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'Plenty of runway' for COVID-19 surge? Medical pros, state data contradict Gov. Stitt's characterization

Gov. Kevin Stitt describes having “plenty of runway” — hospital capacity — for the state to monitor and adjust as COVID-19 surges in Oklahoma, but medical professionals are asking for an immediate course correction.

Stitt on July 10 touted there are “5,000 COVID beds to be able to access throughout our state.”

However, that figure is based off the state’s surge plan developed in the spring and doesn’t account for routine or elective procedures taking place now. Those procedures were temporarily halted during quarantine. Medical professionals also question the ability to staff beds because of nursing and physician shortages.

State Health Commissioner Dr. Lance Frye on Wednesday doubled down, saying the state hospital association and hospital CEOs assure him that “we have capacity still — that we’re doing well.”

Frye said state models project there would have to be 100,000 cases in 14 days — or 7,200 cases per day for 14 days — to reach the 5,000-bed capacity of Oklahoma’s hospital system.

The state’s seven-day moving average reported Friday was 721 cases per day, a record for the 12th consecutive day.

Other medical leaders describe a statewide hospital network that is starting to fill up, with a need “to do something tangible” now. The state’s hospitalizations for COVID-19 are at all-time highs, first topping the 600 mark on Wednesday at 638 before dropping back below by Friday to 547.

Deaths in Oklahoma are beginning to rise, with seven reported Friday and six reported Thursday. That’s the largest two-day total since early May. There were four apiece reported on Tuesday and Wednesday. The four-day total of 21 is the highest since 23 deaths were reported in a four-day span in early May.

“The runway involves — we’re talking about patients’ lives. We’re talking about the fact that people are dying,” Dr. George Monks, president of the Oklahoma State Medical Association, told the Tulsa World on Friday. “Even the statistic that we touted as being a strong point for Oklahoma — that we have hospital capacity — is no longer true. It’s rapidly shrinking. ...

“Instituting a mandatory face mask statewide policy is really the middle road. It’s choosing the best option available, not letting this virus go unchecked and say, ‘We’ve got enough beds for you,’ and let the virus burn things down.”

LaWanna Halstead, vice president of quality and clinical initiatives for the Oklahoma Hospital Association, said hospitals are “very concerned” about the surge, with capacity “becoming strained” as hospitalizations rise.

Halstead, a registered nurse, said Oklahoma for many years has had a nursing shortage, along with one of the lowest physician rates per capita in the nation. A room is of no use if it can’t be staffed, she said.

“We do not want to get into a situation where we do not have the staff, equipment or space to care for Oklahomans in need of any type of health care,” Halstead said.

There were 167 of 983 ICU beds — or 17% — available in Oklahoma, according to the state’s weekday bed survey snapshot Friday. The hospital survey response rate was 83%.

There were 1,269 medical-surgery beds open of 5,746 total, or 22% available. ICU and medical-surgical beds combined were 1,436 available of 6,729, or 21%.

“I thought it was a curious statistic, and we just don’t have 5,000 COVID beds,” Monks said. “We don’t have it.”

Hospitals divert patients

Monks spoke to the Tulsa City Council on Wednesday during discussion about a mask mandate for the city. He told councilors that he has assembled a weekly COVID-19 task force of experts to “keep our finger on the pulse of what is going on so that we can better handle this crisis.”

Monks said that he hears from his colleagues in emergency rooms and intensive care units that many hospitals are going on “divert.” He explained “divert” means that their ICUs might be full for a period of time, so the hospital directs ambulances to go elsewhere if possible.

Specifically, he said Oklahoma County started the week with only 5% of ICU beds available and the counties surrounding it were down to 2%.

“What we bragged about early on and what is true is Oklahoma is blessed with a large hospital capacity,” Monks said. “But I’m afraid to tell you that that capacity is quickly strained.

“It’s getting tight in our hospital system.”

Bruce Dart, executive director of the Tulsa Health Department, said current trends aren’t sustainable — hence his recommendation for the city to implement a mandatory mask ordinance.

