Dispelling Local Rumors
Miller Report for the week of March 30, 2020; by William Miller, MD.
As other places in the US start to see exponential rise in the number of patients in their hospitals, we continue to work diligently here on the Coast to be prepared. Since we still have no patients with COVID-19 in our neck of the woods yet, this is giving us some important extra time to get ready and we are not wasting that time. However, to be sure, the virus is here now or will be soon enough.
Again, we appreciate you all sheltering in place to help reduce the spread of the virus. At a time like this, there is something else that we also need to avoid spreading and that is rumors. There have been a lot of rumors flying around the community about the hospital that are simply not true. This is not helpful and only adds to the state of general confusion and anxiety. Here are some of the more interesting ones that I have recently heard and can dispel.
Rumor 1, we have a physician who is infected with the virus. No, not true. To date, we have not had any staff that are known to be infected or suspected of being infected or who have a known exposure. We do have some traveling staff that may come from parts of the country were the prevalence is higher. In such cases, we follow CDC guidelines and if indicated, ask the traveler to self-isolate and/or to be tested, depending on the situation. If the epidemic hits our health care system as hard as it has hit other places, then we may see a surge of patients in our hospital to such a degree that we will be thankful indeed to all of the help we can get, especially from those outside travelers who help us staff our hospital.
Rumor 2, we have run out of masks. No, not true. As you all know by now, there is a national shortage of all personal protective equipment (PPE). New York City announced this morning that their supply will only last one more week. Thus, supplies are being diverted to those parts of the country that are in greatest need. As a result, we must be very careful to conserve what we have now. Over the last two weeks, we have been asking our staff to re-use the same mask. This is following the CDC guidelines and is also what other hospitals are doing. Fortunately, we just received a small shipment of masks and will be loosening up those rationing requirements. When you consider that we currently still do not have any patients admitted here with COVID-19, it would be a serious mistake to use up our supply of protective equipment at a time when the risk is still very low and then not have enough when we do have patients with the illness, which we know will in fact eventually happen.
Rumor 3, we are missing out in participating in County, State and Federal assistance. Again, not true. All hospitals in the State are now coordinating on a daily basis with the California Dept. of Public Health and reporting on all aspects of our situation including numbers of cases, supplies including PPE, available beds and available ventilators. We are definitely in the line up to receive help if we have the need. The shipment of masks mentioned above came from this coordinated effort.
At this time, we have completed or will complete in the next few days the following. We have increased our ICU bed capacity from 4 to 12. We have ordered 8 more ventilators, to add to our current numbers and we also expect to receive at least 4 of the 20 or so that the County is seeking to obtain. We have expanded our regular med-surg capability by an additional 12 more beds. These bring our total hospital capacity up from 25 to 45. The State has asked us to increase our bed capacity by 30-40%, and as you can see we have far exceeded that at almost a 100% increase including tripling our ICU beds. We are working to obtain all of the extra supplies and medications that such a tripling of critical care beds will require.
The biggest challenge will be staffing. At this time, it looks like we may be able to double our hospitalist coverage at least during the peak of the surge. We are looking at how to potentially use some of our clinic providers to help out in hospital and ER settings. We are also exploring ways to get enough nurses and other staff, including respiratory therapists. Fortunately, we do have the luxury of having just a little bit of time before the storm to make such preparations. As I said before, we are not wasting that time for which we are truly thankful.