How Boca Raton Regional Hospital Is Handling the Spike in COVID-19 Cases

boca regional
Boca Raton Regional Hospital. Photo by Aaron Bristol

Despite Florida’s new surge of COVID-19 cases, Boca Raton Regional Hospital isn’t seeing a new crisis. Yet.

Still, Chief Medical Officer Samer Fahmy is “fairly concerned” about what could happen in the next few weeks. On a scale of one to 10, with 10 being the worst, Fahmy said his level of concern is an eight.

Fahmy sees crowds packing bars and restaurants in downtown Delray Beach and West Palm Beach. Scarier are the live music venues. Against public health advice, many South Floridians are traveling for Thanksgiving. That behavior could replicate itself for Christmas, with travelers bringing cases back with them. Covid Act Now ranks Florida and Palm Beach County as having an “active or imminent outbreak.”

Fahmy and I spoke late last week. A month ago, he said, the hospital had eight COVID-19 patients, none of them requiring intensive care. When we talked, the hospital was up to 29 patients, five of whom were in the ICU.

In keeping with the trend in new cases, Fahmy said the number of young patients is “extremely high.” Compared with the first wave last spring, though, a lower percentage of patients are going into the ICU.

“It’s still not clear why,” Fahmy said. The disease is “less likely to progress” in younger people, possibly because they have a lower viral load. Boca Regional has one COVID unit in addition to the ICU and could open a second COVID unit if necessary.

Baptist Health South Florida, Boca Regional’s parent company, is showing similar numbers. At the height last spring, Fahmy said, the company had 850 COVID patients at its 11 hospitals. The number last week was 210.

Fahmy also said the flu season has been “mild so far.” The hospital had “a lot of co-virus cases” last spring.

One sign of regression is showing. Fahmy said more people are delaying non-COVID visits to the hospital, despite the hospital testing all patients every day. He also worries about having adequate supplies of rapid-results tests. Others can take between 24 and 48 hours to get back.

The most significant new development, of course, is the set of announcements about encouraging vaccines. AstraZeneca on Monday became the third drugmaker to say that it would seek emergency authorization from the Food and Drug Administration.

Fahmy said the stated results have been “a pleasant surprise.” The annual flu vaccine has an effectiveness rate of between 40 percent and 60 percent. Two companies claim that their COVID-19 vaccines are effective up to almost 95 percent. AstraZeneca says its rates range between 70 percent and 90 percent for a vaccine that is cheaper to make and easier to transport.

Fahmy said, “Emergency authorization is not approval.” Boca Regional “has not received any guidance” from the FDA. If multiple vaccines become available, some may work better for different people.

Happily, Boca Regional got a boost with news that the hospital will have a freezer in which to store the vaccines. A spokesman said the freezer “was made possible through a generous gift from Meryl and Ron Gallatin.” They are longtime donors to the hospital and other area causes.

Who should get the vaccines first? Obviously, Fahmy wants priority for health care employees, along with “front-line workers, sicker patients, nursing homes and prisons.” Florida’s prisons don’t have air-conditioning, so there’s no way to filter out the virus.

Fahmy expects Baptist Health to be among the hospital groups to receive early vaccine shipments. The company “is in communication” with the Florida Department of Health. As Fahmy puts it, Baptist Health has “a lot of reach,” from southern Miami-Dade County to Boynton Beach.

When Boca Regional has a vaccine that Fahmy believes is ready for use, “I will be promoting it.” Until then and even after, he also will be promoting more personal responsibility.

Editor’s note: click here to watch our virtual interview with Dr. Fahmy and other Boca Regional healthcare professionals.

Keeping the Promise at BRRH

Boca Regional this week announced a $2.5 million donation from the Harcourt M. and Virginia W. Sylvester Foundation to the hospital’s Keeping the Promise capital campaign.

With that gift, according to a news release, Boca Regional has raised almost $170 million. The campaign’s goal is $250 million. The gift shop in the new patient tower will carry the foundation’s name.

The cancer center at the University of Miami is named for the Sylvester family. This donation is just the family’s latest to Boca Regional and continues a record of philanthropy in Palm Beach County that dates back roughly four decades.

Conversion therapy ban overturned

On Friday, a panel of the 11th U.S. Circuit Court of Appeals struck down Boca Raton’s law that bans gay conversion therapy. The ruling was not a surprise.

Two members of the three-judge panel were Britt Grant and Barbara Lagoa, who was on President Trump’s short list for the Supreme Court vacancy that he filled with Amy Coney Barrett. Critics opposed both nominations in part because of what they considered anti-LGBTQ bias.

Sure enough, Grant and Lagoa formed the majority. They found that Boca Raton’s law, which the city council passed in 2017, unconstitutionally restricted speech. Conversion therapy–known as Sex Orientation Change Efforts–seeks to “treat” gays and lesbians.

LGBTQ advocates have likened the practice to “psychological abuse.” Palm Beach County passed such a law about when Boca Raton did. Delray Beach considered a ban but never approved it. The 11th Circuit ruling applies to all local governments in Florida.

The city and county laws applied to two therapists. They sued. In February 2019, U.S. District Court Judge Robin Rosenberg rejected the plaintiffs’ demand for an injunction. She found that the laws regulated treatment, not speech. Because mainstream psychiatric and psychological groups consider conversation therapy harmful, Rosenberg said the city acted to protect minors.

Because Grant and Lagoa regarded the law as dealing with First Amendment rights, however, they applied a much higher standard of scrutiny. In their view, the laws did not meet it.

“People have intense moral, religious, and spiritual views about these matters–on all sides,” Grant wrote in the opinion. “And that is exactly why the First Amendment does not allow communities to determine how their neighbors may be counseled about matters of sexual orientation or gender.”

Practically speaking, the ruling has little effect on Boca Raton. There is no evidence of either plaintiff offering such therapy within the city.

The city council, though, must decide how to respond. The council could rescind the law, ask for a hearing before the full 11th Circuit or take the case to the U.S. Supreme Court. That last option is unlikely, though the issue might reach the high court at some point. The council will decide after a private meeting with the city’s attorneys.

REI opens at Uptown Boca

In this year of so much grim news for many brick-and-mortar retailers, I should have noted the opening–on Friday the 13th–of the REI store at Uptown Boca.

I reported recently that Uptown Boca–on Glades Road just east of U.S. 441–has come through the pandemic in good shape. The decision by REI to proceed with only its second store in Florida is more reason to be optimistic about the mixed-use project.

No shakeup on the county commission

County Commissioner Robert Weinroth (pictured above, seated, far left), whose district includes Boca Raton and Delray Beach, was in line to become county mayor last week. It didn’t happen.

The mostly ceremonial position has taken on greater importance since the pandemic began. Dave Kerner (pictured above, center) has become the face of decisions about reopening, using power under the county’s emergency order. At the organizational meeting following the elections of two new commissioners–Maria Marino and Maria Sachs–Weinroth as vice mayor should have been elevated.

Instead, Sachs joined Mack Bernard and Melissa McKinlay in voting to keep Kerner. They cited what Weinroth called a need for “continuity of leadership.”