The Ernest N. Morial New Orleans Convention Center is being retrofitted as a “medical monitoring station” with an initial capacity to serve at least 1,000 patients recovering from the coronavirus. Hospitals will start referring patients to the center by April 5 “at the latest,” Gov. John Bel Edwards said at a Sunday press conference. The facility will not accept walk-in patients.
Although the state will be able to utilize a half a mile of convention center space for free, staffing and equipping the center is all being done through private contracting and will cost at least $76.3 million. That’s only for the first 30 days. Extending it could cost an additional $43 million per month or more, based on staffing costs in the recently approved contracts. And it doesn’t include the cost if the state has to increase patient capacity. (Edwards has previously said the capacity could be increased up to 3,000 beds.)
Under a recently approved disaster declaration for the state, however, it’s likely that as much as 75 percent of the costs will be covered by the federal government.
The price tag appears to dramatically increase the amount of public dollars being used to respond to the virus in Louisiana. A week ago, the state said it had spent $71 million total on the coronavirus response.
It appears the state has finalized contracts for much of what it needs to get the facility up and running: patient rooms, medical staff and wrap-around services including meals, laundry and personal protective equipment for support staff. However, none of the contracts appear to provide medical equipment such as oxygen tanks, heart monitors, thermometers or protective equipment for medical workers.
The state already had emergency contracts in place for oxygen, records available through its purchasing database show, but it’s not clear if that contractor will be providing oxygen for the center. The Governor’s Office of Homeland Security and Emergency Preparedness has issued several bid solicitations for personal protective equipment over the past 10 days, but the status of those was not clear on Monday. Edwards’ office did not respond to follow-up questions at the time this article was published.
The plan at the convention center, which came together last week, is an attempt to clear out intensive care unit beds, or ICU beds, in the area’s hospitals. One concern around the world is that mortality rates won’t just be determined by the viciousness of the virus, but also by the availability, or lack thereof, of beds and ventilators to treat people as hospitals are overwhelmed by a high volume of infected people.
On Sunday, Edwards said that the New Orleans metropolitan area could be out of ventilators by April 4 and out of critical care beds by April 10. The state is trying to increase the number of ICU beds and ventilators at local hospitals. Edwards said that Ochsner New Orleans was adding 96 ICU beds while LCMC Health in New Orleans would be adding 70 beds.
Using the convention center for non-critical patients will clear hospital beds for those requiring acute care.
“The goal here is really to have a unit for folks that are all but ready to go home,” Dr. Alex Billoux of the Louisiana Department of Health said on Sunday. “When we talk with medical teams across the city, and frankly across the state, there’s a number of folks who are healing from Covid-19, but may still have need for oxygen, may have need for some nursing … So this facility is really designed for those folks as a bridge.”
The facility in New Orleans won’t be accepting walk-in patients, only those transferred by a hospital or medical facility. It’s a similar strategy employed in other hard-hit regions. New York City, another hotspot for the coronavirus, is utilizing the Javits Center for a similar purpose.
On Sunday, Edwards said that the US Navy would be setting up another facility across the street from the convention center. That facility would be for patients suspected of having the virus who need to be quarantined or isolated as they await test results.
Edwards said that while he was confident the two new medical facilities would help with the projected bed shortages, it remains vital for the state and city to “flatten the curve,” or reduce the rate of infection in Louisiana. He urged people to follow guidance from the state’s Department of Health and continue social distancing.
“If we don’t bend this curve, it’s still likely that some people who need a bed will not have a bed,” he said.
New Orleans has been a national hotspot for coronavirus infections. As of the weekend, The Times-Picayune/New Orleans Advocate reported, Orleans Parish had the highest per-capita death rate of confirmed cases anywhere in the country. The state has consistently been at or near the top of the list confirmed cases per capita.
However, it’s possible that some other states may not have as good a picture of their infection rates. Along with being near the top in infections and confirmed coronavirus deaths, Louisiana is also near the top in testing per capita, Edwards said Sunday. Private and public labs in Louisiana, which has about 4.6 million residents, have performed about 34,000 tests as of Monday. Texas, which has a population of nearly 29 million, has performed about 36,000 tests as of Monday, according to its state health department.
The Louisiana Department of Health reported 4,025 confirmed cases of the virus in the state, 1,058 of whom are hospitalized, as of Monday afternoon. The state has recorded 185 people who have died after contracting the virus, 86 of them were in New Orleans.
The Contracts
The layout of the medical facility was shown in photos shared by Mayor LaToya Cantrell on social media. According to the contracts, the patients will be broken down into 120-person wings, and further broken down into “pods” of 15 rooms. Each room will measure 10-by-10 feet. Each “pod” will have a dedicated nursing station.
The construction is being done by New Orleans-based Dynamic Construction. The first 1000 beds will cost $33.5 million. Dynamic Construction will build the pods, as well as provide showers, sinks and a power generator.
The center will also be outfitted with the help of two field hospitals that the federal government is providing Louisiana. Edwards said the equipment for those field hospitals will be used to equip the convention center. It’s unclear whether that was accounted for in the Dynamic Construction contract.
The two field hospitals were also supposed to help with staffing the center. Originally, they came with a 60-person medical “strike team.” But on Sunday, Edwards announced that the team had been “diverted” to another state.
The state will now staff the convention center through the San Antonio-based non-profit BCFS Health and Human Services. The contract stipulates exactly how each wing and pod in the convention center needs to be staffed. The contract provides for nurses, doctors, respiratory therapists and mental health professionals.
To staff the initial 1,000 beds, BCS estimates it will need 465 people in total including everything from nurses to respiratory technicians to administrative and logistical staff. Edwards said that some of the Navy personnel used to staff the adjacent isolation facility could be used within the convention center if they have extra capacity. Edwards said the Navy was sending roughly 180 people.
BCFS predicts that it will cost $38.3 million to staff the center per month. Edwards said that the facility would be staffed properly.
“Understand that this is a non-acute hospital setting. So these patients who come here are not gonna be fragile, they’re not gonna need a vent, and we believe they will only need to be here for a relatively short period of time before they can be discharged home,” he said. “That plays into the level of staffing that we’re going to need at this medical monitoring station.”
BCFS doesn’t appear to be required to provide medical equipment, and one document indicates that the responsibility falls on the state. However, it’s unclear what the state’s plan is for medical equipment, including oxygen tanks.
The other major contract is with Baton Rouge-based Excel Contractors for “wrap around services” at the site, including food and laundry. (Excel is providing protective gear for its workers.) The contract includes two major sub-contractors: Keta Group in Baton Rouge and Ballard Hospitality in Covington.
All in all, the contract is worth $4.7 million to service 1000 beds for 30 days. That jumps to $6.6 million a month if the convention center facility expands up to 2000 beds.