Some Texas cities revive plans to add hospital bed capacity at convention centers if coronavirus cases climb

Intensive care units in one of the medical tents at NRG Park in Houston. Annie Mulligan for The Texas Tribune

As Texas finishes a second week of record hospitalizations, some local officials are eyeing convention centers and stadiums as potential overflow facilities, reviving efforts tabled earlier in the pandemic.

In Travis County, authorities have been quietly recruiting dozens of volunteer doctors and nurses to staff a possible 100-bed hospital in the Austin Convention Center. The site is not “currently functioning” but volunteers were given an estimated start date of mid-July, according to June emails sent to a member of the state’s disaster volunteer force and obtained by The Texas Tribune.

“Staff will provide hands-on care to COVID + patients with personal protective equipment (PPE) provided. The setting will be similar to a Medical-Surgical Unit with the capability of treating critical care patients," the email says.

The solicitations for volunteers come as researchers predict local hospitals could run out of beds to care for coronavirus patients next month, and as intensive care units in parts of the state have grown increasingly crowded.

Since June, numerous metrics to gauge the spread and severity of the coronavirus have lurched upwards in Texas, prompting Gov. Greg Abbott to pause elective procedures in four big counties Thursday, to free up hospital beds for COVID-19 patients.

Like Travis, Harris County may use a temporary medical facility at a stadium if need arises. The mayor of Dallas said Thursday a previously discussed pop-up hospital would not be erected “at this time.”

A spokesperson for the City of Austin's Office of Homeland Security and Emergency Management, Bryce Bencivengo, said local officials have been planning an alternate care site since March but are not certain it will be needed.

“The community should do everything in its power to stem the current rising tide of infections so this type of facility is not required,” Bencivengo said. “The volunteers could be used in other communities to provide care or they could ultimately not be used.”

While the city and county have described a “surge plan” where backup medical facilities would be available if hospitals became overwhelmed, the June emails provide more detail about what one of these pop-ups would look like.

The city's request included more than 20 registered nurses, four doctors, and nearly 70 other medical personnel, including physician assistants, respiratory therapists and paramedics to staff the 100-bed site, according to the emails.

The positions would last for an “undetermined” duration and would require 12 hour shifts on a seven-day rotation — with the volunteers working one week, and off the next, the emails said.

They were sent through the state’s disaster volunteer registry, a database maintained by the Department of State Health Services that’s meant to “improve volunteer coordination during an emergency.” People who have registered as volunteers are called on to respond to significant disasters or public health crises, and are sent assignments they can choose to accept or reject, like the posts in Austin.

Previous postings include assignments like one at a West Texas hospital, seeking volunteer nurses as a “contingency plan.”

The emails say the state health services department does not provide volunteers with liability protection, workers’ compensation or health care coverage. The agency also does not offer compensation or reimbursement to the volunteers for mileage, lodging, meal or supplies. The city would provide amenities like laundry facilities, mileage, housing and meals.

Chris Van Deusen, a spokesperson for the state health services department, said the agency has not received requests similar to the one from Austin. He said the local health department could best answer questions about their plans.

John Zerwas, a former state lawmaker advising Abbott on the coronavirus response, promoted the volunteer registry at a news conference this week.

“This is the time to do that, is to put your name in there and show where you would prefer to work and where you would be,” Zerwas said. “That’s... a thing that we should look at. It’s not a demand right now, but it’s always good to be ahead of the curve.”

Other metro areas have also considered erecting temporary hospitals.

In Houston, a massive medical center said its regular intensive care unit capacity was full as of Thursday, and its emergency surge capacity could be exceeded by early July.

Harris County Judge Lina Hidalgo told The Tribune that an overflow facility in NRG Park could be fully activated in 72 hours and that staff and materials for the site are on standby. The multi-million dollar facility was set up then taken down in April, without ever receiving patients.

“Any day that we don't use that shelter is a good day. If we end up using it we would be in the type of situation where we're seeing people in the hallways of hospitals and those shelter beds are by no means sustainable long term beds,” she said.

In Dallas, Johnson said Thursday a pop-up hospital in the convention center would not be set up because a local hospital council and the county expects medical facilities can handle an influx of patients. Plans for the overflow facility were first discussed this spring but sputtered to a halt in April due to lack of need.

In San Antonio, county seat of Bexar, the number of people hospitalized with the virus has increased some 500% this month. County Judge Nelson Wolff ordered businesses to require that employees and customers wear masks last week, a directive other local leaders have since copied.

After beginning a phased reopening of the state in May, Abbott on Thursday put a temporary stop to loosening more restrictions. Businesses already operating at set occupancy levels can continue to do so, including bars, amusement parks and carnivals.

The number of people hospitalized with the virus has more than doubled since the start of the month, reaching record high levels for the last 14 days. The positivity rate — a comparison of new infections to tests performed — surpassed 10% on Wednesday, a threshold Abbott has identified as “one of those red flags.”

Abbott adopted a newly urgent tone this week, urging residents to stay home and saying in a statement Thursday that the pause on further reopening would “help our state corral the spread.” He also stopped elective procedures at hospitals in hard-hit Harris, Bexar, Dallas, and Travis, where Austin is.

Abbott has encouraged but not required Texas residents to wear masks and has not permitted local leaders to mandate it, as several have requested. Public health experts say wearing masks can help slow the spread of the virus.