Florida's COVID-19 surge: How one Tampa hospital is addressing it

Fifth in a series.

Dr. Anthony Pidala, Chief of Staff at St. Joseph’s Hospital in Tampa, talks about how the BayCare Health System hospital is dealing with the recent COVID-19 surge in Hillsborough County during an interview with retired OB-Gyn Physician Bruce Shephard for 83 Degrees.

Dr. Shephard: As of this interview, Hillsborough County has a total of nearly 18,000 reported cases of COVID-19. Dr. Pidala, as Chief of Staff of Hillsborough County’s largest BayCare hospital, how has your facility managed with the recent surge in COVID-19 cases?

Dr. Anthony PidalaDr. Pidala: First, from the Emergency Department perspective, 2-3 months ago our volume was down 40-50% with people being afraid of COVID. Now, we’re back up to 80-90% of pre-COVID volume and with a much higher proportion due to COVID. Before, patients didn’t come from fear of COVID; now they’re coming because of COVID. Starting from about mid-June, our volumes began to increase. As you can see from watching TV, the number of patients testing positive, as well as hospitalizations, has greatly increased since the state opened up with bars and everything else.

Dr. Shephard: Yours is one of 15 hospitals in the BayCare Health System that serves the Tampa Bay area and west-central Florida. What kind of numbers of COVID-19 cases are you seeing in these hospitals?
 
Dr. Pidala: Currently, each of the hospital systems in the Tampa Bay area including BayCare Health System, reports twice daily their ICU beds to the AHAC, the Agency for Health Care Administration, as a collective number. In our hospitals and throughout the county we’re starting to see more admissions as well as a greater level of severity in our patients.
  
Dr. Shephard: How likely are you to admit these COVID-19 patients that you are now seeing in the Emergency Department?

Dr. Pidala: First of all, many more patients are testing positive in the Emergency Department. Obviously, many of these patients we are able to discharge as long as they are feeling well, they look well, they don’t have co-morbidities or are not immunosuppressed. There has definitely been an increase both in ED visits and admissions to the hospital since the “reopening.”

Dr. Shephard: How many of the patients admitted for COVID-19 end up in the ICU?

Dr. Pidala: We have about 100 in the ICU now in all of the 15 BayCare facilities, mostly over 65 years of age.

Dr. Shephard: How do the age groups for admitted COVID patients break down?

Dr. Pidala: At BayCare facilities currently 56% are over 65 years of age, 32% are 45-65 years of age, 10% 25-45 years of age, and 2% under age 25 years.

Dr. Shephard: Is it true that younger people have less to worry about with COVID-19?

Dr. Pidala: Younger people must realize they are not immune to this disease. Even if they have no symptoms or only mild ones, that doesn’t mean they can’t become very ill. We’ve had several young people admitted to the hospital who ended up needing to go to the ICU.

Dr. Shephard: There has been much discussion in the media about ventilators and the potential shortage of ventilators. Has that been an issue?

Dr. Pidala: Currently we have sufficient numbers of ventilators for the ICU patients who require ventilation for COVID.  BayCare has been preparing for this situation for 2-3 months now to be sure the hospitals have sufficient ICU beds and ventilators.

Dr. Shephard: So, the ICU bed capacity is not maxed out at present?

Dr. Pidala: No. While BayCare, along with other Tampa Bay area hospitals, has seen available ICU bed capacity decline recently, this has been anticipated. And while it remains an ongoing concern throughout the state, our capacity remains sufficient to meet the current demand. We are a large health system with the ability to shift resources from one area to another to accommodate COVID-19 patients as they come in.
 
Dr. Shephard: What happens if ICU beds reach close to or at the hospital’s peak capacity, as has been reported recently in some hospitals, particularly in Pinellas County but also in Hillsborough County?

Dr. Pidala:  In anticipation of this, what the BayCare hospitals have done is to designate certain beds that can become converted to ICU beds in the event of overcapacity. We might utilize post-operative care unit beds, for example.  So we’re prepared for that.

Dr. Shephard: Has there been sufficient PPE (personal protective equipment)?

Dr. Pidala: Yes, I have not heard of any lack of PPE. My understanding is that as of right now that has not been an issue.

Dr. Shephard: Has there been adequate nursing as well as physician staffing at your facility during this recent surge of COVID?

Dr. Pidala: This pandemic has strained many health systems across the country, including their clinical staff. Like many other areas in Florida, our nurses and other team members are working overtime to care for COVID-19 patients. To deal with the current volume of patients, BayCare will be increasing staffing to shifting staff from other areas of the system to hospitals where help is needed most.

Dr. Shephard: Do you have any recommendations for the general public during this recent COVID surge?

Dr. Pidala: I would add the same things that have been heard a hundred times but are so critical for people to follow: Wearing a mask when out in public or public gatherings, washing your hands, using alcohol cleansers, and social distancing. I think one reason we’ve now had the surge in Florida is because many people, especially younger ones, felt closed in, felt they couldn’t do anything, and as soon as the state opened up, people thought everything was OK again and didn’t continue to follow the guidelines. That, I believe, is what caused the surge in patients who have become ill with COVID resulting in increased numbers of patients being seen in the Emergency Department as well as admissions to the hospital in the past month.

Dr. Shephard: Thank you, Dr. Pidala, for sharing your perspective and helpful advice as a physician leader in one of the principal hospital systems in the Tampa Bay region.

Anthony Pidala is Chief of Staff at BayCare Health System’s St. Joseph’s Hospital, Tampa. Bruce Shephard is a retired Obstetrician-Gynecologist and Affiliate Associate Professor, Department of Obstetrics and Gynecology, University of South Florida-USF Health, Morsani College of Medicine in Tampa.

83 Degrees Media's series on local physicians working in the time of COVID-19:
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