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Texas Hospital CEO: People Need To Change Their Behaviors 'Dramatically'

SACHA PFEIFFER, HOST:

It wasn't long ago that we were reporting about hospitals at capacity and doctors running out of personal protective equipment in New York City. Now similar scenes are playing out at hospitals nationwide as many states see record COVID-19 cases.

We wanted to understand how hospitals are doing and whether they've been able to apply any of the lessons learned in New York to the current situation, so we're going to focus now on Houston, Texas, one of the country's current hotspots for the coronavirus. Dr. Marc Boom is the president and CEO of the Houston Methodist hospital system.

Dr. Boom, welcome to the program.

MARC BOOM: Thank you, Sacha.

PFEIFFER: So virus numbers in Texas were fairly low through May, but they've seen a large spike in the last month. What is the current situation at Houston Methodist?

BOOM: Yeah, it's really been a very busy about six-week period since Memorial Day. Really, over the first four weeks after Memorial Day, we saw about a tripling from, you know, a relatively small number of patients in house to a significant number but still very manageable. Over the last two weeks, that has more than doubled.

So today, we have about 626 patients with COVID in our hospitals across our system. Put that in perspective, we've got about 2,400 beds. So it's about one in four patients, or one in four beds right now that are occupied by someone with COVID.

PFEIFFER: And how would you say that's taxing the system?

BOOM: Well, we're OK, but it's challenging, no question. So we've been, you know, every day converting different units and moving some non-COVID patients out and consolidating them elsewhere and then converting those units to COVID. We're seeing the testing numbers level off a hair in the community - at very, very high numbers, mind you, but they've leveled off. They're not increasing quite as much.

So we're hoping that we're starting to see the beginning of the testing flatten out so that hopefully, you know, in a seven to 10-day period, we might see the hospital numbers start to level out as well. But we are preparing to go quite a bit higher than where we are today.

PFEIFFER: You know, when you say we're doing OK, it makes me torn, and I wonder if other listeners are torn, about how worried they should be. I mean, on one hand, cases are increasing. On the other hand, your hospital seems to be able to handle it. So that leaves people torn about how much they should take this seriously in terms of how it taxes hospitals and how much it could harm their health.

BOOM: Sure. Well, let me be really clear. People should take this extraordinarily seriously. And what we need right now in Houston - and I think we've been seeing over the last number of days - is people to really change their behaviors dramatically.

You know, we're OK right now, but, of course, you know, we've seen this go from, you know, 100 to 300, you know, over a four-week period and from 300 to the low 400s in the next week, now into the mid-600s, and the next week - you know, clearly we cannot keep increasing like this week after week after week without having some, you know, real trouble.

So we have to change what's going on at the base rate in the community in terms of the spread of the virus so that this does not become even more problematic. This past week, we had to start turning off some delayable but necessary procedures. We hate doing that. We hate doing that because we know people are not getting the care they need and want, you know, who don't have COVID. But we had to do that to start freeing up some beds.

And so next comes delaying things that we really don't want to delay at all, that can actually sometimes have harm, like we saw before. And we don't want to do that. And we really don't want the virus to be completely out of control in the community. So the fundamental message is the community needs to continue on the path it's been doing and really changing behaviors so everybody's protecting themselves.

PFEIFFER: President Trump said over the weekend that he considers COVID-19 a largely mild illness that most people will recover from. What are you seeing in Texas in terms of severity of infections and fatality rates?

BOOM: Well, when you give enough people a disease that in many is mild but in some percentage is anything but mild, you have a lot of bad outcomes and a lot of people who get extraordinarily sick and, unfortunately, people who die. And so, you know, we have 626 patients in house today. Many of them are young people. In fact, we're seeing a big shift towards younger people below age 50. So this is not a mild illness by any stretch.

These people describe, you know, feeling like they got hit by a truck, and they describe not being able to breathe. And some of them are ending up on ventilators. You know, some of them as young as in their 20s are ending up on a ventilator. So it is a very severe illness for many people.

PFEIFFER: As we've said, previous hotspots like New York are seeing their numbers decline, but yours are going up. Have you been able to learn any lessons from those New York hospitals that you're now applying to your hospitals?

BOOM: You know, really from the beginning, we've been in close contact with people around the country. I'm on phone calls at least weekly with a bunch of colleagues. And we've also had four months now of experience. We, you know, got as high as probably 250 or so people in house with COVID or being worked up for COVID the first time around. And now it's surged up, and we're up to almost 3,000 people that we've admitted so far for COVID.

So we've got a great deal of experience with this. The good news in that is we, like everybody else around the country, have learned a great deal. You know, whereas at the beginning, the common wisdom was put a breathing tube in right away, we all learned that that actually was harming people's lungs, and now we wait till the last-ditch effort to put a breathing tube in. And we've seen big changes with that - proning, which is keeping people on their stomachs, and on and on.

And so there's a lot more sophisticated medical practice now coming to bear than, you know, what we were all doing right at the beginning of March, when we didn't understand this nearly as much.

PFEIFFER: That's Dr. Marc Boom. He's president and CEO of the Houston Methodist hospital system.

Dr. Boom, thanks for coming on the program this holiday weekend.

BOOM: Thanks so much. Transcript provided by NPR, Copyright NPR.

Hey, thanks for reading.
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