tmc covid-19 monitoring metrics - tmc houston...2020/10/02 · 10 16 28 30 2,000 2,500 1,500 14,500...

October 2, 2020

Daily report

TMC COVID-19 MONITORING METRICS

This document is solely intended to share insights and best practices rather than specific recommendations. Individual institution data is shown as reported and has not been independently verified

2

TMC KEY TAKEAWAYS FOR OCTOBER 1, 2020

1. https://sph.uth.edu/dept/bads/covid19-dashboard2. Source: TX Health and Human Services (https://dshs.texas.gov/coronavirus/AdditionalData.aspx3. Testing positivity charts from the TMC hospital systems have been added to the daily metrics, in addition to the charts presented from the Texas Department of State Health Services data for the Greater Houston Area. Values from the most recent week may be

updated as new test data is compiled.4. Source: Internal data collected from the systems CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB

R(t) for the Greater Houston Area (9-county MSA) is 0.771

‒ This was the twenty-second day below 1.0, which means the virus spread is decreasing. Compared to: ‒ Last week, R(t) was 0.70 for Greater Houston Area

Effective Reproduction

Rate, R(t)1

Testing The current 7-day average COVID-19 testing positivity rate is 3.3% for TMC hospital systems. Compared to:‒ Last week3: 3.4%‒ Last month: 5.7%

2

New cases

Yesterday, 388 new people2 were reported as testing positive for COVID-19 in the Greater Houston Area. DSHS also released 228 older cases recently reported as of yesterday. Compared to: ‒ Last week: 373 new cases/day ‒ Last month: 1,415 new cases/day

3

Yesterday, TMC admitted 81 new COVID-19 patients in TMC hospital institutions4. Compared to: ‒ Last week: 78 hospitalizations/day‒ Last month: 88 hospitalizations/day

Hospitalizations4

As of October 3rd, TMC’s ICU Phase 1 (non-pandemic configurations) is 88% full, and TMC is not into Phase 2 plans for intensive care. ICU capacity5

https://dshs.texas.gov/coronavirus/AdditionalData.aspx


3

R(t): EFFECTIVE REPRODUCTION RATE FOR THE GREATER HOUSTON MSA1

Community Control 1.0

October 1, 2020

R(t) measures how effective our collective behaviors (e.g., mask wearing and social distancing) are in slowing the growth of the virus. It is the average number of people who become infected by one infectious person. If R(t) is above 1.0, the virus spread is increasing; if R(t) is below 1.0, the virus spread is slowing.

Last Week: 0.70 for Greater Houston MSA

1. https://sph.uth.edu/dept/bads/covid19-dashboard

Community Control:


4

TEST POSITIVITY RATES FOR TMC HOSPITAL SYSTEMS1A low positivity rate may indicate declining spread of the virus.

Community Control 5%

Today: 3.3%22 Days < 5%

Community Control:

5This document is solely intended to share insights and best practices rather than specific recommendations. Individual institution data is shown as reported and has not been independently verified

COVID-19 TESTING September 30, 2020

2,67

1

2,77

9

3,04

8

3,02

8

3,02

1

3,01

8

2,57

8

2,64

3

2,70

1

2,75

9

2,79

7

2,81

1

2,82

5

3,23

9

3,15

3

3,12

1

3,10

6

3,06

6

3,05

2

3,02

8

3,00

6

2,85

5

2,82

4

2,94

5

2,92

5

2,92

3

2,93

5

2,93

4

2,91

7

2,59

0

0

1

2

3

4

5

6

0

500

1,000

1,500

2,000

2,500

3,000

3,500

9/29

9/28

9/25

9/24

9/23

9/22

9/21

9/19

9/189/

6

9/17

9/16

9/20

9/15

9/11

9/129/

2

9/7

9/279/

4

9/139/

1

9/3

9/149/

5

9/8

9/9

9/10

9/30

9/26

0

5

10

15

20

25

0

500

1,000

1,500

2,000

2,500

3,000

3,500 22.9%

TMC hospital systems COVID-19 average daily tests performed, last 30 days

COVID-19 TESTING METRICS FOR TMC HOSPITAL SYSTEMS

TMC1 COVID-19 average daily tests performed

“TMC” refers to the group of systems that make up Texas Medical Center

Positivity rates across TMC hospital systems increased from 5% on June 1st to a peak of 23% on July 9th

The current 7-day average testing positivity rate across TMC hospital systems1 is 3.3%.

