Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
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
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
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:
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
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
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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
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
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:
8This 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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
Apr May Jun Jul Aug Sep
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/
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
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
“TMC” refers to the group of systems that make up Texas Medical Center
October 1, 2020COVID-19 CASE TRENDS3
10This 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 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
Apr May Jun Jul Aug Sep
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/
11This 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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
Apr May Jun Jul Aug Sep
Oct daily new hospitalizations 7-Day trend of casesSep daily new hospitalizations
Oct
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
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
“TMC” refers to the group of systems that make up Texas Medical Center
Data not
aggre-
gated
October 1, 2020COVID-19 TMC HOSPITALIZATION TRENDS4
13This 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
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
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
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
Phase 1 Intensive Care
ICU beds occupied by COVID-19 (%)
Total ICU beds occupied (%)
Phase 1 & 2 Intensive care
Phase 3 Intensive Care
7%
9%
12%
53%
69%
88%
Further capacity can be added by converting additional Medical / Surgical beds to ICU
Phase 1 Intensive Care
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 2 Intensive Care capacity
Phase 3 Intensive Care capacity
Phase 1, 2, & 3 Intensive Care
COVID-19 TMC ICU UTILIZATION5
15This 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
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
“TMC” refers to the group of systems that make up Texas Medical Center
COVID-19 TMC IMPACT SUMMARY
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
16
APPENDIXAS OF SEPTEMBER 30, 2020
17This 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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
19This 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
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
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
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
20This 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
TOTAL TMC COVID-19 POSITIVE PATIENTS IN ICU BEDS
Daily
CO
VID-
19 p
ositi
ve p
atie
nts i
n IC
U
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
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
21This 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
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
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
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
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
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
Phase 2 Intensive Care Beds
§ Further planned utilization of Phase 2 levers of surge capacity to provide additional temporary Intensive Care capacity
Phase 3 Intensive Care Beds
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.
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
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
Phase 2 Intensive Care
Phase 3 Intensive Care
TMC leaders are actively managing, and can adjust, elective procedures to ensure sufficient capacity for
COVID-19 needs
2 September 30, 2020
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
24This 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
30
20
15
10
25
5
0
April May June
% c
ombi
ned
occu
panc
y fr
om C
OVI
D-19
2 September 30, 2020
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
25This 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
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
“TMC” refers to the group of systems that make up Texas Medical Center
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
26This 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
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
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
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