Harris County hasn't reached that point, but local public health experts are keeping a close eye on what an influx of cases would do to the county's hospital capacity and what areas might be most vulnerable.
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In places like New York and Seattle, where there were clusters of coronavirus outbreaks, Dr. Stephen Linder, at the UT Health School of Public Health, said as the cases increased, demand for testing and treatment quickly outgrew the available supply.
"I can't say what the case will be in Harris County, but I want to be prepared if that were to happen," Linder said.
13 Investigates compared the number of hospital beds per 1,000 people in the U.S. and Texas to Italy, where hospitals were overrun with COVID-19 patients and doctors have had to resort to makeshift intensive care units.
On Sunday, Texas Gov. Greg Abbott said he's been having conversations with hospital CEOs to discuss strategies to help provide more hospital space.
"We will this week be standing up additional hospital, medical-provided healthcare facilities in the event that they are going to be needed to respond to an increased number of patients who test positive for COVID-19," Abbott said.
Medical experts estimate a moderate COVID-19 infection rate in the U.S. could be 20 to 60 percent of people. A study in the Journal of the American Medical Association estimates 15 percent of those infected get seriously ill enough to be hospitalized.
Using conservative estimates, our data team analyzed the number of available hospital beds in every county in Texas and found space will be a problem before infection rates reach levels experts warn is possible.
Italy had 3.2 hospital beds for every 1,000 people before the outbreak there. The U.S. has less bed space, with only 2.8 beds for every 1,000 people.
In Texas, the number is even less. The nearly 59,000 beds across Texas would run out if just 1.4 percent of the state's population became infected with COVID-19.
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In Harris County, our data analysis shows that if 1.5 percent of the population got COVID-19 at once, there wouldn't be a bed available for every patient.
The UT study shows the areas where beds might be needed most in Harris County. After mapping COVID-19 warning signs, including age, chronic illness and risk for severe illness, using a 2018 Health of Houston Survey, Linder and his team identified the areas where residents are at risk of the highest need.
"We need to begin thinking about and planning for surge capacity in Harris County so that we can match the potential demand for those services to the available supply and augment the supply as need be," Linder said.
About 20 percent of residents in the East Little York-Settegast part of Harris County are considered to be "most likely to need hospitalization," based on age and health factors. The Deer Park-Channel View part of the county is the next one, with 17.4 percent of residents at risk. The Downtown-East End area followed with 15.3 percent of residents at risk, according to The University of Texas Health Science Center of Houston research.
Deer Park-Channel View topped the list of residents who are "most at risk of needing critical care," with 14.2 percent of residents at risk.
Statewide response
This week, the Texas National Guard is deploying to help local hospitals and healthcare facilities respond to the crisis.
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"In certain locations, like I'll mention Dallas and Houston in particular, there may be a need sometime soon to add additional hospital capacity," Abbott said.
To help expand capacity, Abbott signed an executive order Sunday directing all licensed healthcare professionals and facilities to postpone elective surgeries that would otherwise deplete hospital capacity and the use of personal protective equipment needed to respond to coronavirus.
Abbott also suspended certain regulations and is allowing hospitals to treat more than one patient per room. The order is in place through April 21.
"Patient care capacity is essential during this time, which is why the state of Texas is taking action to increase hospital bed capacity, provide additional space for medical personnel to care for patients, and ensure that healthcare facilities have the supplies needed to respond to COVID-19," Abbott said in a news release.
Harris Health System, which runs Ben Taub Hospital in the Texas Medical Center and Lyndon B. Johnson Hospital is northeast Houston, said its occupancy rates fluctuate.
In February, its rate finished at 87.3 percent occupancy, with a total of 668 operational beds. Most of the unused capacity were likely beds for women and infant services.
Linder said for vulnerable populations and for some critically ill patients that are not near hospitals, transportation may be an issue.
"What are you going to do with the people who are in other areas in Harris County who can't get either to the places where hospitalization is available or because most of it's full up, there's not much left," Linder said. "We've got to be able to plan for how to redistribute and to augment our current supply to be able to meet this demand."