COVID-19 case counts continued their rise in Spokane County on Wednesday, when 37 more residents tested positive for the disease. And that has local officials concerned that more cases in the community will lead to more spread of the virus among vulnerable people who might require hospitalization if they contract it.

Dr. Dan Getz, chief medical officer at Providence in the Inland Northwest, said they are predicting hospitalizations will double in the coming weeks.

The unpredictable lag time between the onset of symptoms and the need for hospitalization makes the forecasting challenging. A person who contracts COVID-19 might not have symptoms that worsen for up to two weeks after first experiencing symptoms. The same rings true for the data.

“The cases I know I have right now, it’s someone who has been exposed between one to 14 days ago,” Spokane County Health Officer Dr. Bob Lutz said.

Nineteen county residents are currently hospitalized, and 34 total patients, including those from other counties, are receiving treatment for COVID-19 in local hospitals.

Being hospitalized with the virus can mean at least a two-week stay in the intensive care unit, hospital officials said on Wednesday. And because COVID-19 is incurable and highly contagious, the treatment and recovery process is often laborious. Monitoring patients, many of whom have respiratory problems, is time-consuming.

It also takes a lot of personal protective equipment. Nurses and physicians must don personal protective equipment each time they enter a COVID-19 patient’s room and take it off and dispose of it when they leave.

The care administered to a COVID-19 patient requires much more time and attention than it does for most patients due to the precautions taken to keep health care providers safe.

While the average length of stay in the intensive care unit is about two weeks, that does not mean a patient immediately leaves the hospital. If a patient recovers enough to be moved, finding step-down care is challenging.

“Even if they don’t require hospital-level care, getting them into a skilled nursing facility (or rehabilitation facility) is challenging because there’s a concern that they are still infectious and could transmit disease to others,” Getz said.

Secondly, the virus is unpredictable and can impact patients differently. Some patterns are emerging, and people with underlying health conditions, like kidney disease, heart disease or diabetes, are more susceptible to more severe illness with COVID-19.

Common ailments amongst COVID patients include infections, possible disorientation and hallucination if they have to be sedated often as well as the potential for post-traumatic stress disorder, said Dr. Ben Arthurs, a pulmonologist and intensivist who works in the intensive care unit with MultiCare.

“The patients in our ICUs have been there for two weeks, some for three weeks. We’ve had many survive, most go back to the hospital floor, but that’s just the start of their rehab,” Arthurs said, noting that recovery time can be one to two times as long as a patient’s treatment time.

While Spokane hospitals have plenty of beds available for patients, hospital “capacity” is much less about beds and much more about the staff and equipment necessary to treat COVID-19 patients. Hospital officials told reporters Wednesday that a surge in capacity in ICUs is doable, but that it could come at the cost of curtailing other medical care, like surgeries or other care administered at hospitals, as is happening in other places in the country, such as Houston and Phoenix.

Hospital officials also pointed to the situation in Yakima, where there was bed space but not enough staff to take care of patients, as one potential scenario that could pose a problem in Spokane.

Some Yakima patients with COVID-19 are being sent to hospitals elsewhere.

“We have a lot of capacity to expand ICU space, but bottlenecks are personnel with this disease,” Arthurs said.

Health officials encouraged everyone to wear face coverings as a way to help Spokane County again flatten the curve. Lutz noted that if 80% of the community began wearing masks, transmission rates might begin to drop in about two weeks.

“It needs to be a collective effort if we’re going to be seeing our cases drop in the next couple weeks,” Lutz said.

Meanwhile, though, the county is dealing with 1,416 confirmed cases of the virus.

In the last week alone, 237 people have tested positive, state data shows.

Spokane County Health Officer Dr. Bob Lutz said the median age for residents testing positive continues to drop.

“As of yesterday, the median age of the last 100 cases is 31,” Lutz said, noting the median age a couple of weeks ago was 54.

“We truly have community spread,” he added.