Detroit's $9 million field hospital shuts after treating 39 COVID patients

The TCF Regional Care Center, in downtown Detroit, opened on April 10, and admitted its first patient that Sunday. The facility is no longer accepting patients. (Paulette Parker / Michigan Radio)

Michigan’s first field hospital is no longer accepting COVID-19 patients, less than a month after opening. COVID-19 hospitalizations are leveling off, and health systems no longer need TCF’s beds as an option for overflow. 

The TCF Regional Care Center, in downtown Detroit, opened on April 10, and admitted its first patient that Sunday. 

On May 1, MDHHS confirmed the field hospital would accept no more transfers, and the final patient was discharged on Wednesday. All told, the hospital cared for 39 people.

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According to a spokesperson for the field hospital, the move is a “pause,” not a “closure.” Its beds and equipment (though not its staff) will remain in place in the event of a second surge of COVID-19 cases. Leadership at the facility, and outside experts, see the low census as a sign that Michigan fared better than anticipated during this first surge. 

Lynn Torossian, the field hospital’s CEO, called it the “best-case scenario.” 

Dr. Jenny Atas, who was tasked with getting the facility operational, said social distancing and a milder-than-projected surge contributed to the low patient count. But she also recognizes that many hospitals were on the brink of collapse. She and others are prepared for a second surge. And if they have to reopen TCF, they plan to make some changes. 

“There’s several things I would have done differently,” said Atas. 

Lessons from the surge

In late March, as COVID-19 cases descended on emergency departments in southeast Michigan, Atas was on the ground in Detroit, scouting sites for a field hospital. Atas is an emergency physician. As medical director of the Region 2 South health care coalition, which serves Wayne, Monroe and Washtenaw counties, she sat right in the middle of the state’s beleaguered health care system. 

Working with the Army Corps of Engineers, Atas selected the TCF Center, which could house 1,000 patients in non-critical condition. 

While COVID-19 hospital admissions were rising at the time, available data suggested that Michigan’s critical care infrastructure—its beds, ventilators, and staff—would accommodate the projected surge. So Atas and MDHHS decided not to build an ICU at the field hospital. They also decided to only admit patients 10 days after the onset of symptoms, based on advice they were getting from medical leaders in Detroit, and administrators from the Jacob K. Javits Center in New York City. Both groups said to be wary even of non-critical cases; some of these patients were developing an aggressive immune-system response known as a cytokine storm that quickly drove them into critical condition. 

“If I had to do it again, I would definitely put an intensive care unit in there,” said Atas. 

Stringent admissions criteria and no ICU helps explain why the TCF Center saw so few patients, even when other hospitals were nearing capacity.

 

But more importantly, she added, you must have staff who can work in an ICU. Staff for the TCF Center came from multiple sources, among them the Defense Department and the United States Public Health Service Commissioned Corps. This is the second thing Atas learned: When requesting federal support from FEMA, you need to be specific. 

“You really have to specify what you need coming in,” she said. “When you request these teams, you want clinically active teams.”

In other words, simply requesting a “nurse” won’t cut it. 

Would an earlier opening have helped? 

For at least one hospital system, the TCF Center might have been a more useful resource had it opened a bit earlier. 

According to an update from spokesperson David Olejarz, the Henry Ford Health System hit its peak on April 7, with 752 patients hospitalized with COVID-19. Michigan’s largest health system, Beaumont Health, also peaked on April 7, with 1,223 hospitalizations. (Henry Ford's count includes confirmed positive tests in their hospitals, while Beaumont includes confirmed and pending tests.) 

In that first week of April, as construction was underway at TCF, Henry Ford’s Detroit hospital was admitting a lot of nursing home residents. When these patients were ready for discharge, their skilled nursing facilities were often reluctant to receive them, given the risk of further spreading the disease. 

Bob Riney, Henry Ford’s president of health care operations and chief operating officer, said that if this happens again, it would be helpful to have a “transitional” facility for those elderly patients. 

“If that facility had opened two or three weeks earlier, we probably would have sent some additional patients there, because we were feeling really, really tight,” he said. 

But by the time TCF opened, he said, Henry Ford’s hospitalizations had started to level off. “It wasn’t going to be easy,” he said, “but we could hold our own.”

