Public health experts are monitoring COVID-19’s progress and trying to predict how many Americans it might infect and how many of them will be seriously ill. These questions will be answered by how well the United States “flattens” the curve in the weeks ahead to stop a rapid spread that could overwhelm the national health care system. The state’s top medical official, Dr. Thomas Dobbs said this week that Mississippi is experiencing “low-level community spreading,” which means the virus is moving through communities and is not tied to travel. Dobbs repeatedly appealed to Mississippians to prevent the spread of the virus from spreading later. The state health department reported one death and 50 infections as of March 19. This has flooded the entire state with infection. This week, there were more than 10,000 cases in the country and 172 deaths. Leaders of the state’s only academic hospital and largest institution warned this week of widespread coronavirus cases. The burden of containing the outbreak will be largely on the shoulders of hospitals and communities, as there is no vaccine or treatment. Officials at the University of Mississippi Medical Center said that they are using all of their resources to prepare for the unprecedented incoming wave of patients. They have preserved protective medical equipment for health-care providers and kept people who do not require high-level care away from the hospital. Officials at UMMC said that they are developing an in-house diagnostic test to improve diagnosis across the state. This test is expected to be available in the next weeks. The hospital has launched a telehealth app for smartphones and a live phone line to treat COVID-19 non-emergency patients remotely. Officials said that these services will be available in the coming days. Chair of UMMC’s Department of Emergency Medicine, Dr. Alan Jones urged Mississippians not to ignore calls to stay home and prevent the spread of the virus, echoing Gov. Tate Reeves and Dobbs both warned that Mississippi’s healthcare system could be overrun if it doesn’t control the virus spread. Jones, who heads the hospital’s coronavirus clinical reaction team, said that they are preparing for any potential tidal wave in patients. He explained that some of the reasons you are being asked to change your lifestyle – to stay home, to avoid going to restaurants, and to keep kids out of school – all these things that disrupt your life are not intended to prevent people getting the virus. It’s an extremely effective virus because we know that people will get it. It’s to give health care an advantage.” He said that most people will be able to recover without the need for hospitalization. “We cannot stress enough that we require people to allow us do our job, take care of sick patients and not everyone.” Health care organizations are beginning to raise concerns about overcrowding and medical staff shortages. The American Hospital Association sent a letter to Congress last month stating that the U.S. healthcare system is not equipped to deal with coronavirus. It also requested financial assistance, highlighting the lack of isolation space, protective equipment and treatment rooms. Kaiser Family Foundation, a health policy think tank, used national data to determine how many Americans could become seriously ill from coronavirus. It found that 4 out 10 adults were at greater risk due to their age and chronic illnesses. Although most people will not get seriously ill from the disease, the rate in Mississippi is slightly higher at 44%, which is 993,440 adults. According to the Kaiser Family Foundation’s estimate that 993,440 Mississippians are at risk of serious illness if they contract coronavirus, and the most current hospital bed counts, Mississippi Today’s capacity analysis estimates that the state has approximately one hospital bed per 100 at-risk people and one ICU bed per 1,200 at-risk persons. This week, a Harvard study modeled the on-the ground risk of different levels of virus control depending on how well the country manages spread over the next weeks. The U.S. is broken down into hospital areas. Most of Mississippi is covered by the Jackson and Memphis regions. Harvard research shows that if 40% of Americans are infected over 12 months with coronavirus, Jackson hospitals will need to double their capacity. This is based on an average usage of 324 ICU beds. Jackson still needs 67 additional ICU beds even if every bed in the ICU is free. Memphis, which has over 650 beds, would also be affected by the situation. Memphis still needs 263 beds to care for COVID patients who need hospital treatment, even if all ICU beds are available free of charge. According to the models, Meridian and Oxford are the only hospitals in the state that do not require expansion of current capacity for COVID-19 patient care. These calculations are based upon the availability of beds at any time, potential surges of patients and the number of people who may need hospitalization. They are similar to the Kaiser (map below) predictions. Mississippi is smaller than other areas of the country and has less crowding. However, it has fewer hospitals and medical epicenters, which means that there are fewer patients and more people in the state. There is also less access to healthcare and a greater number of people without insurance who do not have the ability to get care. Already, Mississippi has the highest flu death rate in the country. It can be used as a measure of a region’s ability to deal with flu-like diseases spread. Mississippi has 26 flu-related deaths per 100,000 people, while the national average is 15. Although it is difficult to determine the state’s level of preparedness, officials have assured that they have sufficient tests. Reeves declared that coronavirus testing must be restricted to “hospitalized patients”, “health care workers with symptoms” and “vulnerable citizens with fevers.” He also said: “Our highest risk is that the U.S. healthcare system would be overwhelmed. You can help us keep it safe.” If you look at the websites of larger hospitals, nearly all have a red banner on their homepages assuring the public about the hospital’s preparedness. A closer inspection of the numbers shows a different picture that is more in line with Jones’s, emergency medicine director at UMMC and national warnings about supplies running out. Mississippi Today asked many hospitals in Jackson for exact numbers. Officials from the Mississippi State Department of Health didn’t give specific numbers but they do track bed availability. Since 2015, when Mississippi had 10,592 hospital beds, the MSDH has not released an updated capacity accounting. 