Stunned by projections that coronavirus victims could take up as many as 20% of Oregon’s hospital beds in less than a month, Oregon hospital executives are partnering to use their resources in a coordinated way to handle a surge of Oregonians who may soon need hospitalization.

Gov. Kate Brown Brown unveiled the new unified structure at a press conference Monday. She also said she was issuing a new executive order that calls for the statewide cancellation of all gatherings of 25 or more people. She will also ask restaurants to restrict their business to carry out and delivery only.

Brown said she was instituting the measures to decrease transmission of the virus, flatten the curve of those infected, preserve existing hospital capacity and limit the economic impact of the virus.

The governor acknowledged that the measures would have ripple effects across the state, but said “working together we can overcome these hurdles in an Oregon way.”

Hospital leaders had met with Brown over the weekend in hopes of taking a broader leadership role in the state’s coronavirus response. Their new sense of urgency was informed in part by a report from an OHSU researcher that contains alarming statistics concerning the number of expected COVID-19 cases and the capability of Oregon hospitals to handle them.

Peter Graven, Ph.D., lead data scientist at OHSU and affiliate research assistant professor in the OHSU-Portland State University School of Public Health, predicted that the number of Oregonians infected with COVID-19 will double every 6.2 days, and about 20% of those infected will require hospitalization. Based on those numbers, researchers predict that the state will see a spike in demand for hospital beds in coming weeks. Graven’s modeling showed that by April 11, Oregon hospitals may need an additional 1,000 hospital beds and 400 intensive care unit beds.

As it stands, Oregon has 6,729 staffed hospital beds and 776 ICU beds.

“Our goal is to prevent that surge, so that we don’t actually have the rise and potential peak that this model predicts,” said Renee Edwards, the chief medical officer for Oregon Health & Science University.

In an unprecedented move, the Portland area’s four major health systems say they are uniting to form a regional health system “to implement a coordinated response” to the virus.

Providence Health Systems, Kaiser Permanente, Legacy Health and Oregon Health and Sciences University are all part of the new coalition. Among other things, the new unified operation proposes to bolster existing frontline staffers by providing childcare for current workers, and by activating recent retirees, reserves and potential candidates now working outside of hospitals.

The health care systems plan to jointly manage their inventory of beds and scarce resources such as ventilators, masks and other personal protection equipment.

As testing kits remain in short supply, the hospital leaders said they will align their criteria for testing. They will also coordinate and collaborate to eliminate non-essential surgeries and procedures to preserve bed capacity and equipment, including masks, gowns and gloves.

“This is not just a Portland based solution,” Edwards said. “It will be helpful to other hospitals across the state.”

Brown said Monday that the state made an emergency request to federal authorities for additional medical equipment to be drawn from the national stockpile. Only 10% that request has been met, she said, though she said she expects an additional 15% of the request fulfilled in coming days.

Oregon Health Authority Chief Medical Officer Dana Hargunani stressed that the social distancing measures the governor was announcing were “necessary, urgent and justified."

“If we don’t act now,” she said. "75,000 Oregonians could contract this by May 1.”

Hargunani said Oregon has an existing plan to manage a pandemic. The plan provides a blueprint on how to manage a surge in demand, how to quickly expand capacity, locate alternates sites for medical care, and give health care professionals guidance on how to manage some of the ethical dilemmas they may face.

Former Oregon Gov. John Kitzhaber had raised alarms about Oregon’s response to the coronavirus over the weekend. The former emergency room doctor wrote on his website Sunday that Oregon is “far behind the curve” in working to expand the capacity of the health care system and in helping Oregonians respond to the pandemic.

“This is a true emergency,” he wrote.

Kitzhaber made it clear Monday that he was not speaking for the industry. But he said his bottom-line concern is simple: The number of potential patients far outstrips the 6,700 hospital beds in Oregon. It will take extraordinary steps by the state’s hospitals and health systems to handle that imbalance.

“I believe we can manage our way through this,” Kitzhaber said. “It’s very important to communicate, to let everyone know what the plan is."

Clearly, COVID-19 has taken the entire nation’s health system by surprise. The United States has only 2.8 beds for every 1,000 people, according to the Organization for Economic Co-operation and Development. In contrast, the two countries with the largest outbreaks have more beds for its patients: Italy has 3.2 beds for every 1,000 patients and China, 4.3 beds.

Ventilators, too, are in short supply. There are about 160,000 ventilators available in the U.S., according to the latest available figures in a Center for Health Security at Johns Hopkins February report. Across Oregon, there are 688 ventilators.

Oregon Health Sciences University confirmed it is looking to buy additional ventilators.

Staffing is also a problem. Nurses complain that their crews were already short. Now, given the surge in patients and the likelihood that some of them will get too sick to work, the shortage is sure to worsen.

To prevent coronavirus cases from overwhelming the system, the nation’s health officials are attempting to “flatten the curve.” That flattening of the curve -- or the slowing down the spread of the virus -- is intended to ensure key players, such as health care systems, have the resources they need.

Hence, Brown’s decision to ban mass gatherings, close schools, cancel athletic events and urge everyone to practice social distancing.

Oregon’s hospitals have already been struggling. Nurses and other health care workers have complained that personal protective equipment is in short supply, as well as their training in how to use what they’ve got.

Yet researchers have looked at how to prepare Oregon for a pandemic in the past -- and how to gauge their potential impacts.

A 2008 state Emergency Management Plan includes a section on pandemic influenza that reads like a blueprint for what the governor has done so far: Prohibit mass gatherings, close schools and ask citizens to maintain social distancing – all in hopes of reducing the spread.

If those strategies don’t meaningfully reduce the scope of the virus, the predictions are extremely serious. In the case of a “severe” pandemic, the emergency plan predicts, 1.27 million Oregonians could get ill, more than 150,000 could require hospitalization, 22,913 could need time in intensive care and more than 25,000 could die.

In a moderate pandemic, the numbers would be far lower: 12,206 people ill enough to be hospitalized and just more than 2,500 deaths.

Yet pandemics generally don’t end quickly. The emergency plan predicts that in each individual community, a pandemic outbreak may last up to twelve weeks and may occur in distinct outbreaks or “waves” separated by weeks or months over a period of up to 18 months.

And unlike the mutual aid that normally occurs with other natural disasters, outbreaks expected across the country make that less likely.

The good news with the coronavirus is that of those who contract the virus, 80% are expected to recover. Many will not even know they had the virus. For the other 20 percent, the scenario is not good.

Worldwide, the death toll has surpassed 6,500. In Oregon, 47 people have COVID-19, one has died.

-- jmanning@oregonian.com

503-294-7606

-- Ted Sickinger; tsickinger@oregonian.com; 503-221-8505; @tedsickinger

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