The surge in COVID-19 cases is affecting northern Nevada hospitals. In Washoe County, the seven-day average for new cases is more than 350. Nevada's 14-day test positivity rate is at its highest since the pandemic began, at nearly 15 percent. The high number of cases is leading to more hospitalizations. 

"We need more and more space to be able to continue our daily operations," Dr. Tony Slonim, President and CEO of Renown Health said. 

Back in April, Renown Regional Medical Center transformed the bottom floor of its Mill Street parking garage into an alternative care site. It has not needed to be used until this week. It opened Thursday for adults with COVID-19 who are either recovering or transitioning out of the hospital.

"Activation of the Alternate Care Site allows us to not only treat more patients but to allow for capacity in the higher levels of care that we may need," Dr. Paul Sierzenski, Chief Medical Officer of Acute Services at Renown said. "For example, for those who are in the Intensive Care Unit."

The extra space allows an additional 700 patients but it will start out with small numbers.

"The first phase is to have 20 patients in the Alternate Care Site and then adjust and grow if needed," Sierzenski said.

Renown averages 90-110 patients who arrive and leave the hospital each day. COVID is presenting capacity challenges because the average stay for patients with the disease is about twice as long as another patient. That means more people are checking in than checking out.

"While the numbers of COVID are increasing, we're still seeing patients who are acutely traumatized," Slonim said. "Car accidents continue to occur, people will still have heart attacks and problems with appendicitis and other injuries and issues."

As patients get closer to a full recovery, the goal is to care for them in other ways to allow beds to open up for patients who need more critical care.

"The hope is how can we transition those individuals potentially to either the alternate care site or to their home so we can provide that care," Sierzenski said.

Slonim says Renown is using the alternate care site because demand is rising rapidly. The Renown's South Meadows location added a new unit over the weekend, adding capacity for 35 more patients but that was still not enough.

"We had opened up a brand new unit, it was getting filled up, it was getting advancing team-based care standards and we still had patients in the Emergency Department with COVID who were waiting to get a hospital bed," Slonim said.

The problem is not unique to Renown. That is why it is working with other hospitals throughout the region for things like supplies, equipment, space and personnel. 

"This has got to do with how are we responding together because this is a community event," Slonim said. "This is not a hospital event, for sure."

Officials say Renown has an adequate supply of personal protective equipment. The medical industry had a shortage of doctors and nurses before the pandemic and they say it is worse now because of early retirements, caregiver quarantines, increased competition and requests for higher wages. Renown officials say they are recruiting more staff and hiring more traveling nurses.

"We will alter our ratios as needed to take care of the patients as volumes increase," Dr. Debra Adornetto-Garcia, Chief Nursing Officer for Acute Services at Renown said. "We aim to provide care that continues to be compassionate with high quality as we continue this model."

The number of testing is also rising. Cars line up at the Renown South Meadows for COVID testing. Slonim says they are conducting 5,000 to 6,000 people per week.

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