Notes:

Recent values will be updated each day as new test results are compiled

Test data provided daily from TMC1 hospital systems

1. Testing data includes: CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, and UT HealthNote: May not include all hospitals within each system

7-Day Trend

2

Apr May Jun Jul Aug Sep

Sep daily administered tests reported 7-dy trend of % test positivity for COVID-19


6

WEEKLY AVERAGE OF COVID-19 TESTING METRICS ACROSS TMC HOSPITAL SYSTEMS

768

1,481 1,5021,751

3,084

3,4443,182

2,9522,747

2,794 2,723 2,7942,551

3,1072,904

2,594 2,673

20

500

1,500

3,000

22

1,000

2,000

0

2

184,000

0

3,500

8

2,500

4,500

5,000

6

4

10

14

16

24

12

5.1%5.5%

Week 15(6/29-7/5)

Week 8(5/11-5/17)

Week 6(4/27-5/3)

Week 11(6/1-6/7)

Week 5(4/20-4/26)

Week 10(5/25-5/31)

7.2%5.7%

Week 14(6/22-6/28)

Week 22(8/17-8/23)

Week 9(5/18-5/24)

8.7%

6.3%

Week 12(6/8-6/14)

10.6%

Week 23(8/24-8/30)

5.3%

1,388

Week 16(7/6-7/12)

18.7%

14.8%

Week 13(6/15-6/21)

3,272

22.3%21.2%

Week 7(5/4-5/10)

Week 19(7/27-8/2)

Week 17(7/13-7/19)

3.4%

16.8%

5.7%4.6%

5.8%

20.3%

Week 18(7/20-7/26)

2,612

1,250

Week 20(8/3-8/9)

13.9%

Week 25(9/7-9/13)

3.4%

Week 24(8/31-9/6)

4.0%

Week 21(8/10-8/16)

Week 27 (9/21-9/27)

6.7%

Week 26(9/14-9/20)

10.2%

COVID-19 TESTING


September 30, 2020

1. Testing data includes: CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, and UT HealthNote: May not include all hospitals within each system

Note: The most recent week may be updated as new test data is compiled.

2

7-day trend of % test positivity for COVID-197-day trend of daily # of tests performed


7

DAILY NEW COVID-19 POSITIVE CASES FOR THE GREATER HOUSTON AREAMeasures the public health strategy shift from mitigation to containment. When the number of new daily cases is over 200, it is difficult for public health teams to effectively trace to help isolate further spread of the virus.

Community Control 200

Last Week: 373

1.Source: TX Health and Human Services (https://www.dshs.texas.gov/coronavirus/): Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller

October 1, 2020

Community Control:


DAILY NEW COVID-19 POSITIVE CASESGreater Houston Area1

Source: TX Health and Human Services (https://www.dshs.texas.gov/coronavirus/)1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller

Monitoring threshold:

Threshold is exceeded by the occurrence of a positive daily growth rate (averaged over 7 days) in the new daily case trend

Current status:

0 days of positive daily growth rate (averaged over 7 days) in the new daily case trend

October 1, 2020


1,20

0

803

1,04

6

1,23

7

1,19

7

851

66 1,0

08

1,06

9

1,15

4

705 1,03

2

1,45

9

585

626 785

589 79

1

361 56

8

357

328

366

413

219 28

6

325

388

27

168

56 59 3

55 426 2,52

0

340 224 43

8

613

241 31

3

234

316

2281,000

1,500

2,000

3,000

500

2,500

14,500

0

9/179/

8

28

260

13,6

22

9/7

9/6

9/4

10/19/2

9/11

1,41

29/

12

9/22

9/15

9/20

9/14

9/259/

5

543

9/9

9/3

365

9/18

9/19

328

9/26

385

9/21

475

9/23

9/24

9/13

9/27

9/29

10

9/28

9/16

9/30

9/10

2,000

2,500

1,500

14,500

1,000

0

500

3,000

Daily new COVID-19 cases last 30 days, Houston MSA

Daily new COVID-19 cases, Houston MSA

COVID-19 CASE TRENDS3


Older cases released7-Day Trend of Cases

7-Day Trend of Cases

Older cases releasedSep - daily increase COVID-19 positive cases

Oct - daily increase COVID-19 positive cases

Oct

https://www.dshs.texas.gov/coronavirus/


9

WEEKLY AVERAGE OF DAILY NEW COVID-19 POSITIVE CASES

97194

415234 215 232 227 246 290 267

407 400

962

1,598

1,360

1,776

2,366

1,8182,043 1,992

1,701

1,453 1,415

1,122986

373

Week 26

(9/14-9/20)

Week 25

(9/7 -9/13)

Week 24

(8/31-9/6)

Week 27

(9/21-9/27)

Week 23

(8/24-8/30)

Week 22

(8/17-8/23)

Week 20

(8/3-8/9)

Week 12

(6/8-6/14)

Week 21

(8/10-8/16)

Week 15

(6/29-7/5)

Week 18

(7/20-7/26)

Week 14

(6/22-6/28)

Week 1

(3/23-3/29)

Week 8

(5/11-5/17)

Week 13

(6/15-6/21)

Week 5

(4/20-4/26)

Week 11

(6/1-6/7)

Week 17

(7/13-7/19)

Week 9

(5/18-5/24)

Week 3

(4/6-4/12)

Week 10

(5/25-5/31)

Week 6

(4/27-5/3)

Week 7

(5/4-5/10)

Week 4

(4/13-4/19)

Week 19

(7/27-8/2)

Week 2

(3/30-4/5)

8382

Week 16

(7/6-7/12)