Dart said he speaks with local hospital CEOs or senior executives on a weekly basis.

“They’re starting to become concerned about capacity,” he said.

Dr. David Kendrick, CEO of MyHealth Access Network, also spoke to Tulsa city councilors Wednesday before the governing body ultimately voted 7-2 in favor of a mask mandate.

MyHealth Access Network is a nonprofit health information exchange in Oklahoma. Kendrick said its data show the infection rate continues to go up and that the virus’ spread requires that “we need to do something tangible” to combat it.

He said that over time, the more people who test positive will translate directly into more hospitalizations.

A person on average is hospitalized for six to seven days if they don’t require an ICU bed, according to MyHealth data Kendrick presented councilors. A person in ICU stays for 10 to 20 days, if they survive to leave the hospital.

“The fatality rate for anyone admitted to the hospital (ICU) is over 21%, so that’s a sobering metric to think about,” Kendrick said.

State modifying its plan

The state’s surge plan in April determined through a statewide hospital bed survey that Oklahoma’s capacity was 4,633 available medical-surgical and ICU beds in case COVID-19 got out of hand.

That 4,633-bed cap was derived from a total staff beds figure of 8,611, of which the state reduced to account for specialty hospital beds, non-coronavirus patients and non-elective care patients. Elective or routine procedures weren’t happening until the temporary ban was lifted by Stitt on April 24.

The Tulsa World asked Stitt’s office by email how accurate or inaccurate the governor’s 5,000 figure is now, given that elective surgeries are ongoing again.

Donelle Harder, a spokeswoman for the state for COVID-19 matters, responded that the surge plan is being modified. Additionally, she said, the state is working to add overflow hospitals beyond just OSU Medical Center in Tulsa and Integris-Baptist Medical Center Portland Avenue in Oklahoma City:

Mercy Hospital in Oklahoma City

SSM Health St. Anthony Hospital in Oklahoma City

OU Medical Center in Oklahoma City

Norman Regional Hospital

AllianceHealth Midwest in Midwest City

Harder said the five additional hospital overflow contracts aren’t yet signed, but Harder said the state hopes to get them done next week.

The 125 overflow hospital beds at OSU Medical Center and 110 overflow beds at Integris weren’t included in the state’s bed capacity figure from the spring surge plan.

While all 125 rooms have been renovated at OSU Medical Center, only 10 were equipped and ready for patients last week. Another 40 beds could be “quickly converted to COVID treatment when needed,” according to an OSU Medical spokeswoman.

The U.S. Army Corps of Engineers did the renovation work to prepare the overflow rooms at OSU Medical and Integris, but the state had been waiting for prices to drop on the surplus market before outfitting the rooms with equipment.

“Any renovations that are needed will be on the part of the hospital,” Harder said of the five overflow hospitals in the works. “There are no discussions at this time for renovations through (the U.S. Army Corps of Engineers).”

Monks, who has been president of the Oklahoma State Medical Association since April, said he is skeptical about the state’s ability to flex up to an extra 40%, per the surge plan.

“Those plans are based on the assumption that we’re going to have military people and contract labor to be the staffing on the additional 40%,” Monks said. “And there’s no pool of extra health-care workers out there.

“We can’t hire nurses from Texas to come up here and help us. They’ve got their own problems down there; they’re in bad shape.”

If a crisis demanded it, Harder said, the surge plan would limit or restrict elective surgeries.

“In accordance with OSDH’s new color risk map for COVID-19, once statewide bed capacity reaches 95%, orange counties move into the red risk zone in which the State will consult with local officials to consider action steps such as limiting elective surgeries,” Harder wrote.

Alert system scrutinized

Stitt on July 9 released the state’s county-by-county COVID-19 alert system: new normal, low risk, moderate risk and high risk.

The first three levels are based on each county’s rate of new coronavirus cases, but the high-risk category is only activated when hospital beds or personal protective equipment drop below 5% on a statewide basis, not in the individual counties.

Baylee Lakey, spokeswoman for the governor, said Stitt and Frye cited the White House Coronavirus Task Force report in rolling out the alert system that recently became public in a Center for Public Integrity news article.

