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Oregon has fewest hospital beds per capita in U.S.

Oregon’s expanded Medicaid system, which cares for one in four residents, has worked to improve access to primary care and reduce the need for expensive hospitalization.

But the goal of improving the health of more low-income people has a drawback in the age of COVID-19. The state has only 1.6 beds per 1,000 residents, according to Kaiser Family Foundation.

That’s the lowest ratio in the country.

By next month, Oregon might not have enough capacity to treat the expected numbers of coronavirus patients, Dr. Renee Edwards, vice president and chief medical officer at Oregon Health & Science University, said at a news conference Monday.

Data specialists at OHSU and the Oregon Health Authority expect coronavirus cases to double every 6.2 days. By April 11, Oregon will need 1,000 hospital beds and 400 intensive care beds to serve those patients.

The state has 6,600 licensed beds, including about 1,000 for intensive care, though many of those are designated for cardiac and neonatal patients, according to the Oregon Association of Hospitals and Health Systems. Emergency departments are also “boarding” mental health patients who end up camped out in rooms, requiring extra staff, because they have nowhere else to go.

Then there’s this: The 62 hospitals in the state already run at about 65% of capacity without treating coronavirus patients, and some hospitals, such as OHSU, face even higher demand.

“Without a significant slowing of COVID-19, Oregon will not be able to serve the hospital needs of Oregonians without creating more beds,” Edwards said.

In the Rogue Valley, Asante is taking action now to help slow the expected surge of new patients. The health care system operates the Asante Rogue Regional Medical Center in Medford, the Asante Ashland Community Hospital, the Asante Three Rivers Medical Center in Grants Pass and other health care facilities.

Asante has opened a mobile collection site in a tent in Medford to test people for coronavirus.

Hospitals across Oregon and the nation are setting up tents to add services and treatment capacity.

Local people who contact health care providers and meet COVID-19 symptom criteria will receive a doctor’s order to be tested at the Asante tent. People cannot just show up and ask for a test, said Asante Senior Public Relations Specialist Lauren Van Sickle.

“We’ve opened a mobile collection site at a location away from our hospitals to reduce the risk of exposing people to the disease,” she said on Tuesday. “Having the mobile site moves people out of doctors’ clinics, urgent care and emergency departments where there is a higher risk of exposing others.”

Staff members will conduct nasal swabs on patients and send specimens to a commercial lab for testing. Patients who test positive will be notified along with public health officials. Public health workers will contact patients about quarantine restrictions and other health safeguards they should adopt, Van Sickle said.

Patients who arrive at Asante’s emergency departments are being triaged before they go into the department. The process allows health care workers to identify people with COVID-19 or flu symptoms so their health concerns can be addressed immediately without exposing others in waiting rooms, Van Sickle said.

People who are ill with a fever, cough and shortness of breath but who are not experiencing a medical emergency can call their health care provider or Asante’s COVID-19 hotline at 541-789-2813 before they visit a medical clinic or emergency department. Receiving appropriate care while at home can reduce the chance of spreading the virus, Van Sickle said.

Meanwhile, under an agreement announced Monday, the Portland area’s four hospital systems — Legacy Health, Kaiser Permanente, Providence Health & Services and OHSU, which includes Adventist Health Portland and Tuality Healthcare — are working with the Oregon Health Authority in an unprecedented joint effort to coordinate beds, add capacity and share resources.

The effort is just getting started, and it won’t be enough. State officials said all residents must also pitch in to prevent disaster.

“We’re working hard to prepare for this surge, but we absolutely need your help,” Edwards said. “Social distancing works.”

Gov. Kate Brown announced new measures Monday to encourage people to avoid crowds. She canceled all events of 25 people or more and recommended that gatherings be limited to 10. She also ordered all bars and restaurants to limit service to takeaway or delivery starting Tuesday for at least four weeks.

That comes on top of school closures through at least April 28 that were announced Tuesday.

Grocery stores, pharmacies and workplaces will remain open, though many employees are now working from home.

Hospitals, which are on the frontlines, are scrambling to create more beds.

At Providence, administrators told providers to delay for six weeks any procedure that doesn’t risk significant risk to life or limb. OHSU is postponing all non-urgent procedures indefinitely, and Kaiser Permanente did the same, including postponing dental treatments that are not urgent. Legacy Health did not respond to a request for comment from The Lund Report.

The state has a limited supply of ventilators — 688 — and a 510 negative pressure isolation rooms, which are needed for coronavirus patients to prevent contaminated air from infecting other patients and staff. About half are in the Portland area. But Kaiser Permanente has the capability to convert entire floors in its hospitals into negative pressure rooms, Foley said.

At OHSU, workers Monday were converting the auditorium in the main hospital into a ward by tearing out chairs and putting in beds and medical dispensers.

Besides adding and shifting beds on-site, hospitals may need to move patients who don’t require critical care to clinics or other facilities to free up intensive care units.

That could include moving patients who need rehab to another facility.

“Displacement” is a term that Oregonians might have to get used to. Another word that’s becoming all too common: “shortage.”

In two weeks, the Portland metro area will run out of the disposable gowns, gloves and masks that are crucial for health care workers, Dr. Jennifer Vines, tri-county lead health officer, announced Tuesday. She said the county is pursuing ways to conserve scarce supplies and find ways to create more supplies.

“There is definitely fear,” Vines said Tuesday about frontline health care workers. “There is concern about the lack of personal protective equipment.”

A lack of supplies and beds could mean that health care workers have to “triage,” prioritize patients who most urgently need care.

Overloaded hospitals might have to erect tents outside — as Providence St. Vincent recently did and Kaiser Permanente Medical Center is preparing to do — to triage patients and determine which are in the most dire need of care.

Edwards said the Portland-area hospital collaboration will help rural hospitals as well because they, too, could become overwhelmed. Cases are popping up across the state. As of Tuesday, there were 65 cases, with 18 new patients in Benton, Deschutes, Clackamas, Marion, Multnomah and Washington counties.

This article was provided by The Lund Report, one of more than a dozen news organizations throughout the state sharing their coverage of the novel coronavirus outbreak to help inform Oregonians about this evolving heath issue. Medford Mail Tribune reporter Vickie Aldous contributed Medford-area information to this report.

Jamie Lusch / Mail TribuneA tent is set up Tuesday outside the emergency room at Providence Medford Medical Center in Medford.