# Daily average new cases in Greater Houston Area1 (Monday-Sunday)

1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller2. Includes only net new cases. Excludes 4,135 cases reported by the state as “old” cases during week of 9/14


October 1, 2020COVID-19 CASE TRENDS3


COVID-19 POSITIVE CUMULATIVE CASES• There have been

198,152 total positive COVID-19 cases to date

• Cumulative case load is ~1.0X what it was 7 days ago

0

50,000

100,000

150,000

200,000

Greater Houston Area1

October 1, 2020

“TMC” refers to the group of systems that make up Texas Medical Center Source: TX Health and Human Services (https://www.dshs.texas.gov/coronavirus/)1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller

155,

552

156,

365

157,

438

158,

703

159,

900

160,

751

160,

817

161,

825

163,

062

164,

272

165,

743

166,

803

167,

835

169,

294

170,

305

173,

451

174,

496

175,

450

176,

581

177,

166

178,

062

192,

041

192,

754

193,

558

194,

446

195,

278

195,

805

196,

443

197,

536

198,

152

355

426

2,52

0

365

340

328 13

,622

385

438

475

613

313

316

0

50,000

100,000

150,000

200,000

09/2

2

09/2

0

260

09/2

4

09/1

8

09/1

6

09/1

4

09/2

1

09/3

0

09/1

5

234

09/1

3

09/1

2

09/1

1

09/0

9

09/0

4

10/0

1

59

224

56

09/0

2

09/1

7

168

09/0

6

09/0

5

09/0

8

09/2

3

2709

/03

09/1

0

09/2

7

09/2

5

09/1

9

09/2

6

10

09/0

7

241

09/2

8

28

09/2

9

228

Cumulative COVID-19 positive cases last 30 days

Cumulative COVID-19 cases

COVID-19 CASE TRENDS3


Oct daily cumulative cases Old cases reportedSep daily cumulative cases

Texas DSHS released 13,622 in older cases on 9/22

Oct

https://www.dshs.texas.gov/coronavirus/


TMC DAILY NEW COVID-19 HOSPITALIZATIONSOctober 1, 2020

116

112

107 1

30

78

45

94

111

59

48

112

76

135

97

57

102

86 81 85

62

91

80 88

76

97

52

78 71 62

81

0

20

40

60

80

100

120

140

9/30

9/27

9/25

9/23

9/21

9/22

9/26

9/199/

4

9/18

9/17

9/16

9/15

10/19/6

9/14

9/129/

7

9/119/

2

9/109/

8

9/29

9/28

9/209/

3

9/249/

9

9/5

9/13

0

100

200

300

400

500

TMC Daily new COVID-19 hospitalizations, last 30 daysMonitoring threshold:Threshold is exceeded by the occurrence of a positive daily growth rate, averaged over 7 days

Current status: -1.7% daily growth rate (averaged over 7 days) in the COVID-19 daily hospital admissions trend

Notes:While new daily cases may fluctuate for a variety of reasons (e.g., testing), the daily hospitalization trend shows an objective view of how COVID-19 impacts hospital systems


Source: TMC institution clinical census

TMC daily new COVID-19 hospitalizations (ICU and Med/Surg)

4

7-Day Trend of Cases

COVID-19 TMC HOSPITALIZATION TRENDS


Oct daily new hospitalizations 7-Day trend of casesSep daily new hospitalizations

Oct


12

WEEKLY AVERAGE OF TMC DAILY NEW COVID-19 HOSPITALIZATIONS

5882

58 50 50 49 4255 63

80101

186

252

360346

296270

197

165147

120

88105

7892

78

Week 27

(9/21-9/27)

Week 23

(8/24-8/30)

Week 20

(8/3-8/9)

Week 21

(8/10-8/16)

Week 2

(3/30-4/5)

Week 19

(7/27-8/2)

Week 4

(4/13-4/19)

Week 11

(6/1-6/7)

Week 16

(7/6-7/12)

Week 22

(8/17-8/23)

Week 24

(8/31-9/6)

Week 18

(7/20-7/26)

Week 12

(6/8-6/14)

Week 7

(5/4-5/10)

Week 9

(5/18-5/24)

Week 17

(7/13-7/19)

Week 1

(3/23-3/29

Week 10

(5/25-5/31)

Week 14

(6/22-6/28)

Week 8

(5/11-5/17)

Week 5

(4/20-4/26)

Week 13

(6/15-6/21)

Week 26

(9/4-9/20)

Week 6

(4/27-5/3)

Week 25

(9/7 -9/13)

Week 15

(6/29-7/5)

Week 3

(4/6-4/12)

# average daily hospitalizations in TMC system (Monday-Sunday)

1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller


Data not

aggre-

gated

October 1, 2020COVID-19 TMC HOSPITALIZATION TRENDS4


TOTAL TMC COVID-19 POSITIVE PATIENTS IN HOSPITAL

2,500

2,000

500

1,500

1,000

0

Source: Internal data collected from the systems CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB“TMC” refers to the group of systems that make up Texas Medical CenterAll guidelines should be in accordance with CDC guidelines

