March 20, 2020
To:

Special Joint Committee on Coronavirus Response

Re:

COVID-19 preparedness

Co-Chair Roblan, Co-Chair Holvey, and Members of the Committee,
I am the Chief Medical Officer for OHSU Health which means I am responsible for managing the
clinical operations and patient care provided by OHSU’s health system which includes Adventist
Hospital Portland and Hillsboro Medical Center.
Thank you for the opportunity to speak to you today about projected hospital capacity needs
over the next several weeks and our work to prepare for what is being called “the surge”. When
we say “the surge”, we are talking about a possible significant number of Oregonians needing
hospitalization and ICU level care from COVID-19.
OHA’s data scientists, Dr. Dean Sidelinger and Dr. Peter Graven have worked together to enable
us to produce an initial projection for what hospitals should be planning as this outbreak moves
forward. Dr. Graven has modeled the hospital bed and ICU needs through April 16. Their model
only goes through April 16 because the forecasted need from that date is dependent upon what
we do now, leading up to mid-April. I want to emphasize that this is a situation that changes
every day. It is a model.
But as Dr. Jacobs said, we have an obligation to work together to prepare for the worst-case
scenario and be ready to treat those who need our care. We are concerned by what we are
hearing from our health care colleagues in other states, particularly in Washington, and from
around the world. And we must prepare for a similar situation.
The current modeling assumes the number of cases in Oregon will double every 6.2 days, and
that 1 in 5 Oregonians infected with COVID-19 will require hospitalization. We know this based
upon how the virus has spread in other cities. The good news is that 80% of people with COVID19 recover at home and do not require hospitalization. But this modeling does tell us that
without a significant slowing of COVID-19, Oregon will not be able to serve the hospital needs
of Oregonians without creating more hospital beds.

 OHSU Health alone may need 80 ICU beds for our expected number of COVID-19 patients by
mid-April. This happens to also be near our current ICU bed capacity. On a normal day, our ICU
is already full of Oregonians who need critical care even without the COVID crisis. We need to
recognize that those health care needs will continue. As Dr. Graven noted, according to
available data, Oregon may need 1000 hospital beds and 400 ICU beds dedicated to the
treatment of COVID-19 patients by April 16th.
Absent wide-spread testing and evidence that the measures that have been taken to date to
slow the spread are working, the hospital community has a moral imperative to prepare to
meet the hospital-based needs of Oregonians who will require this care. We are taking a
number of steps at OHSU to prepare for a surge of COVID-19 patients. I’m going to share a few
of those things with you today to give you a sense of the breadth and focus OHSU has on this
critical issue.
We have significantly ramped up our telemedicine and telehealth services to Oregonians. For
your reference, prior to the COVID-19 pandemic we typically provided about 100 video visits
per month. On Monday, we provided 180 video visits in a single day.
From what we know, about 10% of COVID-19 hospitalized COVID-19 patients need critical care.
Typically, about 30-40% of OHSU’s ICU patients require ventilation. What we’ve seen from Asia
and Europe is that number is almost 75% for COVID-19, significantly increasing the ventilator
use for these patients compared to an average ICU patient at OHSU.
We’ve established a critical care surge plan at OHSU to meet these patients’ needs in the event
of an overflow of our ICU. We are also repurposing operating room ventilators for an ICU
capability in our preparations to maximize all possible critical care assets.
While we know it is a lot to ask, we have asked our providers to keep their pagers on at all
times to ensure we are ready to respond in the event of a surge. I have been overwhelmed and
humbled as each and every person at OHSU has stepped up and is working tirelessly and
selflessly around the clock – and have been for weeks – because of their deep commitment to
our mission to care for Oregonians.
This is not just happening at OHSU, but Oregon’s health care providers are stepping up across
the metro region and the state. The metro area health systems are taking significant steps to
make room in our hospitals and to operate in a more coordinated way in the Portland metro
area and we will collectively be in a better position to support the hospitals throughout Oregon.
We have cancelled all elective and non-urgent surgeries and procedures to free up space in the
hospital while also conserving supplies and personnel. And now Governor Brown’s Executive
Order extends that across the state. It is important to note that OHSU is one of only two Level 1
trauma centers in the state which calls us to continue to provide life-saving treatment to
Oregonians apart from COVID-19

 We’ve joined together with major Portland metro area hospitals to work together across the
region to implement a coordinated approach for a regional COVID-19 emergency response and
address the projected surge of patient cases. This collaboration includes Kaiser Permanente,
Legacy Health, Providence Health & Services and OHSU Health.
A main objective of this coordinated approach includes coordination of available hospital beds
to meet the expected surge of COVID-19 patients. This bed coordination can and should be
extended statewide. Coordination of bed capacity in real-time through available technology will
allow us to use every available bed for Oregonians who need hospitalization or ICU level care.
A regional and statewide approach is critical to meet hospital-based care needs for COVID-19
patients and maximize the efficient and effective use of personal protective equipment, testing
supplies and necessary health care staff. We stand ready to support a statewide tool that will
ensure the state is maximizing every hospital bed, ICU bed, and ventilator available in Oregon
and any new capacity stood up through our statewide effort.
We are working hard to prepare for this surge, but we need the broader community to do its
part. We endorse the recent actions announced by Gov. Kate Brown to put social distancing
measures in place to reduce the spread of the virus and guard against overwhelming Oregon’s
health systems and health care workers.
I join Dr. Jacobs and many health care providers across the state in asking that all Oregonians
take physical separation from group settings very seriously right now. The goal is to slow the
spread so that fewer people need hospital care at the same time. Every Oregonian, especially
healthy Oregonians, can take actions now that will literally save lives. We understand that there
are very hard tradeoffs that impact the lives of Oregonians.
Absent widespread testing and real time data that we are bending the curve we have to do
everything we can to slow the spread of the virus. It is imperative that we practice extreme
caution in our travel outside of our homes during this spring break season. We urge Oregonians
stay in their home community and to stay home to the greatest extent possible, except for
essential workers and activities that can maintain six feet of social distancing. We all need to do
our part to prevent transmission of COVID-19 in our communities. We are all in this together.
Thank you again for the opportunity to speak with you today.
Renee Edwards, M.D., M.B.A.
Chief Medical Officer, OHSU Health