Beaumont did not provide a comment for this story.

Henry Ford was the partner hospital in setting up the TCF Center, providing leadership, staff, and IT support. As chief operating officer, Riney is responsible for assessing Henry Ford’s surge capacity and deciding how sites like TCF will fit into a plan for transferring overflow patients.

If there is a second surge, he said a “reasonable” threshold for reopening the TCF Center would be health systems reaching 25 percent available bed space. If given the command, Atas says TCF could become operational again in five days. 

What’s in store for this big empty space?

The construction and staffing of the TCF field hospital was an expensive and complex effort, convening local, state and federal agencies to convert 350,000 square feet into a specially outfitted medical facility in just nine days. Though the accounting has just begun, the cost is already well into the millions. 

According to the Army Corps of Engineers, the construction costs came in at almost $9.5 million. That includes erecting room partitions, retrofitting the HVAC system to create negative pressure, and designing and building a system for delivering oxygen to the patients’ bedside, among other improvements. Under FEMA’s public assistance grant program, FEMA covers 75 percent of that cost, with Michigan picking up the rest. 

For some resources at TCF, FEMA is paying the full amount. For example, Region 5 administrator James K. Joseph says FEMA will be fully funding the logistical, transportation, and bed-construction work provided by the Michigan National Guard. The cost of other federal resources will be known once those agencies submit their expenses to FEMA, according to a FEMA spokesperson.

For the foreseeable future, the massive field hospital isn’t going anywhere. Other than retaining staff, who have left the premises, the TCF Center stands by, ready for a second surge. 

“I feel very fortunate and very privileged to have had that experience as an emergency physician,” said Atas, who guided the TCF Center from convention hall to field hospital. “Because you never know when you’re going to need to do it again.

“And I definitely, easily, could do it again. In my sleep, quite frankly.” 

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Comments

Revere
Fri, 05/08/2020 - 11:12am

LOL. Shut down after accepting THIRTY NINE patients?
And our crosseyed idiot of a governor extender her illegal "order" until the end of the month?
39 patients for 9 million is a cost of only about TWO HUNDRED THIRTY THOUSAND per patient, by the way. And that doesn't count the cost of all the personnell - Only the cost of the facility modifications.
That's tyrant logic for you.
Ignore the shutdown. Violate it at every chance. And for pete's sake, don't wear masks, the CDC established in 2015 that cloth masks increase your chance of infection by over 10 times!
"Tyrants get the rope" ;)

A Yooper
Sat, 05/09/2020 - 10:30am

Better safe than sorry eh?
If it was your sorry self who needed it you'd grateful, you ungrateful sod.

Revere
Sat, 05/09/2020 - 3:08pm

Yooper,
You think and speak like a communist. You need to move to china. Now. You and your way of thinking has no place in America. You've lost it. Maybe you never had it.

A Yooper
Sun, 05/10/2020 - 9:27am

This fits you like a glove.
Here's to you ignoramus:
It may be shocking to some people in this country to realize that, without meaning to do so, they hold views in common with Hitler when they preach discrimination against other religious, racial or economic groups.
~Henry A. Wallace, Vice President of the United States, 1941-1945

Revere
Sun, 05/10/2020 - 7:16pm

Yooper,
My goodness you are off the deep end.
Henry Wallace would NEVER have applied that statement to someone speaking of communists. Are you kidding me?
Please, for the love of everything, start thinking for yourself! Come on, man!!!

duane
Fri, 05/08/2020 - 11:18am

It is so encouraging to see a facility that was created so quickly in such times of stress turned out not to be needed. It demonstrates the knowledge and skills of the medical care professionals in Michigan and particularly in southeast Michigan. Congratulations to all!!!

What would also seem probable is that the FEMA and Army Corp of Engineers staff stepped up and delivered quite well, though it is disappointing that neither the author or those interviewed felt those efforts are worthy of public recognition, especially how our Governor was dismissing what the federal government [people] were delivering then to help Michigan while also delivering such support across the country. It seems Michigan was not slighted at all in having our needs filled.
I would like somewhere to read an article that describes how appreciative the residents of Michigan are, not only thankful of the risks taken, the sacrifices made, the expertise applied by our own medical and support staff in this crisis but the thank you would be extended for those who came from elsewhere to help us.
Thank you to all for it was from your efforts that so many have survived and so many families are still whole.