Current status: -1.2% total daily growth rate (averaged over 7 days) in COVID-19 patients TMC hospitals• -0.9% ICU daily growth

rate• -1.4% Med Surg daily

growth rate

Notes:While new daily cases may fluctuate for a variety of reasons (e.g., testing), the number of COVID-19 positive patients being treated in med surg and ICU shows an objective view of how COVID-19 impacts hospital systems

October 1, 2020

7-day trend of COVID-19 patients in ICU & Med Surg

COVID-19 positive patients in TMC hospitals (Med Surg & ICU)

432 423 415 426 410366 374 376 384 346 360 362 353 355 350 359 345 325 327 322 324 315 311 306 306 279 299 298 288 280

265 262 246 224 220225 219 227 207

203 189 182 191 188 186 171 161158 154 158 154 163 174 164 155

164 162 162 159 157

300

50

750

150

200

250

100

500

400

550

600

650

350

450

0

700

09/2

4

09/0

6

09/0

2

09/1

0

09/0

3

09/2

9

09/2

1

09/1

1

10/0

1

09/0

8

09/0

9

09/0

5

09/1

4

09/1

2

09/2

6

09/1

3

09/1

6

09/0

7

09/1

7

09/1

9

09/2

0

09/2

2

09/2

3

09/0

4

09/1

5

09/2

5

09/2

7

09/2

8

09/3

0

09/1

8

7-day trend of COVID-19 patients in ICU & Med SurgOct MS Oct ICUSep ICUSep MS

COVID-19 positive patients in TMC hospitals

COVID-19 TMC HOSPITALIZATION4

Apr May Jun Jul Aug Sep Oct


14

OVERVIEW OF TMC ICU BED CAPACITY AND OCCUPANCY

1,330

373

504

157 – CurrentCOVID-19 ICU patients

1,177 – TotalICU beds occupied

Internal data collected from CHI St Luke’s, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB“TMC” refers to the group of individual hospitals and institutions that make up Texas Medical CenterAll guidelines should be in accordance with CDC guidelines

October 1, 2020

Potential additional Intensive Care capacity

Phase 2 Intensive Care


ICU beds occupied by COVID-19 (%)

Total ICU beds occupied (%)

Phase 1 & 2 Intensive care


7%

9%

12%

53%

69%

88%

Further capacity can be added by converting additional Medical / Surgical beds to ICU


This can be managed by appropriately transferring patients from ICU to Medical / Surgical beds and potentially by delaying some procedures

This capacity is actively managed by each of the hospitals and changes on a minute-by-minute basis

Phase 1 Intensive Care capacity



Phase 1, 2, & 3 Intensive Care

COVID-19 TMC ICU UTILIZATION5


TMC COVID-19 PATIENT SUMMARY• TMC has served

24,805 positive in-patients to date

• Of those served,

21,961 patients have been successfully discharged

October 1, 2020

24,805

2,407

21,961

DeathsDischargedCurrently hospitalized

437

Total hospitalized 2

Day/day: 0% -2% 0% 0%Week/week: 2% -10% 2% 2%

1. Persons under investigation for COVID-19 but not yet confirmed2. Houston MSA includes 9 counties: Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and WallerSource: Internal data collected from the systems CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB

COVID-19 positive patients (excludes PUIs1) through TMC system2


COVID-19 TMC IMPACT SUMMARY


16

APPENDIXAS OF SEPTEMBER 30, 2020


Data from Texas Department of State Health Services

2

4

26,000

4,000

16

2,000

26

10,000

22,000

24,000

30,000

10

6

12

8,000

0

12,000

14

22

8

32,000

16,000

20

20,000

28

24

18,000

6,000

14,000

28,000

0

18

08/0

3

08/1

3

08/0

208

/01

23%

08/0

5

07/3

0

08/2

5

07/2

807

/27

06/2

3

15%

09/1

4

07/2

0

25%

07/1

6

5%

07/1

5

09/1

5

07/1

4

09/1

0

07/1

1

06/1

8

07/1

0

9%

07/0

9

08/0

4

07/0

807

/07

07/2

6

07/0

4

07/1

7

08/1

4

06/2

4

07/0

307

/02

09/2

0

06/2

8

06/2

6

7%

07/1

3

06/2

7

08/1

0

22%

08/2

4

07/1

2

06/2

5

06/2

2

06/2

0

07/2

1

07/0

5

09/2

9

06/1

6

08/2

6

08/1

1

06/1

406

/13

08/1

8

06/1

1

06/0

8

06/1

0

6%

09/1

3

06/1

2

06/0

7

09/0

7

06/2

9

08/1

6

3%

08/1

7

5/24

-5/3

0

4%

07/0

1

08/0

8

08/1

9

07/1

8

3%

09/1

1

07/2

5

09/0

3

4/26

-5/2

08/0

9

08/2

0

08/2

2

09/0

1

08/1

2

08/2

3

08/2

7

08/3

0

15%

07/1

9

07/3

1

08/2

9

08/3

1

06/0

9

08/0

7

09/2

1

09/0

2

09/0

4

09/0

6

6%

09/0

9

07/0

6

09/1

2

09/0

5

5/10

-5/1

6

09/2

3

09/1

6

08/2

1

11%

07/2

9

5/3-

5/9

5/31

-6/6

09/1

7

5/17

-5/2

3

07/2

3

09/2

5

09/2

8

08/1

5

07/2

4

08/0

6

06/2

1

09/1

809

/19

09/2

2

7%

08/2

8

06/1

5

09/2

4

06/1

9

09/2

6

07/2

2

06/3

0

09/0

8

09/2

7

06/1

7

Source: TX Health and Human Services (https://dshs.texas.gov/coronavirus/AdditionalData.aspx)

