Nashville Hospitals Are Seeing ‘Sickest Patients’ Yet From COVID-19

Nashville’s hospital system is bracing for the coming surge of COVID-19 patients as cases spike in Tennessee. While capacity hasn’t been a problem, they say the people they’re treating are the sickest they’ve seen.

For many, even a ventilator isn’t enough. Some are requiring “prone ventilation,” where patients are placed on their stomachs. Hospitals have special beds that can turn patients, but when one isn’t available nurses are having to turn patients manually. As a last resort, some are also being placed on an ECMO machine where their blood is oxygenated outside their body.

“It may be easy to think of yourself as invulnerable to this experience,” says Dr. Brett Campbell, a critical care anesthesiologist from Ascension Saint Thomas. “But I’d ask you to consider that our highest ICU volumes for our hospital and the highest acuity — that means the sickest patients — have come in the last few weeks.”

Campbell says these patients tend to be beyond middle age. Nashville has had a 10% mortality rate for patients with diagnosed cases of COVID-19 who are over age 65.

In the last two days, Davidson County hospitals have admitted at least 30 new patients with COVID-19, bringing the total to 188. They’re still well under their capacity, and no hospital has initiated its internal surge plan. But they say they may have to in the coming weeks.

If that capacity is taken, the state could decide to open the city’s alternate care site, which was built on several unused floors of Nashville General Hospital.

Statewide, the capacity for open beds is hovering around 20%, which public health officials have used as a cutoff for what’s considered acceptable. But beds are becoming a problem in some pockets. Jackson-Madison County General Hospital is close to reaching capacity of its ICU. But hospitalizations are as high as they’ve ever been, with 65 patients added statewide on Thursday.

Tennessee Health Commissioner Dr. Lisa Piercey said Wednesday the more pressing concern is whether there will be enough staff to take care of the growing number of patients.

The good news? People who are hospitalized are becoming more likely to survive, because a lot has been learned in the last four months.

“The sheer volume of global cases has led to a flood of experience and scientific learning that has made us better at treating this virus, in particular,” says Campbell of Ascension Saint Thomas.

But he points out that the disease is “preventable” through social distancing and protective equipment like face coverings.