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Race is on to prepare Georgia hospitals for COVID-19 peak

As some states plan reopening, Kemp wants to keep the focus on fighting coronavirus around the state. (Report by Greg Bluestein, Video by Ryon Horne/AJC)

One month after Georgia reported its first death from the novel coronavirus, state officials are racing to ensure hospitals can handle a surge in critically ill patients — now expected in about two weeks.

Gov. Brian Kemp said Monday that hundreds of beds for noncritical coronavirus patients could be quickly set up at the Georgia World Congress Center in downtown Atlanta. This would free up space in hospitals for sicker patients by May 1, the expected peak of statewide demand on health care resources.

With computer models projecting Georgia’s death toll to exceed 3,700 by summer, Kemp also relaxed protocols for who may be tested for the virus.

Among those now eligible are workers in “critical infrastructure” jobs who display symptoms and people without symptoms who have been exposed to the virus through contact with others who have it. Testing appointments may be made through local health departments; a doctor’s referral is no longer required.

Public health experts say additional testing is necessary to control the virus. Georgia ranks 45th among the states in tests per capita.

“The status quo is not acceptable,” Kemp said. “We need to be firing on all cylinders to prepare for the days and weeks ahead.”

Kemp, who was among the last of the nation’s governors to order stringent social-distancing measures to curb the virus’ spread, spoke with urgency Monday of the rush to prepare for the outbreak’s peak.

“It’s time to hunker down, make sure we can get to the peak, flatten it out and then head in the other direction,” Kemp said.

For now, however, both deaths and confirmed cases of COVID-19, the disease caused by the coronavirus, continue to increase at a dramatic pace.

The official death toll rose to 480 on Monday, up by 38 since Sunday. State officials acknowledge that their count lags behind real-time reports from around Georgia.

Almost 1,100 additional coronavirus diagnoses were confirmed Monday, bringing the total of known cases to 13,621.

During a news conference outside the state Capitol, Kemp announced he was suspending enforcement of a century-old state law that prohibits wearing face masks in public. He also spoke, very deliberately, about eventually lifting restrictions that have disrupted commerce, education and day-to-day life for all Georgians.

“There’s going to be a lot of moving parts going into something like that,” Kemp said. “I don’t want to speculate until we get to that peak and we can tell when we’re coming down off of this.”


COMPLETE COVERAGE: CORONAVIRUS IN GEORGIA


Shortly before he spoke, governors of seven Northeastern states announced they would coordinate their decisions to reopen businesses and schools. Those states have reported almost two-thirds of all coronavirus deaths in the country.

But Kemp said: “Our focus is on the hospital surge capacity, the ability to test more. We’re a little behind the curve on where our peak is going to be.”

Kemp’s shelter-in-place order is set to expire April 30. That is one day before hospital needs are projected to peak — and three days before Georgia is expected to reach its greatest number of daily deaths.

A sign on the doors of State Farm Arena in Atlanta on Monday, April 13, 2020, informs the public of shows canceled because of the stay-at-home mandate imposed amid the coronavirus pandemic. JOHN SPINK/JSPINK@AJC.COM
A sign on the doors of State Farm Arena in Atlanta on Monday, April 13, 2020, informs the public of shows canceled because of the stay-at-home mandate imposed amid the coronavirus pandemic. JOHN SPINK/JSPINK@AJC.COM

Kemp said an inventory of hospital capacity shows that Georgia facilities have more than 9,000 beds: 2,617 in emergency rooms, 929 in critical-care units and 6,000 on general inpatient wards.

Georgia Adjutant General Tom Carden said models predicting hospital surges are “a decent guide … but not a foolproof guide.” The capacity easily exceeds the median projected need, he said, but “looking above that, we are not in great shape.”

Temporary hospitals can serve as a “relief valve,” Carden said. But “I frankly pray that we don’t need it.”

Shortages of hospital beds may be especially acute in southwest Georgia, which continues to be the state’s hardest-hit region, despite its lack of an international airport, coastline or even an interstate highway.

Eight mostly rural, sparsely populated counties there have accounted for more than one-fourth of the statewide death toll. The outbreak is so bad that if the rest of Georgia matched the death rate of tiny Terrell County, for example, coronavirus fatalities statewide would already exceed 12,000, an analysis by The Atlanta Journal-Constitution found.

Under that scenario, more than 1,200 people would have died in Fulton County, nearly 1,100 in Gwinnett and almost 900 each in Cobb and DeKalb.

A group of masked individuals leave the Georgia World Congress Center on Monday, April 13, 2020. Gov. Brian Kemp announced on Easter Sunday, April 12, that the state will convert part of the sprawling Georgia World Congress Center into a 200-bed hospital for coronavirus patients. JOHN SPINK/JSPINK@AJC.COM
A group of masked individuals leave the Georgia World Congress Center on Monday, April 13, 2020. Gov. Brian Kemp announced on Easter Sunday, April 12, that the state will convert part of the sprawling Georgia World Congress Center into a 200-bed hospital for coronavirus patients. JOHN SPINK/JSPINK@AJC.COM

Data on confirmed cases of COVID-19 is incomplete, largely because of Georgia’s testing deficiencies. Still, southwest Georgia has seen a disproportionate number of cases compared to the state as a whole.

In Randolph County, for instance, more than 1.5% of the 6,800 residents have tested positive for COVID-19. If that rate held statewide, about 170,000 Georgians would have been diagnosed to date — almost 13 times the current total.

This analysis reflects several harsh realities about public health in Georgia. The eight counties — centered on Albany, southwest Georgia’s largest city with about 75,000 residents — are like many others outside metro Atlanta: older, sicker and poorer than the state overall.

How COVID-19 has affected southwest Georgia

An analysis of coronavirus deaths per 100,000 population shows how devastating the outbreak has been in mostly rural counties in southwest Georgia. Here is a comparison of the counties with the highest death rates versus those with the greatest populations:

Terrell County: 11 deaths (116.1 per 100K)

Dougherty County: 77 (78.9)

Randolph County: 6 (73.1)

Baker County: 2 (64.7)

Mitchell County: 15 (63.1)

Fulton County: 52 (4.8)

Cobb County: 35 (4.6)

Clayton County: 12 (3.8)

Gwinnett County: 22 (2.1)

DeKalb County: 14 (1.85)

Sources: Georgia Department of Public Health, AJC research

Note: Figures last updated at noon Monday

 

Moreover, people there are even less likely to have health insurance than Georgians as a whole. Georgia ranks next to the bottom among the 50 states and the District of Columbia in the rate of insured residents.

Most of the eight counties also have a larger African American population than the state as a whole; four are majority black. Dr. Carlos del Rio, an infectious disease expert at Emory University, said last week that the coronavirus demonstrates that minorities “do not have the same access to health care, do not have the same access to testing (for the virus) that other communities have.”

As the outbreak intensified last month, the state Department of Public Health and the federal Centers for Disease Control and Prevention dispatched epidemiologists to southwest Georgia to investigate how the coronavirus spread so broadly there.

So far, these teams — often referred to as “disease detectives” — have had to focus more on preventing and containing the outbreak than in investigating its origins, said Nancy Nydam, a spokeswoman for the public health agency.

As deaths continue to increase in places like Terrell County, where the population is only 8,600, everyone knows someone who has died from the virus, Coroner James Hamby said.

The outbreak has left a baffling trail around Dawson, the county seat, Hamby said.

“I don’t know why one person will get it and another person can be in the same room and not show any symptoms,” he said.

Regardless, “It’s been devastating to the county.”

Staff writer Greg Bluestein, audience specialist Pete Corson, and data specialist John Perry contributed to this article.