1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller2. Test data on chart will have a 1-day lag

COVID-19 CASE GROWTH TRENDSeptember 29, 2020


7-day trend of daily # of tests performed7-dy trend of % test positivity for COVID-19

Monitoring threshold:

Threshold is exceeded by the occurrence of a positive 7-day average growth in % test positivityCurrent status2:

0 days of positive average growth in the % test positivity trend

Note: Public testing data for this chart may lag several weeks

1

Note: Excludes days with no tests reported

Reflects retroactive changes in testing data made by Texas Department of Health and Human Services on 6/9/2020

COVID-19 TESTING TRENDS FOR GREATER HOUSTON AREA1

(weekly averages)

Note: DSHS released 13,622 older cases on 9/22/2020 impacting positivity trend


18

AVERAGE DAILY COVID-19 TESTING METRICS BY WEEK ACROSS GREATER HOUSTON AREA

5,075 8,265 8,654 8,271 5,930

11,217

5,259

9,352 9,99212,045

10,642 10,967 11,343

30,057

16,020

12,703 15,203

25,000

35,000

22

20,000

810,000

18

6

15,000

14

16

30,000

10

4

20

25,000

12

0

24

0Week 25

(9/7-9/13)

3.6%

Week 10(5/25-5/31)

2.8%4.5%

2.8%

Week 5(4/20-4/26)

Week 9(5/18-5/24)

17.6%

Week 8(5/11-5/17)

14,223

7.5%

13.4%

16.0%

Week 11(6/1-6/7)

7.6%

Week 7(5/4-5/10)

19,163

6.9%

Week 12(6/8-6/14)

Week 6(4/27-5/3)

7.5%

3.5%

10.3%

Week 14(6/22-6/28)

Week 20(8/3-8/9)

11.3%

3,373

Week 15(6/29-7/5)

Week 16(7/6-7/12)

18.0%16.6%

Week 13(6/15-6/21)

4.3%

Week 24(8/31-9/6)

Week 18(7/20-7/26)

6.6%

Week 27

(9/21-9/27)

19,265

22.2%

13,092

Week 19(7/27-8/2)

Week 26(9/14-9/20)

10.6%

Week 21(8/10-8/16)

Week 22(8/17-8/23)

10.8%

8.8%

6.9%

13,246

Week 17(7/13-7/19)

Week 23(8/24-8/30)

Source: TX Health and Human Services (https://dshs.texas.gov/coronavirus/AdditionalData.aspx)

1. Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller

COVID-19 CASE GROWTH TREND


7-day trend of % test positivity for COVID-19

1 September 29, 2020

Note: Excludes days with no tests reported

Reflects retroactive changes in testing data made by Texas Department of Health and Human Services on 6/9/2020

Data from Texas Department of State Health Services Note: Public testing data for this chart may lag several weeks