The document is dated July 14 and lists 18 states in a “red zone” for daily rate of COVID-19 cases, with Oklahoma being one of them.

The report recommends, among several actions, that counties in the red — Tulsa, Oklahoma, Okmulgee and Ottawa last week — close bars and gyms, as well as limit social gatherings to 10 or fewer people.

Lakey wrote that the colored alert system is based off White House methodology in looking at new cases per 100,000 population. She said that Oklahoma doesn’t have the same types of urban centers that many other states do, such as Texas, California and Florida.

“The governor will continue to monitor recommendations issued by the White House,” Lakey wrote. “In the meantime, the governor and OSDH are actively providing local communities with critical data so they can make informed decisions on the local level.”

Dr. Dale Bratzler, chief COVID officer for University of Oklahoma, participated Friday in a live streamed media interview.

Bratzler said the state’s COVID-19 alert system “is not helpful at this point.” He pointed to how the state is mostly one color, even though there are ongoing and specific hot spots in the state.

“It looks at the entire state’s capacity of medical-surgical bed and ICU beds, and, honestly, I don’t think we’re going to transfer patients from an academic medical center — or a Saint Francis in Tulsa — out to some small rural hospital because they have a med-surg bed available. I think it’s just unrealistic.”

Bratzler framed the situation in stark terms.

In Oklahoma during the 2019-20 influenza season, he said, there were only 85 confirmed flu deaths. Since March, the state has reported 445 COVID-19 deaths as of Friday.

There were 137,864 deaths overall in the U.S., according to CDC data on Friday.

“When’s the last time you remember hospitals commissioning refrigerated trucks to hold bodies during flu season? I just don’t remember that,” Bratzler said. “But that’s what’s happening in these hotspots around the country with COVID-19."

Gallery: COVID-19 basics

COVID-19 basics everyone needs to know as the pandemic continues

Local
Let's Talk resumes with focus on evictions

Tulsa’s eviction crisis will be the topic of the next Tulsa World Let’s Talk virtual town hall.

Eric Hallett, an attorney and coordinator of housing advocacy for Legal Aid Services of Oklahoma, and the Rev. Jeff Jaynes, executive director of Restore Hope Ministries, will be guests on the program, which will be posted on the Tulsa World Facebook page Wednesday morning.

The discussion will be moderated by Wayne Greene, editor of the Tulsa World’s editorial pages.

Questions for the event can be submitted to wayne.greene@tulsaworld.com before 10 a.m. Tuesday.

Tulsa World’s Let’s Talk virtual town halls are sponsored by the George Kaiser Family Foundation.


Featured video


Government-and-politics
After long wait, action on Equality Indicators reports could come soon

More than two years have passed since a group of local residents joined a national civil rights group in demanding that city councilors hold public meetings within 60 days to examine racial disparities in police practices detailed in the city’s inaugural Equality Indicators report.

That was in May 2018. The City Council’s first public meeting on the Equality Indicators report took place in June 2019. The fourth and last meeting occurred in September 2019.

This week, after months of conversations, consultations and a COVID-induced delay in deliberations, city councilors hope to begin addressing the inequalities they’ve spent the last two years trying to understand better.

It hasn’t been exactly two years. The City Council did not vote to hold public meetings on the Equality Indicators reports until early 2019. Councilors could not agree on the format.

Councilor Vanessa Hall-Harper, who was among the 50-plus residents demanding City Council action, wanted councilors to invoke their power to subpoena witnesses.

Councilor Phil Lakin and several of his colleagues weren’t going to agree to that.

“We can have civil discourse and discussions to reach conclusions that will shape the outcomes of our city positively,” Lakin said. “...Many of us thought we may not get the same kind of input and participation if we had utilized that subpeona.”

The dynamic of the discussion changed when four new city councilors — Crista Patrick, Kara Joy McKee, Cass Fahler and Lori Decter Wright — were elected in the summer and fall of 2018. The new City Council class was sworn in December 2018, and by early 2019 councilors had voted to hold public meetings on the Equality Indicators reports.

