Washington hospitals reported 254 admissions of people showing symptoms of COVID-19-like illness during the third week of March, according to state statistics that offer a window into the pandemic’s impact on the state’s health care system.

The information in a Department of Health (DOH) surveillance report is part of a stepped-up effort by the state amid widespread concerns that patients suffering from the disease, caused by the novel coronavirus, could eventually overwhelm some hospitals later this spring.

The report covers admissions collected from 84% of Washington hospital emergency departments. Starting this week, all hospitals, as well as other health care facilities, must immediately report all confirmed and suspected COVID-19 cases, according to a March 21 letter sent to hospitals and local health officials from Dr. Kathy Lofy, the state health officer.

The state has for years tracked influenza through a health care reporting system, and this report reflects how the system has been revamped to try to monitor the flow of possible coronavirus patients into hospitals. Lofy said the state data shows a continued upward trend of patients admitted with COVID-19-like symptoms. In the last week of February, there were 61 hospitalizations. The week after that there were 126, and the following week 229.

Lofy cautioned that the numbers need to be taken with “a little grain of salt” because they are based on symptoms displayed by patients and may miss some that actually have the disease caused by the virus, and they include others whose testing may later determine they do not have the virus.

So far, a spokeswoman for the Washington State Hospital Association says that shortages of supplies — not hospital beds — remain the most serious problems for health care facilities taking in patients that have symptoms of the COVID-19 illness.

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“We have not heard the concern, yet, in terms of space,” said Beth Zborowski, the association spokeswoman.

Lofy said the state’s hospitals still have capacity to take care of coronavirus patients, and called that “good news.”

Washingtonians have been on high alert for weeks as the virus has spread through the state. As of Tuesday evening, confirmed cases totaled 2,469, and included 123 deaths.

For health care officials, in Washington and other states, the number of coronavirus cases severe enough to require hospitalization represents a crucial measure. They are deeply concerned that very sick patients, many requiring ventilators and lengthy intensive care, could pour into hospitals.

Inslee, in a March 17 letter to President Donald Trump, said that “we anticipate our hospitals will be in crisis by the end of the month,” and hospitals have scrambled to increase space for these patients as they cancel — under Inslee’s orders — many elective surgeries.

That scenario has  started to play out in New York, a state with more than 25,000 cases, and the prospects of a big surge in Washington in part spurred Inslee’s stay-at-home order announced Monday.

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“It’s time to hunker down in order to win this fight,” Inslee said as he announced the new measures.

Officials watching for surge

In recent weeks, Washington hospitals have been scrambling to prepare for COVID-19 patients.

Statewide, Washington has more than 11,800 hospital beds. Before the outbreak of the coronavirus, 1,493 of those beds were in intensive care units, where many COVID-19 patients receive care. And typically 970 of those are occupied, according to data developed by the Harvard Global Health Institute.

To increase their ability to respond to the pandemic, Washington hospitals in recent weeks have canceled many elective surgeries and worked to increase the intensive care unit capacity, including more negative pressure rooms that help to limit the spread of contagious disease inside the hospital.

To aid in that effort, Inslee last weekend appointed retired Navy Vice Adm. Raquel Bono to coordinate Washington’s health-system response.

Bono told reporters Tuesday she spent her first days in Washington “looking at a lot of data sources to understand actual reality … and comparing that to the modeling figures that a variety of places have provided for us.”

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“Candidly, many of those models predict large numbers of patients and we could quickly be overwhelmed,” but it’s not yet clear whether that scenario is materializing, Bono said, suggesting Inslee’s stay-at-home order could help officials over the next week or two get “a little bit better idea where we actually are on those modeling curves.”

“I think we do need to have our data and be transparent about it,” Bono said, noting that would allow her to direct medical resources to the right locations at the right times.

Inslee’s chief of staff, David Postman, said that the types of spikes in cases seen elsewhere in the world is not happening in Washington. He noted that the rate of Washingtonians testing positive for the coronavirus has hovered around 7%, even as many more tests have been done. “That, I’m told by the experts, is a good sign.”

But Postman stressed that a surge could still come.

“Nobody in the conversations I’ve been in has said, ‘We’re done. Don’t worry about it,’ ” Postman said. “It’s always been, ‘This is okay for now, but let’s talk tomorrow.’ “

COVID-19-like cases

The state DOH surveillance data tracks the number of potential coronavirus cases during the third week of March as many businesses shut down, schools closed and many people stayed at home.

A note on last week’s report advises caution interpreting the data, which tracks admission of people with symptoms that include fever or chills and coughs, shortness of breath or difficulty breathing. Some people with only one of these symptoms would not be included in the data and yet still might have the virus.

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The report does not break down the 254 hospitalizations by a county. It does say that COVID-19-like illness hospitalizations were “statically elevated” last week at hospitals in 16 of the state’s 39 counties.

A lot of those cases are in King County. UW Medicine, alone,  has 66 confirmed cases and 11 pending across four hospitals: Harborview; UW Medical Center, Montlake; UW Medical Center-Northwest; and Valley Medical Center, according to Susan Gregg, a spokesperson for the UW Medicine system.

Other Puget Sound area hospitals with significant numbers of COVID-19 patients include EvergreenHealth Medical Center in Kirkland, Providence Regional Medical Center Everett and Overlake Medical Center in Bellevue, according to Zborowski, the state hospital association spokeswoman.

In southwest Washington, Vancouver-based Peace Health System has 11 confirmed cases in its hospital network, according to Jeremy Rush, manager of public affairs, who noted triage sites are being set up at hospital emergency departments to prepare for a possible influx of patients.

Bono, in her call with reporters, said more information about the state’s health care capacity to handle coronavirus patients should be compiled and released, and that addressing the issue would be a top priority.

Correction: An earlier version of this story misspelled the name of the Washington State Hospital Association’s Beth Zborowski.

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