7-day trend of daily # of tests performed


TOTAL TMC COVID-19 POSITIVE PATIENTS (ICU & MED SURG) IN HOSPITAL

451

492

484

438

419

403

399

426

527

579

609

641

626

634

635

680

682

776

832

883

921

946

997

1,08

81,

137

1,21

11,

299

1,36

41,

428

1,44

71,

545

1,69

01,

747

1,86

31,

884

1,93

32,

226

2,26

12,

204

2,31

52,

365

2,33

12,

344

2,46

22,

455

2,44

42,

402

2,39

92,

382 2

,312

2,32

72,

367

2,33

32,

319

2,29

32,

164

2,07

82,

060

2,04

41,

964

1,92

7 1,80

11,

664

1,64

41,

634

1,59

51,

561

1,49

11,

452

1,39

11,

353

1,30

61,

239

1,24

81,

210

1,19

01,

143

1,12

71,

159

1,11

91,

039

993

959

938

908

916

877

815

766

756

728

738

736

706

697

685

661

650

630

591

593

603

591

549

549

544

544

543

536

530

506

483

481

480

478

478

485

470

461

443

461

460

447

0

800

1,000

400300

2,100

1,300

2,200

1,200

100

900

200

1,100

2,000

2,400

600

1,900

1,7001,600

1,800

2,500

1,5001,400

2,300

700

500

08/3

1

07/1

3

07/0

807

/07

09/2

5

08/2

7

07/0

6

07/1

107

/12

07/0

507

/04

08/1

3

07/1

6

06/2

9

09/1

0

2,02

9

07/1

4

08/2

2

06/2

2

07/1

7

08/2

9

07/0

1

09/1

4

06/3

0

07/1

8

06/2

3

07/1

907

/20

07/2

1

06/0

8

07/2

8

07/0

2

06/2

6

08/2

3

07/3

0

06/1

0

07/2

307

/25

08/0

5

08/1

8

07/2

6

07/2

9

08/2

8

06/1

6

09/2

4

08/2

5

06/2

1

06/1

5

08/2

6

4/19

-4/2

5

06/1

1

06/2

5

09/2

7

06/1

806

/20

06/2

4

5/24

-5/3

0

06/2

7

09/1

7

07/2

7

09/1

3

07/3

1

08/1

608

/14

5/03

-5/0

9

06/1

206

/14

08/1

9

06/1

7

08/3

0

08/0

1

07/1

5

06/0

9

06/2

8

09/0

9

08/0

2

4/05

-4/1

1

07/0

9

06/0

7

08/0

3

5/17

-5/2

3

09/0

2

08/0

4

5/10

-5/1

6

07/0

3

08/1

1

07/2

4

5/31

-6/0

6

08/0

6

08/0

908

/07

4/26

-5/0

2

08/1

2

08/0

808

/10

4/12

-4/1

8

09/0

5

08/1

5

09/1

1

06/1

3

08/1

7

08/2

008

/21

09/0

6

08/2

4

09/0

309

/04

09/0

1

07/2

2

09/0

7

09/1

9

09/0

8

09/1

509

/16

09/1

2

06/1

9

09/1

809

/20

09/2

209

/21

09/2

3

09/2

609

/28

09/2

909

/30

1,85

3

07/1

0

7-day trend of COVID-19 patients in ICU & Med Surg

Daily COVID-19 patients in ICU & Med Surg

Daily

CO

VID-

19 p

ositi

ve p

atie

nts i

n IC

U a

nd M

ed S

urg


2

Current status: -0.7% daily growth rate (averaged over 7 days) in COVID-19 patients in med surg and ICU combined

Notes:While new daily cases may fluctuate for a variety of reasons (e.g., testing), the number of COVID-19 positive patients being treated in med surg and ICU shows an objective view of how COVID-19 impacts hospital systems

September 30, 2020BED OCCUPANCY

June July AugApril – May (weekly averages) Sep


TOTAL TMC COVID-19 POSITIVE PATIENTS IN ICU BEDS

Daily

CO

VID-

19 p

ositi

ve p

atie

nts i

n IC

U


2

Current status: 0.2% daily growth rate (averaged over 7 days) in COVID-19 patients in ICU

Notes:While new daily cases may fluctuate for a variety of reasons (e.g., testing), the number of COVID-19 positive patients being treated in ICU shows an objective view of how COVID-19 impacts hospital systems

September 30, 2020ICU BED OCCUPANCY

192

225

204

175

157

170

193

224

224

223

230

221

207

216

217

227

237

252

273

303

304

329

347

352

362

374

398

414

414

445

460

480

507

512

540

568

589

600

615

626

646

651

646

682

674

676

678

689

700

667

664

686

691 71

671

468

169

168

267

765

062

563

963

261

7

570

542

512

510

501

496

477

460

464

450

432

404

417

416

398

361

363

359

335

326

312

302

301

285

289

276

271

266

271

265

262

246

224

220

225

219

227

207

203

189

182

191

188

186

171

161

158

154

158

154

163

174

164

155

164

162

162

159

50

350

500

100

400

150

0

250

550

750

450

600

200

700

650

300

07/0

6

07/1

007

/12

06/2

6

09/1

0

07/0

5

08/2

0

07/0

407

/03

06/0

7

07/1

3

06/1

7

06/3

0

08/2

9

07/1

4

08/2

2

06/2

9

07/1

507

/17

06/2

3

08/1

1

06/1

4

07/1

8

06/2

7

09/0

2

06/2

5

08/3

0

07/1

9

06/2

1

08/0

6

07/2

1

4/05

-4/1

1

06/1

3

07/2

0

06/1

8

07/2

2

07/1

6

06/1

6

07/2

3

08/2

6

09/3

0

07/2

4

09/2

3

07/2

5

08/3

1

07/2

6

06/1

5

07/2

7

08/2

4

07/2

9

09/1

3

08/1

0

08/0

5

07/3

0

08/2

3

08/0

1

06/1

9

5/24

-5/3

0

568

08/0

308

/04

06/1

2

07/0

1

08/1

7

06/1

0

4/19

-4/2

5

07/2

8

08/0

708

/09

5/03

-5/0

9

09/0

9

08/1

2

06/2

0

06/0

8

09/1

6

5/17

-5/2

3

08/0

2

07/1

1

08/1

3

07/0

9

08/1

408

/15

5/10

-5/1

6

06/0

9

08/1

6

07/3

1

07/0

2

08/1

9

09/1

7

5/31

-6/0

6

08/1

8

06/1

1

08/2

1

08/2

5

178

07/0

7

08/2

8

09/0

109

/03

09/0

4

4/12

-4/1

8

569

09/0

5

09/1

9

09/0

6

09/2

7

06/2

8

06/2

2

09/0

809

/07

09/1

1

09/2

4

09/1

209

/14

09/2

1

09/1

8

08/2

7

06/2

4

07/0

8

09/2

009

/22

09/1

5

09/2

509

/26

08/0

8

09/2

809

/29

4/26

-5/0

2

7-day trend of COVID-19 patients in ICU

June July AugApril – May (weekly averages)