1,223 of these beds were in the intensive care unit, which provides high-level care such as that required for hospital-based COVID-19 therapy. 766 were general use and were not dedicated to pediatrics, neonatal or burn specialties. These numbers show that in 2015, 12 per cent of the state’s total beds were dedicated to ICU care and 7 percent for general ICU medical/surgical use. Four hospitals in the state have closed since 2015 when those numbers were made public. The 2019 state hospital directory from the health department, which is the most current count of beds without an updated hospital report, showed that the state had 10,169 beds in non-psychiatric hospitals. These beds were mostly used for acute inpatient care. The state has approximately 712 general-use ICU beds, if the ICU beds have remained constant since 2015. The majority of the ICU beds above 100 were between 5-14 percent of the total number of beds. A 200-bed hospital can house 24 ICU beds, while a 268 bed hospital can house 13. The average percentage of ICU beds per 100 total beds was 10. This is consistent with the national rates. According to the Harvard model’s 2018 data, approximately two-thirds of the beds are currently in use in Jackson’s most populated hospital area. UMMC is the state’s largest hospital, and it offers Level 1 trauma care. It has 93 ICU beds, which are often at capacity. Kevin Cook, the CEO of UMMC’s healthcare system, said Wednesday that the hospital is always full. Based on the Harvard study’s data, Mississippians would have access to approximately 1,500 beds in the state and nearby areas. This is not accounting for any current use. Johns Hopkins University researchers estimate that 1 million people will need hospital care for a mild outbreak. 200,000 would require ICU care. This is more than four times the total number of ICU beds in the U.S. currently, which is approximately 48,000. Statistics show that we must increase our ability to deal with a potential patient surge in Mississippi, where there were 50 confirmed cases. Georgia’s regional problems include sudden surges in patients at its hospitals and staff shortages as doctors, nurses, and staff are quarantined at home following potential exposure. Georgia had 197 confirmed cases as of Wednesday. This makes it one of the most affected states in the region, alongside Louisiana which has experienced dramatic case growth over the past week. According to Mississippi Today, the state’s health department and medical association urged all doctors to cancel any elective care during the pandemic to stop the spread of the disease and preserve resources. The state health department issued a statement to physicians on Thursday telling them they must delay non-essential or non-urgent care. MSMA Recommendation for Elective Surgery031820 (Text). MSMA Recommendation for Elective Surgery031820 (Text). Wednesday’s confirmation by UMMC officials that two of the six Hinds County cases were a student at UMMC and a nurse caused other staff members to be quarantined. Officials confirmed that medical students’ clinical rotations were cancelled. Jones, the head of emergency department, stated that there are very few health care providers and that personal protective equipment is scarce. “And we must conserve those resources as best we can.” Jones said that UMMC was trying to give advice to clinics throughout the state on how to prepare patients flow and protect them, noting that no health care system is ready to handle a pandemic. “We work closely with clinicians, communicating as quickly as possible, and getting as prepared to deal with a pandemic as possible. He said that he knows it won’t suffice. “That’s exactly what we face. We will be prepared. Joyce Pearson, director for emergency preparedness at the Mississippi Hospital Association, said that the state’s hospital association is trying to improve the state’s emergency plans. This includes increasing bed capacity and ventilators. “Hospitals are constantly working on their emergency preparedness plans, which include surge capacity for beds and ventilators. Mississippi may need additional hospital beds. Given the current crisis, it is critical that Mississippians use their health care system properly, take precautions to stay healthy, and follow social distancing guidelines in order to prevent the spread of the disease. She stated that the social distancing guidelines were being implemented to prevent this need. There are currently 160,000 ventilators available in the United States, with 8,900 reserve. At least 200,000 Americans will require ventilator care in moderate outbreak situations. Only UMMC and 14 other smaller regional hospitals answered questions regarding negative pressure rooms and ventilators. According to officials, UMMC has 40 negative pressure rooms and can expand to 100 if necessary. To prevent the spread of COVID-19, the hospital plans to move all COVID-19-infected patients to one unit. ICU beds will still be available for those who are critically ill or injured. Officials also stated that they could soon have hundreds of ventilators, drawing from all hospitals and adapting equipment. On average, there are 10 negative pressure rooms in each regional hospital. Hospitals with more than 100 beds are likely to devote 10 percent of their ICU capacity. On-hand ventilator counts varied from 1 to 86 in hospitals that responded, with an average of 17 per hospital. Mississippi Today’s COVID-19 Resource Portal is available by clicking here. Editor’s Note: A previous version of this story had 12,014 non-psychiatric hospital bed numbers in Mississippi. This was due to an error in editing. This caused us to estimate that there were 840 general-use ICU beds. This story has been updated with actual ICU beds. This is consistent with the national research that was done after publication. It shows that there are 824 ICU beds in Mississippi. Some ICU beds are dedicated to specificties like cardiac patients and burns, so not all of them are considered “general-use”. Thomas Dobbs, the state’s health officer, has stated that the state is working with rural areas to convert ICU beds to ICU and is looking at old military and hospital space to provide ICU COVID care. On Monday, March 30, 847 COVID patients had been identified in the state. 32 percent (271) have required hospitalization.