Could Mount Nittany reach capacity in the fall over COVID-19? Here’s what the hospital said
Dr. Nirmal Joshi, Mount Nittany Health’s chief medical officer, understands the community’s concern over his hospital’s capacity, especially given the influx of Penn State students — but he tried to allay those fears in a recent interview, saying Centre County’s lone hospital is “well-equipped” to battle COVID-19 in the fall.
For Mount Nittany Medical Center to get to the point where it’s overwhelmed, he said, the process would be gradual enough that alarm bells would be sounded well before it reached a doomsday scenario.
“I don’t think we will be restricted by resources in a way that we don’t have ventilators or we don’t have an ICU,” Joshi told the Centre Daily Times. “There will be a lot happening around us, as opposed to within us.”
When asked where the COVID-19 case level would have to be for the proverbial panic button to be hit, or what data residents should pay attention to, Joshi hesitated. It’s not that simple, he explained, because cases and hospitalizations don’t always match up.
Take a look at the hospital numbers in May and June, for example. In May, Centre County experienced 57 positive cases — and Mount Nittany saw 14 hospitalizations that lasted an average of two weeks. In June, there were 126 positive cases — but the hospital saw just nine hospitalizations with an average stay of one week
Because Mount Nittany can’t easily predict the severity of cases, or the average stay, it’s difficult to put a hard number on its capacity. If 20 patients are hospitalized next month with severe symptoms, all requiring ventilators and 45-day stays, Mount Nittany would be overwhelmed — as would many hospitals in that extreme scenario. If 30 patients are hospitalized next month with mild symptoms, Mount Nittany would be fine.
“A lot depends on the severity of the illness,” Joshi added. “So simply having folks in the community that have positive tests does not determine capacity for us.”
Dr. Kevin Black, interim dean of Penn State’s College of Medicine, raised the community’s concern during a July 30 town hall when he said Mount Nittany could handle an average of one COVID-19 admission per day. But, Joshi added, that assumes the cases are severe.
That’s an extreme scenario. Most likely, Joshi said, Mount Nittany would be able to see the issues coming. If Mount Nittany’s 24 licensed ICU beds are full, that means its 208 medical/surgical beds are also likely bordering on full — which means the case count in Centre County likely exploded. That’s not something that would likely happen over just one or two weeks, especially considering Mount Nittany hasn’t had to treat more than seven COVID-19 patients at once since the start of the pandemic, according to Joshi.
(According to the state Department of Health’s hospital preparedness dashboard, Mount Nittany has no COVID-19 patients, seven open ICU beds, 40 open medical/surgical beds, six open pediatric beds, 18 open airborne isolation beds and more than a dozen ventilators — although Joshi said the hospital has several flexible plans in case one of those limits is approached, such as reopening its COVID-19 wing.)
“Well before we reach our capacity on some of those resources, such as ventilators, there will be at minimum state alarm bells ringing that could massively change how communities function,” Joshi said, “whether it’s limiting the number of elective surgeries, having mandatory stay-at-home orders, or what have you.”
With Penn State students moving into the dorms this week, and class set to start Monday, the county’s population is set to increase more than 25% this fall from where it was in the summer. Positive cases are expected to rise but, Joshi said, that might not have the impact on the hospital some might think.
Although Joshi estimated Mount Nittany is preparing for scenarios through about 10 lenses, here’s one lens: According to the Centers for Disease Control and Prevention, there were about 60 hospitalizations per 100,000 18- to 29-year-olds over a 160-day period. Extrapolate that to Penn State students for a rough-and-simplistic estimate, and you get less than 20 hospitalizations for the fall semester.
Sure, that doesn’t take into account community spread and a lot of other variables. But the point is that students might not put a direct strain on a health care system that laid off about 10% of its staff — 250 employees — in June to overcome a $70 million revenue shortfall.
The layoffs were part of a restructuring process undertaken by the health care system that began in May with the elimination of about 50 management positions.
Regardless, Joshi remains confident in Mount Nittany’s preparedness for the fall. And he’s constantly hoping for the best while preparing for the worst.
“The single biggest determinant to how we fare over the coming months is how well our community works together to prevent the spread of the virus, which is by washing their hands, social distancing and masking,” Joshi said. “This may seem cliched at this point, even boring, right?
“But I can tell you, as a clinician, as a physician, how important we believe these measures are. I personally, strongly, believe one reason our community has not seen the kind of spread some other communities have seen is because we have been more responsible.”
This story was originally published August 19, 2020 at 5:18 PM.