Sep


TOTAL TMC COVID-19 POSITIVE PATIENTS IN MED SURG BEDS26

728

026

124

523

023

430

335

538

641

140

542

741

946

345

553

958

061

061

864

266

874

178

584

992

596

61,

014

1,03

31,

230

1,26

71,

356

1,37

21,

393

1,63

71,

661

1,58

91,

689

1,71

91,

680

1,69

81,

780

1,78

11,

768

1,72

41,

710

1,68

21,

645

1,66

31,

681

1,64

21,

603

1,50

91,

483

1,38

71,

367

1,30

21,

214

1,16

91,

047 1,06

61,

025

1,01

997

994

289

085

7 779

784

760

758

739

710

743

721

678

630

600

603

582

604

575

514

481

467

452

467

470

435

432

423

415

426

410

366

374

376

384

346

360

362

353

355

350

359

345

325

327

322

324

315

311

306

306

279

299

298

288

0

800

300

200

1,200

1,400

700

1,300

100

1,800

1,000

500

900

1,700

1,600

400

1,500

1,100

600

07/0

6

09/1

6

06/1

7

09/0

9

07/0

8

07/0

207

/03

08/1

3

07/0

106

/29

06/2

8

09/1

9

08/0

2

09/0

8

06/2

0

07/1

107

/12

08/2

2

08/0

3

07/1

307

/14

08/2

5

5/24

-5/3

0

09/0

4

06/2

5

4/26

-5/0

2

06/2

6

07/1

5

08/1

0

07/1

7

1,31

4

07/2

1

09/2

0

07/2

2

08/0

6

06/1

9

07/3

1

1,10

0

09/1

7

06/1

5

07/2

407

/26

08/2

1

07/1

6

09/2

3

07/1

8

4/05

-4/1

1

08/2

3

06/1

8

09/0

7

07/2

7

06/2

3

08/0

4

07/1

0

09/2

1

08/0

1

08/3

0

06/0

7

08/0

5

06/2

7

06/1

3

07/2

0

08/0

908

/11

07/3

0

08/1

4

06/2

2

08/1

908

/20

08/2

4

09/0

6

09/1

4

08/2

7

06/0

8

07/2

5

08/2

8

09/1

8

08/3

1

5/31

-6/0

65/

17-5

/23

08/2

6

06/1

0

09/0

109

/03

244

07/0

4

09/1

2

5/10

-5/1

6

07/0

7

09/0

5

09/1

009

/11

06/3

0

08/1

2

09/1

509

/13

08/1

8

06/1

2

08/1

7

4/12

-4/1

8

06/2

1

09/0

2

5/03

-5/0

9

09/2

2

06/1

4

07/2

8

06/2

4

08/0

7

07/2

9

06/1

6

09/2

409

/25

1,46

1

1,37

8

08/2

9

07/1

9

08/1

6

07/0

9

09/2

609

/27

08/0

8

09/2

809

/29

09/3

0

07/0

5

08/1

5

4/19

-4/2

5

06/0

9

1,07

5

829

06/1

1

07/2

3

7-day trend of COVID-19 patients in Med Surg

Daily COVID-19 patients in Med Surg

Daily

CO

VID-

19 p

ositi

ve p

atie

nts i

n M

ed S

urg


2

Current status: -1.2% daily growth rate (averaged over 7 days) in COVID-19 patients in med surg

Notes:While new daily cases may fluctuate for a variety of reasons (e.g., testing), the number of COVID-19 positive patients being treated in Med surg shows an objective view of how COVID-19 impacts hospital systems

September 30, 2020BED OCCUPANCY

June July AugApril – May(weekly averages)

Sep


22

TMC CAPACITY PLANNING PROTOCOL

Definitions Capacity planning

Phase 1 Intensive Care Beds

§ ICU bed configuration and staffing under non-pandemic situations

§ Builds on ICU capacity using our existing plans - through increasing staffing levels and ratios, mobilizing additional Intensive Care equipment & utilizing additional beds


§ Further planned utilization of Phase 2 levers of surge capacity to provide additional temporary Intensive Care capacity


Our hospitals are very experienced at operating at near 100% capacity and are able to flex up and down when needed (e.g., with additional staffing)

We have proactively developed our surge plans and are able to add extensive capacity when needed (e.g., by adding additional staff, additional equipment, additional beds, and increasing densification)

Additionally, we can moderate intake of non-COVID 19 patients, based on the clinical needs of the elective portion of these patients. Non-COVID 19 patients today represents the vast majority of our patients.


