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State releases more information on COVID-19 patient management as hospitals scramble to keep up

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DENVER — As the flood of COVID-19 patients threatens to overwhelm Colorado’s health care system, the state is quickly implementing plans to manage the demand.

The Colorado state Unified Command Center (UCC) released more details Wednesday on its plans to open up alternative care sites throughout the state, including the previously announced conversionof the Colorado Convention Center in Denver into a 2,000-bed medical facility.

The lease on the the 2.2 million square feet convention center has been completed, and construction on the conversion by the Army Corps of Engineers has begun. That facility is expected to be ready to accept patients by April 27. The state will pay Denver $30 per patient, per day, according to a letter of intent to the city.

The state has also secured a lease for space at the Larimer County Fairgrounds and Events Complex in Loveland. The Ranch facility at the fairgrounds will have a 1,060-bed capacity and is expected to open April 29.

The UCC also plans to finalize leases with three other alternative care sites — St. Anthony North in Westminster, St. Mary-Corwin Medical Center in Pueblo, and Western Slope Memory Care in Grand Junction — by the end of this week, and is working to secure additional facilities.

These Tier 3 alternative care sites will be used to provide medical care for patients who have stabilized in-hospital and no longer require critical care. Alternative care sites serve as medical shelters and are not field hospitals. The agency stressed that these facilities would not be open for members of the public seeking medical care or diagnosis.

The UCC provided the following information on how the medical surge system works:

  1. Individuals showing signs of illness should seek guidance by calling their primary care physician, a nurse care line or community health center. If an individual is having difficulty breathing, and they suspect COVID-19, they should seek urgent care at a hospital-based emergency department. Triage will determine which care setting is appropriate.
  2. Patients with critical needs are admitted into a critical care setting (ICU or medical nursing unit) - this is considered Tier 1 care.
  3. As patients within a hospital recover, they may be transferred by a fleet of state-managed ambulances to an ambulatory surgical center, free-standing emergency department, or critical access hospital -- all which can provide acute care to COVID-19 patients whose needs fall below critical care. This is considered Tier 2 care. A state dispatch center will manage these patient transfers among facilities.
  4. As further recovery ensues, healing patients may be transferred by the state-managed ambulance fleet to alternative care sites that have been created by the state, by hospitals and/or by state/local partnerships with public health and emergency management. This is considered Tier 3 care. Alternative Care Sites are medical shelters. They are not hospitals.
  5. Patients who are ready to return home but who can’t because of extenuating circumstances or because they need to quarantine in order to protect others, may be transferred by non-EMS to a hotel that has been converted to a medical shelter. This is Tier 4 care.