Texas hospitals take steps to accommodate COVID-19 case surge


Eli Kirshbaum


As COVID-19 hospitalizations increase at their fastest rate ever and facilities confront severe capacity strains, Texas hospitals are implementing measures to fight the impacts of the recent Delta variant-fueled wave of COVID-19 cases.

Total hospitalizations in the state increased from 1,500 in June to over 10,000 in August so far. The seven-day average of COVID cases rose from below 1,000 to over 12,000 between June and August.


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A graph of the state’s COVID cases since March of 2020, from the Texas Department of State Health Services:


Image: Texas Department of State Health Services


In response to an order from Gov. Greg Abbott on Monday, hospitals — among other measures — are postponing elective procedures in order to focus their resources on accommodating the increasing number of COVID-19 patients. Some facilities are closing their emergency rooms in order to transfer their staff to facilities where they can help treat COVID patients.

In a letter to the Texas Hospital Association, Abbott said:

“I am asking Texas hospitals to take steps to ensure the availability of adequate hospital capacity to care for COVID-19 patients. Among other strategies, hospitals could voluntarily postpone medical procedures for which delay will not result in loss of life or a deterioration in the patient’s condition. Hospitals could also refer some COVID-19 patients to infusion sites, thereby freeing up hospital beds for more serious cases.”

The halt of certain medical services has consequences for individuals with non-COVID-related health issues, as illustrated by this tweet from a Texan whose mother was in dire need of care on Saturday.



In addition to capacity concerns, hospitals are also facing an understaffed health care workforce. The Texas Department of State Health Services (DSHS) Center for Nursing Workforce Studies found the state to be 27,000 registered nurses short, and predicts a shortage of 57,000 by 2032. COVID — of course — only worsens this issue.

Already short on money, many hospitals don’t have the financial capacity to hire additional nurses. Some nurses are also leaving the profession due to COVID-19. Abbott’s office said it’s “utilizing staffing agencies” to bring nurses from other states into Texas to help. He also recently announced the deployment of 2,500 medical personnel to help hospitals.

The Texas Nurses Association told State of Reform that increasing the nurse workforce will be helpful, but the primary way to help nurses is to get vaccinated.

“Nurses are caring for increasing numbers of critically ill patients with COVID-19, more than 95% of whom are unvaccinated. The lack of a coordinated crisis staffing effort has made this situation especially challenging. While it helps to bring nurses in from other states, COVID cases have been increasing nationwide. Until most of the population is vaccinated, we will continue to see spikes that strain the health care system, putting all Texans at risk. “

State hospitalizations are particularly prevalent among children. While they generally experience less severe symptoms than adults, the Delta variant’s high transmissibility is leading to high COVID rates among children. Pediatric COVID hospitalizations in the Dallas-Fort Worth region are at their highest levels ever, according to Steve Love, President and CEO of the Dallas-Fort Worth Hospital Council.

“…the [Dallas-Fort Worth region’s] children’s hospitals are treating an unusual number of RSV patients for the summer season. The overall percent occupancy of all inpatient pediatric patients to bed capacity is currently running [at] 97.60 percent and we only have 2 pediatric ICU beds available in Trauma Service Area E. We have 150 pediatric patients on ventilators.”

John Hellerstadt, commissioner of the Texas Department of Health and Human Services, testified before the Senate Health and Human Services Committee during a meeting convened on Tuesday to hear from stakeholders about increasing strains on hospital capacity. Hellerstadt highlighted the magnitude of climbing hospitalizations among children.

“That [pediatric hospitalizations] is very worrisome because if you look back into the January timeframe … you can see that we have now actually exceeded the total number of pediatric admissions to hospitals in a very short period of time.”

COVID vaccines are still undergoing trials before being approved for children under 12, exacerbating the issue by making these children particularly vulnerable to the disease. In an effort to protect its patients, Texas Children’s Hospital followed in the steps of numerous other state facilities and announced Wednesday it will require all of its staff to be fully vaccinated by Sept. 21.

Memorial Hermann Hospital, which also recently mandated vaccines for employees, addressed children’s vulnerability to the recent wave in a statement.

“Currently, children under 12 years old are ineligible for the COVID-19 vaccines and, as such, are vulnerable and unprotected. Young people are being hospitalized for COVID-19 in growing numbers, staying longer and are sicker than we have seen at any other time during the pandemic.”