John G70
Fri, 05/08/2020 - 5:24pm

Yes the Corp of Engineers and FEMA did a great job of hiring private contractors to do the modifications!

A Yooper
Sat, 05/09/2020 - 10:33am

And.....if they hadn't you would have whined they should have hired it out. The bid process would have taken forever and time was critical.

duane
Sat, 05/09/2020 - 12:16pm

John,
Thank you, those contractors and those who did the hands on work have also earned our gratitude.
I think your point of contractors is important, it highlights how we are an integrated society and rely on many outside the traditional images roles we have grown up with and what we read about. This suggests an article how the medical and other organizations have been supplemented by contractors to treat and protect our communities in this crisis, it shows how our society is ever changing the avenues for people to work in our economy.

Kevin Grand
Fri, 05/08/2020 - 11:23am

More bad data and poor modeling.

What else did the "experts" miss the mark on?

CMAC
Fri, 05/08/2020 - 11:25am

$243,589.74 per patient served. Good job! Totally needed!

Thank God
Fri, 05/08/2020 - 4:07pm

Great job, everyone! We flattened the curve, saved thousands of lives. We're prepared for any spikes and can let other irresponsible states use the equipment, if need be.

Anonymous
Fri, 05/08/2020 - 4:08pm

At least now we are prepared for the fall.

Anonymous
Fri, 05/08/2020 - 7:59pm

As others have already stated and pointed out, another stain for the current administration of the once great state of Michigan

Mixed feelings
Fri, 05/08/2020 - 8:01pm

So happy we were able to flatten the curve, but terrified by the risky rush of the public to pretend the virus is gone. We learned from the Spanish Flu that such complacency will be met with far greater devastation in the fall.

Revere
Sat, 05/09/2020 - 9:14am

It is crazy to me to see how many people have bought into this false "flattening the curve" religion. I did not realize how many people had a total lack of understanding of even basic statistics.
I guess that explains a lot about the direction this country is going.
I highly recommend that you get some basic education and start thinking for yourself.

Subee
Sat, 05/09/2020 - 10:52am

Oh pray tell, Revere, how you came to the conclusion, based in your unique understanding of statistics, that you came to the conclusion that "flattening the curve" is fallacy. So that would follow, by your logic, that a falling curve would also be a meaningless construct? The fact that we are still on a plateau gives us no information where we are at this point in time. People make plans (unless you ignore your paid advisors) on the best data they have at the time. In this case the data changes so rapidly it's impossible to make decisions that are 100% correct all the time. Statistically and logically impossible. So, please, explain how you've come to your opinion ..based on what?

Revere
Sun, 05/10/2020 - 9:00pm

Subee,
Oh, I don't know, maybe how we are acting on numbers that are statistically insignificant to the population? LOL.
See, if you want numbers that are representative of the population, you must collect a truly random sample of the population. None of the published media "numbers" are from random samples - They are targeted testing of people who think they are sick, are sick, or have been known to be exposed to a sick person. Therefore, these numbers only apply to people in that group, and are totally irrevelant and totally not representative of the population.
Very basic logic and common sense dictate that making decisions for a population with statistical numbers that are irrelevant to that population are, to put it lightly, very STUPID.
This is very, very basic statistics. Highschool level stuff. You should check it out, you must have been sleeping during that part of math class. I would also highly recommend thinking for yourself someday - You will find it very rewarding.

janet
Sat, 05/09/2020 - 11:22am

The first time I've seen the cost reported, but then, I'd expect no less from Bridge. I have mixed feelings--cost vs. necessity--but this dedicated mask-wearer, a part of the very vulnerable population-is grateful that the facility exists thanks to the efforts of hundreds of people who created it, and to those who are staffing it-all for the greater good.

Jake K
Sat, 05/09/2020 - 3:19pm

Somewhere, sometime within our Governor’s VP campaigning and media appearances I truly hope she will thank the Fed’s for the investment in TCF instead of continuing to deride them for their alleged lack of support. Hope.