The Struggle is Real

I.C.U. units reaching capacity, nurses and staff falling sick, staffing shortages, and financial uncertainty. COVID-19 is challenging hospitals across Texas.

Texas hospitals have stepped up in heroic and unprecedented ways to meet the challenges of COVID-19.  As outbreaks have occurred across the state infecting almost half a million people, hospitals have increased testing efforts and treating Texans in an effort to save lives and minimize the virus’ spread. In some of areas of the state, this includes establishing testing tents, adding general and intensive care unit (ICU) bed capacity, and developing COVID-19 units to isolate and treat patients with the disease while safeguarding the health of other patients and hospital staff.

Treatment for COVID-19 has created incredible demand for certain medical equipment and supplies as the virus has disrupted supply chains, increasing the costs that hospitals face to treat COVID-19 patients. At the same time, COVID-19 has led to unprecedented job losses, giving way to a rise in the number of uninsured. And while doctors, nurses, and other health care workers have met the COVID-19 challenge with heroic efforts, many hospitals, especially those located in hotspot areas of the pandemic, are struggling to survive financially, physically and emotionally. 

According to Texas Department of Health Services data, as of July 24, 13,476 of 51,031 hospital beds were available statewide, with 1,267 ICU beds open. According to the COVD Tracking Project (, Texas has more COVID-19 patients hospitalized than any other state, with 10,893 COVID-19 patients as of July 24.   Some Texas hospitals have had to form ethics and triage committees to screen all COVID-19 patients for survival potential and send home those with low survival chances. The committees determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly are advised to go home rather than dying alone at a hospital thousands of miles away from family members. Some hospitals are not accepting transfer patients in order to maintain space, while others are converting areas not typically used for ICU patient care like emergency rooms, conference rooms or lobbies. In some area’s ventilators are in short supply and ambulances are waiting hours to deliver patients.  

Hospitals are not at fault for being full.  They are doing the best they can with the resources available.  Due to COVID-10, patients are staying in ICUS’s longer for the care needed.  Since most hospitals are not set-up for long term care, a ripple effect is taking place throughout the state. Extended care leads to increasing risks of exposure to the virus for those on the frontline while other hospitals in a region receive patients that have been turned away. 

State data shows the hardest-hit regions include most of Texas’ biggest cities, as well as large swaths of South and Central Texas and the Gulf Coast.  Meanwhile, rural hospitals are struggling as well.  They were fighting for their survival long before COVID-19. Texas leads the country in rural hospital closures. Roughly half of the state's rural hospitals are considered vulnerable. However, being vulnerable does not excluded them from the frontline fighting outbreaks. 

Although, most rural hospitals are in good shape with PPE and have bed capacity, they lack resources such as staff and sufficient ventilators to treat the sickest COVID-19 patients. Rural hospitals are running out of options. Larger hospitals are refusing transfers, forcing rural doctors and staff into new, often difficult, unknown situations trying to navigate treating COVID-19 patients. 

All of these challenges have created historic financial pressures for Texas hospitals. Hospitals have cancelled non-emergency procedures, and many Texans are postponing care for either fear of contracting the virus or due to cost.  

When elective procedures where banned by Gov. Abbott, hospitals immediately begin losing income.  Texas hospitals, both large and small, make a large portion of the revenue from non-emergency procedures.  The procedures are the financial foundation for many hospitals.  

Making matters more challenging, many hospitals are currently spending big sums to treat patients and keep their staff safe during the pandemic. There are reimbursement revenues associated with Covid-19 patients, but not comparable to what hospitals typically make from elective procedures. In addition, many patients are delaying primary care, and emergency rooms are less packed than usual as even patients with life-threatening conditions worry about exposure and avoid coming in.

In the age of coronavirus, hospitals across Texas will continue to struggle with immense challenges to keep their footing until a new normal can be maintained.