Las Vegas Sun

March 28, 2024

Las Vegas’ shortage of acute care beds in hospitals points to looming crisis as outbreak spreads

 Intensive Care Unit

A patient rests in the Trauma Intensive Care Unit at Sunrise Hospital. ICU beds are vitally important in the fight against COVID-19 because they are equipped to treat patients with respiratory issues that require ventilators, but Las Vegas is woefully lacking in the number of ICU beds when compared to other areas of the country.

Las Vegas appears poised for an acute-care bed crisis, based on an analysis of the region’s preparedness to handle the coronavirus outbreak.

The Las Vegas region ranks 298th out of 306 hospital referral regions in acute care bed capacity at 914 beds, according to the 2018 American Hospital Association Annual Survey of more than 300 referral regions. The Las Vegas region also includes parts of Northern Arizona and Eastern California because residents in those areas would be treated in Southern Nevada facilities.

When comparing areas with populations between 1.78 million and 2.5 million, Las Vegas rates dead last in acute bed capacity. In fact, many regions have double the bed capacity — in Cleveland, whose population mirrors the Las Vegas area, there are 3,650 acute care beds. And in the Reno area there are 605 acute care beds for about one-third of the population of Las Vegas.

The demand on resources is quickly changing as new cases of the virus are confirmed, which increases pressure on hospital resources. On March 20, there were 126 coronavirus cases that had resulted in two deaths in Clark County. A week later, there were 443 cases and 10 deaths.

New York is the nation’s ground zero for the hospital capacity crisis in the COVID-19 outbreak, with 25,000 confirmed cases and at least 366 deaths as of Friday. Some patients there suffering from coronavirus reportedly died in emergency rooms while waiting for unavailable intensive care unit beds at hospitals overwhelmed with patients.

For now, the situation in the Las Vegas area isn’t as dire, but it could become bleaker than what New York is experiencing.

A study from Dartmouth Institute for Health Policy & Clinical Practice found that for every 100,000 inhabitants in Clark County, there are 15 ICU beds. It’s closer to 10 beds on a normal week, when there’s 800,000 or so visitors to the area. New York has more than twice as many ICU beds as Las Vegas, at 37 per 100,000 population. ICU beds are a subset of acute care beds.

“Las Vegas has an influx of people,” said Stephanie Tomlin, director of the Dartmouth Institute’s Data and Analytic Core. “One would assume the health system is built around that of the needs of the people with the full understanding that population includes a lot of tourists.”

But it isn’t built that way.

There are about 450 ICU beds in hospitals in Clark County, according to reports. Statewide, 72% of the 683 beds were in use as of Friday, reports Nevada Health Response, a website operated by the state to share data on the outbreak.

Those beds are occupied by patients with all sorts of maladies, not just COVID-19. As of Thursday, only 193 ICU beds were available statewide to accept new patients.

ICU beds are vitally important in the fight against COVID-19 because they are equipped to treat patients with respiratory issues that require ventilators. The Southern Nevada Health District said on Friday there were 16 Clark County patients with COVID-19 being treated in an ICU setting. The state says 40% of about 700 available ventilators are in use already.

Dr. Shadaba Asad, an infectious disease specialist in Las Vegas, says it’s too premature to predict when the pandemic will gradually lessen.

Array Advisors, a Washington, D.C.-based group that uses data for health care strategy to help medical systems devise strategy for a sustainable future, projects the outbreak will cause a shortage of beds in Clark County by April 7. Initially, its projection was April 25, but COVID-19 cases are now doubling every three days, said Catherine Castillo, a strategic planner with Array.

Once ICU beds in Las Vegas are all in use, new coronavirus patients who otherwise might survive stand a higher likelihood of perishing simply for the lack of resources. If the Array Advisors projection is accurate, Las Vegas will experience a shortage of ICU beds in a little over a week.

“Our goal was to create as much of an accurate model for the potential demand of hospital beds and the potential supply,” Castillo said. “What hospitals need to add more capacity? Some can add beds; many cannot.”

The group’s findings on Thursday indicated that 20% of the nearly 80,000 infected nationally by the coronavirus required hospitalization, with 24% of those patients needing treatment in an ICU. The survival rate for COVID-19 patients being treated in an ICU is 64%.

Clark County has grown by leaps and bounds over the past 20 years to its current population of more than 2 million residents. Its hospital systems “haven’t been able to keep up with the growth,” said Maureen Schafer, the president and CEO of Nevada Health and Bioscience Asset Corp., the group behind getting the UNLV School of Medicine building constructed.

That’s not the narrative in Reno, which the Dartmouth study found has almost twice the number of acute care beds per 1,000 residents as Las Vegas. And in New Orleans, a city that also relies on tourism, there are more than three times the acute beds per 1,000 residents. New Orleans ranks in the top third of nation’s hospital regions for acute beds while Las Vegas is a whisker away from last place. Importantly, Mardi Gras took place right as the coronavirus outbreak was percolating and New Orleans now faces a looming crisis in ICU availability despite its store of ICU beds. Mardi Gras attracts about 1 million people to New Orleans once a year. When the Strip is fully operating, it attracts about 814,000 visitors every week.

The need for more capacity is illuminated during a pandemic. But, even when the coronavirus dies down, the hospital system in Southern Nevada will still be taxed. That Las Vegas trails the nation in bed capacity suggests to many health care professionals a clear need to expand capacity permanently once this crisis is over.

“Our hospitals are full almost every day of the year,” Schafer said.

On the night of the Oct. 1 mass shooting in 2017, Schafer said, every victim who arrived at University Medical Center came out alive. Patients lined the hallways waiting for their turn to be treated, as medical officials prioritized care and improvised solutions in an unprecedented situation.It showed the quality of medical professionals at work in Las Vegas.

But the pandemic presents different challenges. Injuries are not communicable and a pandemic poses a special threat to health care workers and the sustainability of care as cases mount.

“Imagine doing that for two, four, five, six or eight straight weeks,” Schafer said. “But the type of providers we have here are incredible. They are dedicated. They are high-quality. They are up to the challenge.”

The pandemic may quickly become a nightmare here if the resources run dry. That’s why Gov. Steve Sisolak and others are stressing that people stay at home and avoid putting themselves at risk of being infected with the coronavirus.

“When you see these dates (of capacity), it’s not a joke,” Castillo said. “Individually, no matter your background or profession, the best you can do is stay at home. Limit the times you are out there. Our model can only emphasize the continued strain on health systems that is unmanageable.”