There would end up being four — one each in June, July, August and September.

“When a white person says it, then all of a sudden it’s critical,” Hall-Harper said. “As long as I was the only one at the table asking for it, it wasn’t critical. So when Councilors Lori Decter Wright and Kara Joy McKee were elected and started pushing for it, then it had instant legitimacy and consideration. That is just the fact.”

Lakin said he never thought the council was acting in response to residents’ demands. Examining the Equality Indicator reports finding was just the right thing for the city’s elected officials to do.

“We were reacting to what we needed to do as a city,” Lakin said.

What’s ahead

Mayor G.T. Bynum described the initial Equality Indicators report as the “statistical baseline for understanding inequality in our city.”

The report, which is issued annually, looks at dozens of indicators — from education levels to access to transportation — to compare outcomes of groups likely to experience inequalities to groups less likely to experience inequalities.

But it was the report’s data on police practices that prompted 51 Tulsans to sign a letter along with the NAACP Legal Defense and Educational Fund seeking public hearing to gather more information and recommendations regarding the Police Department’s use-of-force and arrest practices.

The report found that blacks were five times more likely to experience officer use of force than Hispanics, and whites were half as likely to experience use of force by police than Blacks.

Police have disputed the results and the methods used to reach them.

Nonetheless, councilors agreed to focus their meetings on justice-related issues: racial and gender disparities in police arrests of juveniles; racial and gender disparities in police arrests of adults; racial and gender disparities in police use of force; and minority and gender under-representation in the Police Department.

Since the City Council’s last public meeting on the Equality Indicators reports in September, councilors have been meeting regularly to review what was discussed at the meetings, consult with local stakeholders and identify and prioritize the issues they have the authority to address.

“At the beginning of the process of the Equality Indicators special meetings, most of the City Council was afraid of what it is we were asking; and when we got to the end everyone was saying, ‘This is important, this was good,’ ” McKee said.

Councilors are expected to begin work on their first priority — addressing the unequal effects of fines and fees — at their Wednesday meeting.

Other areas identified by the council for possible action include:

The Police Department is not following all national standards for data collection, nor making data readily available.

Some citizens do not trust police because of an apparent lack of accountability and transparency.

Biases in police policies and practices are having a negative impact on some people.

“I really want us to get to the point where nobody feels afraid to call the police for fear that officers on the scene would make things worse instead of better,” McKee said. “And I don’t want any of the police officers to be feeling like the situation is going to escalate unnecessarily because people are afraid that I am some sort of dangerous racist.

“We have got to get this important work done for everyone’s safety.”

Lakin said some issues will be easier to resolve than others but that it is important for the council in coordination with the Mayor’s Office to do more than talk about them.

“Let’s demonstrate to the community that we’re focused in on action items and let’s also demonstrate to the Police Department and every other affected entity that we can work more efficiently throughout the city,” Lakin said.

Hall-Harper said changing public policy, especially law enforcement policy, takes time in a conservative state with a history of racism.

“So when you take all those things into consideration, yeah it is going to take time,” she said. “Yes, I would like to be able to snap my fingers and we instantly have best practices as it relates to law enforcement in this city, but that is just not the reality of living in Tulsa, Oklahoma.”


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Tulsa's Equality Indicators Reports: A basic guide to what they are and what they measure

Tulsa's Equality Indicators Reports: A basic guide to what they are and what they measure

News
"I want to find the victims of the Race Massacre': Burial search is personal for some with ties to the past

Brenda Alford has a surprising connection to the search in Oaklawn Cemetery for unmarked burials from Tulsa’s 1921 Race Massacre.

Her own great-grandmother, who survived the massacre and died in 1925, is buried in Oaklawn — but the family has no idea where.

“My personal relationship in this is that I know how it feels to have someone buried out there and not be able to find them,” Alford said.

Alford said the family has a piece of paper showing Rosetta Moore was interred at Oaklawn, and Alford’s father, Clarence J. Nails, and his siblings visited the grave as children. But cemetery records are not as complete as one might think, and many graves have lost their markers over the years.

