Every day at 3:30 p.m., leaders of health care systems in 13 counties around the Akron-Canton region join a phone call to discuss how they are preparing for the upcoming surge of coronavirus patients who will need to be hospitalized.

Their goal is to make sure their hospitals are prepared with enough inpatient beds and ventilators, personal protective equipment and even potentially community sites to be used for the sickest patients in the coming weeks.

The health care system CEOs and top leaders are from what’s called the Northeast Central Ohio Region 5, an area stretching from "Youngstown, Akron, Canton, all the way to Mansfield and down to Holmes and Tuscarawas counties," said Grace Wakulchik, president and chief executive officer of Akron Children’s Hospital.

Wakulchik is also chair of the Akron Regional Hospital Association, which has 14 hospital members in the Akron-Canton region and is part of the larger, 43-member Region 5 area.

The daily calls started on March 13 with CEOs of the Akron regional group, including the Summit County Public Health Department, but that quickly grew to include partners such as Akron Mayor Dan Horrigan and other regional leaders. More recently, that daily call now has CEOs from 25 to 30 hospitals, health systems or rehabilitation hospitals in the region, said Wakulchik.

"The cooperation and collaboration from everyone in all the counties and the cities has been phenomenal," Wakulchik said in an interview Tuesday. If another call other than the daily call is needed, "everyone gets on the line. It's been absolutely amazing."

The regional group is focusing on three things: increasing inpatient hospital capacity, boosting capacity outside of hospitals and setting up a regional surge management center.

Dr. John Crow, Akron Children’s associate chief medical officer and head of surgery and the burn institute, is leading the Northeast Central Ohio Region 5 subgroup preparing for the COVID-19 "patient load surge" — the expected peak of patients who need hospitalization.

The latest estimates from the state for Region 5’s peak of COVID-19 patients needing to be hospitalized is between the third week of April and the first week of May, Wakulchik said.

Crow said "we want (the surge) closer to May because that means the health care systems are less burdened."

Added Wakulchik: "We’re hoping, quite honestly, that people are listening to the governor and staying home, washing their hands and keeping socially distant. That means for us we can impact the timing of the surge...we want it to be as little as possible."

A surge of cases still will happen, but hopefully the peak will be much smaller because of the stay-at-home order and other efforts to slow the spread of the virus, Crow said.

"The surge will be made up of everyday people in general. With the communicability being so high, with a long carrier state where people don’t know they have it and a long time of shedding the virus, all of the social distancing measures cannot completely eliminate the spread among the community," he said.

Crow said there is a significant percentage that will need hospitalization so the higher numbers in the community, the more admissions.

"A simple touch of the face after touching a surface where the virus has been deposited by sneeze or cough or inadequate hand washing is enough to get the infection," he said.

"The highest-risk people due to age or health conditions are more likely to become sick enough to need ICU care or even die. But it can happen to anyone, even if previously healthy. The health care workers are more at risk due to exposure. Areas where people live in close contact (nursing homes, prisons) are more likely to be infected due to close proximity," he said.

Surge levels

There are three levels of surge operation classifications, Crow said. Level 1 is normal institutional planning.

The region now is at Level 2, which involves contingency and capacity planning, "where you look at where you can open up new places outside your own institution," Crow said.

Recently, inpatient bed capacity has increased about 250 percent across the region between regular and ICU beds as well as beds at long-term rehabilitation hospital facilities owned by Select Specialty hospitals in Akron, Boardman, Canton, Warren and Youngstown. The facilities can care for patients on ventilators, said Crow.

Level 3 would be crisis capacity. New York — and perhaps Detroit — at at this stage, Crow said, "when you start to open up other sites outside of hospitals, such as college dorms, hotels. We’ve started working on that."

In Summit County, Wakulchik said while discussions have been taking place with the health department, there are no formal plans in place yet for using buildings outside of the hospitals.

"Of course, we’re looking at all kinds of options," she said.

Unprecedented collaboration

The collaboration among local and regional health-care leaders is one of the positive outcomes of this whole pandemic, Wakulchik said.

CEOs are evaluating how physicians and other staff who wouldn’t normally work with COVID-19 patients, such as Children’s Hospital pediatricians or Crystal Clinic orthopedic surgeons, can be helpful once the surge hits, she said.

"As this happened, one of the benefits is I talk to (the other CEOs) every day," said Wakulchik. "I’ve never talked to them this much before. It’s upped the collaboration and camaraderie in this region.

"We’re going to all be better for that," she said. "We’ve dropped all the competition and are trying to work together to try to provide the best care we can for patients and families of this region."

Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.beaconjournal.com/topics/linfisher