Essentia Health rolls out a commendable plan to boost ICU capacity

As the COVID-19 pandemic bore down on the United States back in March, one of the most alarming questions was whether the nation had the hospital capacity to care for those who became severely ill.

Italian hospitals were swamped. China built a 1,000-patient hospital from the ground up in about a week. The outlook didn't look good in the U.S., either.

"If the infection curve is not flattened and the pandemic is concentrated in a 6-month period, that would leave a capacity gap of 1,373,248 inpatient beds (274 percent potentially available capacity) and 295,350 ICU beds (508 percent potentially available capacity)," concluded a March 17 report in the journal Health Affairs. "If the curve of transmission is flattened to 12 months, then the needed inpatient and ICU beds would be reduced to 137 percent and 254 percent of current capacity."

Fortunately, lockdowns and other measures such as delaying elective procedures flattened the curve and kept U.S. hospitals in all but the hardest-hit cities from being overwhelmed. Nevertheless, this pandemic isn't over, and the future will bring other pathogens. The nation was caught flat-footed when it came to hospital capacity. It shouldn't ever be again.

That's why Minnesota's congressional leaders should lend their support to a timely new proposal from a state health care system. Duluth-based Essentia Health has rolled out a national ICU readiness plan. Essentia's leaders are calling for a $1 billion federal investment to expand the number of high-level care rooms nationwide.

The plan would boost the number of ICU-capable beds by 2,500, with the new capacity to be divided among the 10 hospital regions designated by the U.S. Department of Health and Human Services. Hospitals with the added capacity would serve as regional care hubs when a crisis strains capacity.

To stretch the dollars more efficiently, Essentia says the funding priority should go to hospitals with expansion projects underway or planned. That would enable the filtration systems, electronics, piping and other specialized equipment to be built in rather than added through expensive retrofitting.

"Compared to the economic cost of trillions of dollars that the coronavirus has caused, a little prevention to prepare for the next crisis is warranted," Essentia's leadership argues in plans shared with the Star Tribune Editorial Board.

Essentia, to be sure, has an institutional interest beyond expanding ICU capacity nationally. It serves Minnesota, Wisconsin and North Dakota. It is investing nearly $1 billion in its "Vision Northland" project to replace the more than 100-year-old St. Mary's Hospital in Duluth with a 14-story hospital tower, expanded clinical space and surgical suites.

Its pitch for expanded ICU capacity nationally includes $101 million in funding to convert 224 previously planned hospital beds in its Vision Northland project to ICU-capable rooms, boosting its overall ICU capacity to 288. Asked why Essentia can't fund this on its own, leaders said there's a national interest in medical preparedness. In addition, they pointed to the massive Vision Northland investment and say they've already taken on all they can. The project is the "second-largest hospital construction project in the United States,'' Essentia officials said.

Essentia's self-interest doesn't take away from the soundness of the ICU readiness idea. The pandemic has been an eye-opening experience. Along with the ICU capacity concerns, shortages of ventilators and personal protective equipment have exposed disturbing gaps in our medical system.

The nation's lawmakers should take up Essentia's proposal and, as part of those deliberations, put a broad spotlight on what else has gone wrong and what can be fixed. Ventilators and personal protective equipment must be part of the mix.

It's unclear if Congress would act in time to meet Essentia's construction schedule, or if the medical center would win out over other medical centers for the funding if an ICU readiness plan were approved. Still, the Duluth health care leaders are to be commended for identifying a practical yet farsighted solution — one that merits the Minnesota delegation's support.