23

1,012 6,513 2,650288159

OVERVIEW OF TMC BED STATUS

COVID-19 – Intensive Care Beds usage

Non-COVID-19 –Intensive Care Beds usage

COVID-19 - Medical Surgical Beds usage

Current available (unused) beds2

Additional capacity (if needed)

Non-COVID-19 – Medical Surgical Beds usage

Phase 1 Intensive Care Beds (1330 beds) Phase 2 Intensive Care Beds (1703 beds) Phase 3 Intensive Care Beds (2207 beds) ICU bed configuration under non-pandemic

conditions Planned additional Intensive Care capacity for the

duration of pandemic Planned temporary Intensive Care surge capacity Ability to further increase Phase 3 through conversion of

non-Intensive Care beds

Phase 1 IC1



TMC leaders are actively managing, and can adjust, elective procedures to ensure sufficient capacity for

COVID-19 needs


Intensive care beds in use

Medical/Surgical beds in use

Empty beds

1. Intensive Care2. Total bed availability may fluctuate over time, given ongoing planning and operational considerations. On June 28th and 29th, the total unoccupied beds should have been 3,506 and

3,565, respectively. These data updates did not change ICU or med-surg occupancy and did not change ICU capacity percentages reported on any date.

Current phase


30

20

15

10

25

5

0

April May June

% c

ombi

ned

occu

panc

y fr

om C

OVI

D-19


1. Daily occupancy is smoothed over a two-day periodNote: For projections, non-COVID-19 occupancy is assumed to stay constant at modeling rate on day of forecast

TMC 2-WEEK PROJECTION USING BED OCCUPANCY GROWTH% total bed occupancy1

Internal data collected from CHI St Luke’s, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB“TMC” refers to the group of individual hospitals and institutions that make up Texas Medical CenterAll guidelines should be in accordance with CDC guidelines

• For the past 7 days, the average daily growth in occupancy for COVID-19 patients has been:⁻ 0.2% for ICU ⁻ -1.2% for Med Surg

• TMC is in Phase 1 Intensive Care Capacity

• If this growth continues, TMC: ⁻ Will likely not move into

Phase 3 Intensive Care within 2 weeks

• This calculation assumes a similar occupancy for non-COVID-19 procedures as today

BED OCCUPANCY

The health and wellbeing of our community requires that each of us do our part to slow the spread of COVID-19, including:• Maintaining social distance• Wearing a mask while in public• Washing hands regularly• Test and self-isolate, if sickJuly

Phase 1 IC

Phase 2 IC

August

Phase 1 IC

Phase 2 IC

Phase 1 IC

Today

Sept

Phase 2 IC

Phase 1 IC

Oct 14

ICU forecastMed/Surg actuals Med/Surg forecastICU actuals


TMC EXPECTED PPE NEEDS

1. Calculated using trailing 2-week average burn rateSource: Internal data collected from the systems CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB

3

N95 respirator masks

Surgical face masks

Eye protection

Gowns

Gloves

Estimated days available

274

144

634

121

45

Average daily burn rate1

7,572

133,336

4,259

55,792

1,037,641

Status

TMC SYSTEM EQUIPMENT & PPE NEEDS

No concernModerate concernWarning

September 30, 2020


Monitoring threshold:30-day supply of critical PPE items

Current status:All critical PPE items within range

Note:Data shown represents all TMC institutions and might vary from institution to institution


15,32917,479 17,564

Expected capacity (4-6 weeks)

10,000

Expected capacity (2-4 weeks)

5,000

Current capacity

Turnaround time currently 1-48 hours depending on site

PCR tests, (#/day)

Monitoring threshold: 5,000-10,000 PCR tests per day available for hospital patients and healthcare worker surveillance (with


27

TMC DATA COLLECTION PROCESSClinical dataPrevious day’s clinical data submitted by each hospital system1 by 4p.m. daily Bed capacity data regularly confirmed with each hospital system as individual surge capacity plans evolve

Houston MSA COVID-19 casesNew daily COVID-19 case data for Houston MSA2 collected from TX DHS3 (Data captured on publication date, but reflects data from the previous day)

Dashboard compilationHospital clinical data and Houston MSA data analyzed and aggregated into dashboards by TMC

1. System-wide clinical data collected from CHI Texas Division, Harris Health System, Houston Methodist, MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital, UTMB. TMC institutions represent ~70-80% of licensed beds in the 9 Houston MSA counties

2. Houston MSA includes 9 counties: Austin, Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery and Waller3. Source: txdhs.gov

Houston MSA COVID-19 testsNew daily testing data for Houston MSA2 collected from TX DHS3 (Data captured on publication date, but reflects data from 2 days prior)

TMC dashboard publicationFinalized dashboard published on tmc.edu website

Leadership ReviewCompiled dashboards reviewed and finalized by TMC leadership

tmc covid-19 monitoring metrics - tmc houston...2020/10/02 · 10 16 28 30 2,000 2,500 1,500 14,500...

Documents