For the next five days, Delaware hospitals should be able to handle coronavirus cases without any need for additional housing for patient overflow. But from there, things are more uncertain.
"The hospitals would still be managing within their walls, with their staff, very comfortably, we'll put it that way," said A.J. Schall, director of Delaware's Emergency Management Agency (DEMA).
Schall joined Governor John Carney Tuesday hosted at a news conference--a day after announcing the latest amendment to his State of Emergency declaration which restricts short-term rentals like vacation homes and hotels to select individuals like emergency workers and closed additional retail outlets like electronics stores and ice cream shops that don't provide drive-thru service.
On April 7, 2020, Carney, joined by Dr. Karyl Rattay, director of the Division of Public Health, and A.J. Schall, director of the Delaware Emergency Management Agency, who said they're still focused on what they believe will be a coming surge in the number of positive novel coronavirus COVID-19 cases in the state.
"Everything that we do...has been with the objective of minimizing the health impact and economic impact...the objective is to limit the spread of the virus across our state," he said. "That hospitalization number, we look at every day and try to predict where it's going to go in the days ahead and then, as we've been saying for the last several days the next two weeks and maybe a little beyond are really going to be critical for here in our state. We're going to see the number of positive cases continuing to trend up in a way that's going to look frightening, I think, to all of us. And, very concerning, we're going to see the number of those hospitalizations go up as well, and we're preparing for that."
Because the greatest accuracy in test results comes only after someone already knows their ill, it can be tough to get ahead of the virus spread, which is why social distancing is so important.
"It is important that people are tested at the right time; that is, when they have symptoms," Rattay said. "If people are tested before [there are] symptoms, they're more likely to have a false negative test result."
Schall provided a look at Delaware's landscape as the state prepares to respond to a surge on hospital resources.
"We're watching the hospital capacity, we know what the hospitals can manage, what their limiting factors are, and then what the state can do to assist," Schall said. "We are going by the assumption right now that 20% of the positive cases tested will need hospitalization."
"We need to make sure we're erring on the high side of some of these numbers, hopefully, and not taking into account the orders the governor put out almost two-and-a-half weeks ago now," he said. "We know by about day 21, we'll see how effective those stay-at home orders were."
Using the 20% estimation as a determining guide, the state anticipates 650 persons to be hospitalized with COVID-19 around April 12, 2020.
Schall said hospital capacity, right now, is lower than usual because elective surgeries have been canceled and cases of influenza are down compared to last year.
"For the next 5-7 days, I feel confident that the hospitals are able to adequately respond to the increased demand."
But he's worried about high rates of COVID-19 infection in hospital staff.
"Everybody in the hospitals from the people that run supplies up and down to the nurses and doctors, are the heroes in everyone's books right now...they are the ones that if something happens to that staffing core--the nurses and the doctors--if a hospital gets a high rate of, maybe, positive COVID personnel, that's going to have a trickle down effect."
That's where contingency plans come into play, where hospitals like Christiana have plans to transfer patients to St. Francis, before using alternate hospital locations like Nemours A.I. duPont Hospital for Children in Rockland and Governor Bacon Health Center in Delaware City.
Carney said they can only continue to create a game plan based on data that's fluctuating rapidly.
"All of this is uncharted waters, right, and we are reacting and making decisions based on recommendations from the...public health experts."
The governor also expected to issue guidance, in the coming days, for wearing masks in public, but noted mask-wearing may not appropriate in all settings. The CDC has updated its guidance and recommended that cloth masks can prevent further spread of the virus. Dr. Rattay said the guidance would likely include wearing a cloth mask--not a N95 mask--in indoor settings where social distancing could be difficult like the grocery store.
Editor's Note: The state's livestream of this news conference experienced a technical error, lasting for approximately 30 minutes, so some information may be be missing.