southeastern Pennsylvania.

“We’re definitely not past the worst of this,” Farley said.

At the five hospitals run by Trinity Health Mid-Atlantic — in West and North Philadelphia, Darby Borough, Langhorne, and Wilmington — administrators have reported needing intensive care beds, but have been “able to manage this increase within our own facilities," spokesperson Ann D’Antonio said.

Penn Medicine is in “frequent communication” with the city health department and other hospitals about capacity issues, and has developed guidelines for transferring coronavirus patients to Penn hospitals “when most appropriate for the patient, including for advanced life support options,” said Patrick Norton, a spokesperson, in a statement.

Crozer-Keystone, which operates four hospitals in Delaware County, said it had adapted some units to accommodate COVID-19 patients, “so we are not limited by the number of ICU beds we have in our system,” Rich Leonowitz, a spokesperson, said in an email.

The health system has transferred a few non-coronavirus patients based on their needs, Leonowitz said. “Likewise, when neighboring facilities need us to accept patient transfers, we handle it as we always do.”

And the overflow sites that some Philadelphia health systems had created for a surge in patients have not yet been used.

No patients have had to be moved to the facility set up at Temple University’s Liacouras Center. And though the Hospital of the University of Pennsylvania had planned to fast-track the opening of its new Patient Pavilion building to create more capacity for COVID-19 patients, the hospital hasn’t needed the additional space, said Nate Wardle, a spokesperson for the state Department of Health.

Jefferson Health has experienced “episodic COVID-19 patient surges,” particularly at its suburban Philadelphia and South Jersey hospitals, said Stephanie D. Conners, Jefferson’s chief operating officer, in a statement, but has enough beds and ventilators in the system as a whole.

The health system is also accepting transfers from other hospitals “as appropriate” when patients require special treatment.

Bridget Therriault, spokesperson for Main Line Health, which runs Bryn Mawr Hospital, Lankenau Medical Center, and Paoli and Riddle Hospitals, said Friday that there are 239 COVID-related hospitalizations across Main Line Health hospitals and they have not had to divert any patients to facilities out of their network.

“We have seen a slow but steady increase as opposed to a dramatic uptick all at once,” Therriault said.

Chestnut Hill Hospital declined comment.

Staff writers Erin McCarthy, Wendy Ruderman, Inga Saffron, and Sean Collins Walsh contributed to this article.

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