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Houston hospitals hit 100% base ICU capacity. Then they stopped reporting data. – Houston Chronicle

https://www.houstonchronicle.com/news/houston-texas/houston/article/Houston-hospitals-hit-100-base-ICU-capacity-15372256.php

Texas Medical Center hospitals have stopped reporting key metrics showing the stress rising numbers of COVID-19 patients are placing on their facilities, undermining data that policy makers and the public have relied upon during the pandemic to gauge the spread of the coronavirus.

The change came one day after the hospitals reported their base intensive care capacity had hit 100 percent for the first time during the pandemic, with projections showing the institutions — which together comprise the world’s largest medical complex — were on pace to exceed their “unsustainable surge capacity” by July 6.

It also followed discussions between Gov. Greg Abbott and hospital executives in which the governor expressed displeasure with negative headlines about ICU capacity, sources familiar with the talks said.

Abbott spokesman John Wittman said any insinuation that the governor directed the executives to stop publishing certain data is false.

“The governor’s office believes all hospitals should be reporting accurate data to the state and to the public as often as possible,” Wittman said Sunday morning. “We demanded more information to share, not less.”

The shift, in which TMC deleted charts from its online COVID-19 dashboard, also accompanied public confusion surrounding the hospitals’ ability to withstand a massive spike in cases that has followed Abbott’s May decisions to lift restrictions intended to slow the virus.

Last Wednesday, 11 TMC leaders issued a statement warning that an “alarming” increase in hospitalizations soon could “overwhelm” their systems.

The next morning, Abbott issued an order restricting elective procedures at hospitals in Harris and Texas’ three other largest counties, saying he wanted to ensure the facilities retained enough beds to deal with the surge of cases.

Shortly after, four of the 11 TMC CEOs held a video press conference to tone down the concern they had expressed just 18 hours before. Hospital leaders wound up “unintentionally sounding an alarm bell too loudly,” Houston Methodist CEO Dr. Marc Boom said.

Boom and his three peers, including Dr. David Callender of Memorial Hermann, Mark Wallace of Texas Children’s Hospital and Dr. Doug Lawson of CHI St. Luke’s, said their systems were not in imminent danger of turning away patients and had plans to accommodate the surge.

On Friday morning, Harris County Judge Lina Hidalgo moved the county to the highest threat level, however, warning that the current hospitalization rate is “on pace to overwhelm the hospitals in the near future.”

Hospital revenues had plunged after Abbott last restricted elective procedures in late March.

In April — when the roughly month-long ban was in effect — Houston’s health care sector shed nearly 33,000 jobs; Methodist and CHI St. Luke’s in mid-May said they had seen huge drops in outpatient surgeries and ER visits, and Memorial Hermann said a shift from elective procedures to COVID-19 care had reduced revenues and increased costs so drastically that $92 million in federal COVID-19 relief did not cover the system’s losses.

Friday morning, 24 hours after the four CEOs’ press conference, the TMC released no new data. After reporting 17 charts and graphs on most days for three months, the organization did not post from Thursday morning until Saturday at about 9 p.m.

When the charts re-appeared, eight of the 17 original slides had been deleted — including any reference to hospital capacity or projections of future capacity — and the lone remaining slide referencing the risks associated with shrinking capacity had been altered.

An “early warning” chart on Thursday reported base ICU capacity had reached 100 percent, and was marked with a red dot signifying a “warning.” On Saturday, the same chart no longer discussed ICU capacity but instead intensive care “census growth,” and was marked with an orange dot signifying “moderate concern.”

The item acknowledged rising numbers of ICU COVID-19 patients but stated, “Currently TMC institutions are able to serve all patients requiring intensive care.”

Boom, of Houston Methodist, said in an email late Friday that the TMC leaders are in discussions about how to “best educate” news media and the public on hospital capacity issues.

“Therefore, the publicly released deck will, at the present time, not include projections or capacity until we can work together to improve the communication of and education around such data,” Boom said.

Neither TMC CEO Bill McKeon nor any other hospital system in the medical center returned calls for comment Friday.

A note posted on the TMC website Sunday morning said the charts posted Saturday night were “incomplete” and that “new slides as well as a number of updated slides that were absent yesterday” would be released later Sunday to “provide a more comprehensive and accurate description of the current status.”

News media and public officials had been referring to the capacity projections for weeks without the TMC or its member hospitals raising any concerns.

Angela Blanchard, a disaster expert and former BakerRipley CEO, said the decision by hospital executives to hold back data is troubling, given that still-inadequate testing capabilities make hospital capacity one of the best available metrics to track the virus.

“From the beginning, we were told to work together to flatten the curve with the specific goal of keeping our hospitals from being overwhelmed. We sacrificed for that,” she said. “TMC needs to retain our trust by being forthright. If they’re worried that the metric misses some nuance, they should explain it. We’re not children.”

Hospitals throughout the region have continued to report data to the Southeast Texas Regional Advisory Council, which coordinates the region’s emergency response to disasters. One of that organization’s charts showed 95 percent of Harris County’s “operational” ICU hospital beds in use as of Saturday, with additional surge capacity beyond the “operational” level.

The altered TMC data also still includes a slide showing daily growth in ICU and “med surg” hospitalizations, showing a 6.2 percent average daily growth in COVID-19 hospitalizations.

Neither the SETRAC data nor the remaining TMC hospitalizations chart reference the facilities’ capacity to accommodate further growth in admitted patients or projects beyond the current date.

Lisa Gray contributed reporting.

mike.morris@chron.com

zach.despart@chron.com

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