Flanked by doctors from three hospitals, Gov. Gina Raimondo on Thursday said Rhode Island’s health care system is becoming “overwhelmed” as COVID-19 cases continue to surge – and that the state is rapidly approaching the point at which more dramatic action will be needed to curb the spread of the coronavirus.
“That’s where we’re heading, folks, total lockdown, if we don’t start to get more serious and follow the rules,” she said, referencing the restrictions currently in place in European nations like Italy, Germany and the United Kingdom.
She added: “This is very real. We are in a terrible spot, and for those folks out there who think it’s not OK to follow the rules … you need to know that that’s costing lives.”
Dr. Laura Foreman, chief of emergency medicine at Kent Hospital and medical director of the Cranston field hospital site, said COVID-19 has “pressed us to the brink.” She said what she has experienced since the spring is akin to what she has seen working in “refugee camps and battlefields,” and that the recent surge has placed new strain on an already exhausted nurses and doctors.
The latest warning came as Rhode Island, for the third consecutive day, set a single-day record in the number of new COVID-19 cases reported by the Department of Health. It was the second straight day in which the case count topped 900, with 936 more Rhode Islanders having been diagnosed with the disease.
Those cases were found among 19,841 tests, a positive test rate of 4.7 percent. In recent days, however, the rate has approached or exceeded 7 percent – well above the 5 percent threshold health officials have frequently pointed to as the safe ceiling.
Seven more COVID-associated deaths were reported Thursday, bringing Rhode Island’s toll to 1,250 since the onset of the pandemic.
Hospitalizations stood at 232 as of Thursday, and Raimondo said 84 percent of the state’s existing COVID beds are presently filled. As a result, she said, the diversion of ambulances to other hospitals has become common, as have long waits at emergency rooms. She also said if the current course continues, the existing COVID beds will be filled within a week.
The governor said surge capacity plans at hospitals can bring the total number of available COVID beds at those facilities to roughly 600, but current trends would still require use of the field hospital – which has not yet been needed for any patients – within roughly three weeks.
Drills have started at the Cranston site, she said, so that health officials are “ready to roll when we need to turn it on.” She also noted that the planned decommissioning of the field hospital site at the Rhode Island Convention Center has been put on hold. The third field hospital location, at the Quonset Business Park in North Kingstown, is currently empty, she added.
The governor also said a health care coordination center is being established to manage the state’s hospital capacity and the movement of patients in various facilities as needed.
Forman, too, said that based on current trends and projections, the Cranston field hospital site – which has approximately 350 additional beds – will need to be mobilized “within days to weeks.”
Week-to-week metrics underscore the increasing cause for alarm. Data released earlier this week show the state’s positive rate for last week was 3.9 percent, up from 3.3 percent the week prior. The number of new hospital admissions rose from 163 to 228 over the same period of time, while the number of new cases per 100,000 residents rose from 279 to 362.
The hospital admission and cases per 100,000 metrics have both well exceeded their thresholds, earning red warning arrows in a chart on the state’s data portal.
There were no announcements regarding new restrictions or actions during Thursday’s briefing, which came a week after the governor announced a two-week stay-at-home advisory for overnight hours and other modest measures.
Raimondo and Forman devoted much of their remarks to underscoring the human toll of the pandemic in Rhode Island – and warning of the exceedingly difficult months to come if spread of the virus continues at its current pace.
“These next few months,” the governor said, “are going to be the toughest of the virus.”
Raimondo acknowledged, and lamented, that the “incremental steps” she’s utilized to this point have failed to produce the desired results. She said the data indicate Halloween, like other holidays, became a point of spread as people gathered socially, and she said “very strict” guidelines for Thanksgiving will be coming next week.
“We’re overrun, and we might just need some blunt instrument to settle things down … I might not have a choice,” she said of a more total lockdown.
She added: “If everybody committed themselves to not having these social gatherings, to wearing masks … we would have the control to put a lid on this virus. But it doesn’t seem to be working that way, and I fear that we are moving toward another lockdown … It is still my hope that it will be enough, but I’m not optimistic based on what I’m seeing in the data.”
The governor also said she views a return to phase two of the reopening process as an insufficient measure to curb the virus. The latest data, she said, continue to show that it is informal, social settings – and not more structured environments like businesses and schools – that is driving the surge.
“I don’t think phase two would help. It’s not enough,” she said.
Forman spoke of the disparate paths a coronavirus infection can take, and of the role she and other professionals play in patient care.
While some people who contract the coronavirus recover after mild illness, she said, others “may never get back to normal,” struggling with non-fatal after-effects such as strokes, blood clots and chronic fatigue. Currently, she said, the medical community is still trying to understand why the illness can take such divergent courses in different people.
With no cure yet developed and treatments still having varying degrees of effectiveness, the worst cases result in death. Because of safety protocols, Forman said, COVID patients who are in their final moments typically have no loved ones at their side, left to say goodbye over FaceTime.
“[People are] dying in our hospitals with a stranger holding their hand … while their families get a last look at their loved one through a cell phone,” she said, adding: “The human cost of this is real, and this pandemic is real.”
Elsewhere during Thursday’s briefing:
* Raimondo made a call for Rhode Islanders with health care experience to visit skillsforri.com as the state seeks to strengthen its available medical workforce. She also said previous temporary license extensions and transfers will be extended further.
“We need you now. We need to staff up, and we need help,” she said.
* Raimondo said “substantial progress” has been made in providing simple access to COVID-19 test results. Starting Thursday, she said, Rhode Islanders can find test results at portal.ri.gov/results regarding of how they scheduled their test. She acknowledged there will be glitches as the system comes online, and said people can also call 222-8020 if they experience issues.
Asked about reports of long wait times to receive a test, Health Director Nicole Alexander-Scott said officials have placed “a definite focus on expanding the testing availability.”
* News this week that initial studies found a COVID-19 vaccine developed by Pfizer is 90 percent effective in preventing infection is a “huge boost,” Raimondo said. She said the subcommittee she convened to evaluate any vaccines and plan for eventual distribution in Rhode Island is continuing its work.
“We’re not sitting around waiting for the vaccine,” she said.
She also noted that the vaccine, once available, will be distributed in phases to different populations based on risk factors.
“If you’re a young, or youngish, healthy person, it’s going to be a while before you get a vaccine,” she said.
* Raimondo said next week’s briefing will return to its regular 1 p.m. Wednesday timeslot. The briefing was delayed until Thursday for the past two weeks because of Election Day and Veterans Day.