To read the full "Crisis Standards of Care Guidelines" document, follow this link. For full audio of R.I. Department of Health Medical Director Dr. James McDonald's Thursday afternoon conference call with reporters, click here.
Significant increases in COVID-19 cases, deaths and hospitalizations were reported by the Rhode Island Department of Health on Thursday afternoon, while guidelines issued to hospitals on how to handle patient care in the event of a surge have been released publicly for the first time.
Thursday’s update – provided shortly after Gov. Gina Raimondo concluded a remote briefing for students – includes 374 new positive cases of the disease. That brings Rhode Island’s total case count to 8,621 since March 1.
Fifteen more people have died in connection with COVID-19, bringing Rhode Island’s cumulative toll to 266.
The update also listed 339 people as currently hospitalized due to the virus – a sharp increase from Wednesday’s 269. Of those patients, 85 were said to be in ICUs and 54 were intubated and on ventilators.
A press release from the Department of Health addresses the increased hospitalization figure and attributes it to an “updated COVID-19 reporting tool” being used in conjunction with hospitals.
The release states: “This allows for more streamlined, systematic, electronic submissions. The prior reporting system was developed in the first days of the pandemic in Rhode Island was very labor intensive. It focused on reports and reviews of medical records for patients who are hospitalized because of COVID-19 like illness. The new reporting system will bring consistency to hospitals’ reports. Rhode Island is continuing to develop its systems for tracking and responding to COVID-19, including its data systems, as the scope of the public health emergency has broadened.”
It adds: “Using this new system, there are 339 patients with COVID-19 currently hospitalized in Rhode Island. The historical numbers will be adjusted to fit this new system. In addition to the data shift resulting from the reporting change, RIDOH is looking closely at hospitalization data to determine whether activity from around the holidays or enhanced screening at hospitals are impacting the numbers.”
In terms of city and town case counts, Providence continues to lead the state by a large margin. To date, 2,682 cases have been identified in the capital city.
It is followed by Pawtucket (826), Cranston (511), North Providence (463), Central Falls (429), East Providence (350), Warwick (327), Woonsocket (295), Cumberland (188), Smithfield (160), Johnston (143), North Kingstown (134), West Warwick (130), Coventry (106) and Lincoln (90). All other communities had fewer than 80 reported cases as of Thursday.
In terms of the hospital guidance, known formally as “Crisis Standards of Care Guidelines,” the full document is available for viewing on the Department of Health’s website. The department’s release states that the guidelines are “intended to ensure an equitable and just allocation of patient-care resources, should a scarcity arise.”
These Guidelines, which could be implemented during any public health emergency, are not currently in effect,” the release states. “Rhode Island hospitals are currently below capacity and are not experiencing any shortages that would trigger the implementation of these Guidelines. These Guidelines would only be implemented when all other surge strategies are exhausted and no other regional resources are available. The swift construction of temporary surge or ‘alternate hospital sites’ in Rhode Island as a part of the State’s coronavirus disease 2019 (COVID-19) response provide another buffer from the need to implement these plans, should Rhode Island experience a surge in the near future. The Crisis Standards of Care Guidelines would only be implemented in a hospital in Rhode Island at the direction of RIDOH.”
The release indicates the guidelines were “developed in partnership with the acute care hospitals throughout the state, the Hospital Association of Rhode Island, and many other partners throughout the state and the region.”