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Inside A Rio Grande Hospital With No ICU During A COVID-19 Outbreak

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The Texas Department of State Health Services is responding to calls for help from more than 70 hospitals around the state. Most are in the Rio Grande Valley, and they are overwhelmed by COVID-19 patients.

Doctors at Starr County Memorial, a small hospital three miles from the border, recently gave us a sense of what it's like inside.

Outside The Norm

Carlos Paris is one of three physicians on duty at Starr County Memorial, and he worked on his day off. All 48 beds there were full. Most of the patients had COVID-19 and were very sick.

"They are all complicated. They are all ICU level patients," Dr. Paris said.

This is a problem because the small county hospital in the Rio Grande Valley doesn't have an Intensive Care Unit. They don't have up-to-date ventilators or negative pressure rooms where airborne organisms are filtered out.

Paris and his colleagues were in PPE, or personal protective equipment, from head to toe. He intubated patients and performed complicated procedures.

"Things like that, we don't usually do in this type of low-level hospital," he said.

'A Tsunami Of Patients'

The hospital's board president, Dr. Jose Vazquez, said they saw this local outbreak coming. He knows his community in the Rio Grande Valley is especially vulnerable: It's largely Mexican-American, poor, with the highest rate of diabetes and obesity in the state.

So, the hospital had been preparing for a COVID-19 outbreak since March. They increased the number of beds, and brought out all the PPE the hospital had been collecting for months.

"We were well prepared. However, sometimes a tsunami is just a tsunami," Dr. Vazquez said. "It's a tsunami of patients, critically ill, seeking attention in a place that's not designed to take care of that kind of patient."

Nurses started getting sick. Patients needed care the hospital couldn't provide, and people were dying.

Vazquez said there have been more than 30 COVID-19-related deaths. Earlier this month, he called the state's regional health director for help. Within hours, a team of 34 people arrived — respiratory therapists, nurse anesthetists, lab techs and operational staff.

Vazquez also hired a telemedicine group to take care of critically ill patients.

'It Was Like A War Zone'

Dr. Pritam Ghosh treats patients at Starr County Memorial from his home in Dallas.

"The first day I rounded at Starr was about a month ago. I logged on from my computer and it was like a war zone," Ghosh said. "It was literally a scene of a movie. I logged on, and every single person was running around. These patients were showing up sick, and then just acutely turning the corner and becoming even worse."

The team sent in by the state helped to coordinate transfers to better equipped hospitals.

"Last week they had somebody they had to transfer to New Mexico because there were no hospital beds available on the I-35 corridor from San Antonio to Dallas. They're so backed up," Ghosh said. "It just highlights what kind of a dearth we have for actual resources in terms of ICU care and ICU beds."

Vazquez said the lack of resources also includes basic medical necessities. He said five patients at Starr are waiting to be discharged, but they are stuck at the hospital because they can't get the oxygen they need for their homes.

"You know, when you live in America an oxygen tank or an oxygen concentrator should not be the reason why a patient is not discharged, when you are needing those beds for somebody sicker than you," Vazquez said.

A state official is working on getting oxygen concentrators to the region to free up more beds. Dr. Ghosh said he's still concerned.

"It's just, at times it feels like rearranging the deck chairs on the Titanic. You're just opening up a slot for somebody else to crash and get sick," he said.

In just a few days, the state's team was scheduled to leave. Vazquez said he's requesting they extend their three-week contract because he still needs their help.