“I don’t know exactly what happened,” Alford said. “Over the years, they were unable to locate her again.”

That experience is one reason Alford spent every sweltering day last week at the cemetery, peering into a long, deep trench, and wondering if the next bucket of dirt would contain the lost remains of a human being.

It didn’t, but she told reporters Friday she is gratified by the city’s efforts and the work of the people involved.

Alford is the volunteer chairwoman of the citizen’s committee overseeing the search initiated by Mayor G.T. Bynum. Chairing the committee is a big job, in part because it’s a big committee, and in part because there are so many opinions about where investigators should be looking.

A Tulsa Technology Center administrator herself, Alford’s family connections to Tulsa and the historic Greenwood area stretch back to before statehood. Her grandparents, James and Vasinora Nails Sr., operated several businesses in Greenwood before the massacre and at one time owned what is now Lacy Park.

Their images are included in the mural decorating one wall of the Lacy Park community building.

The family still owns property near northeast Tulsa sold to them by Cyrus Avery, famous as the Father of Route 66, and the Mayo Brothers, builders of the Mayo Hotel.

Alford’s Aunt Cecilia Nails Palmer was the first African American professor at the University of Tulsa.

“I want to find the victims of the Race Massacre,” Alford said. “Being the descendant of survivors and Black Wall Street entrepreneurs who struggled greatly, I have this innate want inside myself to do whatever I can.”

Every day last week, from close to 7 a.m. until the archaeological excavation crew knocked off in late afternoon, John Patrick Kinnear watched from just beyond the fence on the west side of Oaklawn cemetery.

Kinnear has no known family connection to Greenwood or the 1921 massacre. He was raised in Tulsa but spent most of his adult life in California.

A 6-foot-5, bushy-bearded white man who looks like he might be at home on a Harley, Kinnear said he underwent something of an epiphany at the funeral of a friend — a Black man — not long ago.

“I just started bawling,” he said.

Kinnear said he feels compelled to “bear witness” to the activities at Oaklawn.

“Nobody else is out here,” he said. “That hurts my heart. Not everyone agrees with what they’re doing here and I understand that.

“I don’t know that it would mean closure, but I hope they find something that will get some sort of answers,” he said.

One might think Kavin Ross’ long involvement delving into the massacre’s secrets is due to his father, former state Rep. Don Ross.

Kavin Ross says it isn’t.

Ross, who is also a member of the oversight committee and spent last week at the excavation site, said he was “definitely inspired” by his father, but was more influenced by the late John Hope Franklin and by hours he spent video recording the stories of massacre survivors in the late 1990s and early 2000s.

“I always enjoyed talking to those people who once lived on Greenwood,” Ross said. “It would take me back in time to when my grandmother and grandfather would take me up and down Greenwood, visiting friends and family. My grandfather would take me to Shorty’s Barbershop ... and listen to all the barbershop talk.”

Ross said his own older relatives did not like to talk about the massacre because “they were just so angry.”

His great-grandparents owned the Zulu Lounge at Cameron and Greenwood. It was destroyed in the massacre and the location is now occupied by an Interstate 244 overpass.

Amazingly, Greenwood survived and even flourished after being burned to the ground in 1921. But it did not survive the business, social, political and demographic changes that devastated it and many other commercial districts beginning in the 1960s.

“I remember visiting as a child, when it was still a little active ... then when I came back in the late ‘70s and ‘80s, what I remembered as a child no longer existed.”

Mayor G.T. Bynum’s Tulsa family history is well-known and documented, which is perhaps one reason he says the race massacre and the way it has been handled over the past 99 years so pains him.

Like many others, Bynum says he had little or no knowledge of the event until fairly recently, and that pains him.

“As a dad,” he said, “I don’t want my kids growing up in a city that could have mass graves in it where the city didn’t do everything it could to find their location.”


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Gallery: Test excavations in Tulsa Race Massacre mass graves search

Gallery: Digging continues Tuesday for Tulsa Race Massacre mass graves at Oaklawn Cemetery