The novel coronavirus is forcing a transformation of how hospitals operate, as they try to respond to growing numbers of patients and heightened safety concerns in the midst of a global pandemic.
For most nurses, doctors and administrators, this is unlike anything they’ve ever had to deal with.
“It hasn’t been just the last few days. We’ve been preparing for this for four or five weeks now, when we started seeing vestiges of it in other places in the world,” said Phil Cormier, president of Beverly Hospital and Addison Gilbert Hospital in Gloucester, which are both part of the Beth Israel Lahey network. “Since this is unprecedented, a global pandemic, you aren’t sure of everything you can prepare for but do the best you can.”
And that, Cormier said, involves “monitoring it and adapting to the rapidly evolving situation.”
As of Wednesday, the two hospitals were reporting 31 patients who tested positive for COVID-19, 50 suspected cases among inpatients, and 12 employees who tested positive. Meanwhile, new data from the state Department of Public Health says there are 885 confirmed cases in Essex County.
On Tuesday afternoon, North Shore Medical Center President David Roberts outlined one of Salem Hospital’s biggest challenges this week.
“We have 26 patients that are on ventilators right now, which is quite a lot for a hospital of our size,” he said. “We have expanded from our ICU into another floor and turned it into a second ICU. Both floors are now full, and we’re opening and repurposing another ‘med surg’ (medical and surgical) floor and turning it into a third intensive care unit to create additional capacity for sick patients and patients who might need ventilatory support.”
Roberts recalled speaking to a respiratory therapist “that had worked here for 40 years, and she said this is the most vented patients she’s seen at the same time — in 40 years.”
Typically, he said, the hospital handles no more than eight patients at once on ventilators, but they now have enough equipment to care for about 50 patients on ventilators. “We have capacity,” Roberts said.
In Beverly, what was once a gift shop is now an extension of the hospital’s check-in process “so we can re-use part of the Emergency Department,” Cormier said.
Entire floors aren’t the only things being repurposed. In Salem, for example, doctors from one discipline — maybe they were a cardiologist last week — are pitching in in other areas because they know how to work in an intensive care unit. Primary care physicians from elsewhere in the hospital’s network and doctors who retired recently are also stepping in.
“Everybody is mobilizing from all parts of the North Shore Medical Center family to get into the hospital and do what they can so our patients are being taken care of,” Roberts said. “It has really been amazing to watch. We have retired docs coming back on staff to work.”
That’s also happening in Beverly, according to Cormier.
“We’ve re-trained staff,” he said, “to be able to work in various areas they might’ve had previous experience in but not current experience.”
But everything adds its own struggle, according to Roberts.
“The four things that have hospital CEOs worried: One is ICU beds; two is ventilators; three is intensive care staff — including doctors and nurses that know how to do intensive care medicine; the fourth is the workforce getting sick,” he said. “The way we prevent that is adequate access to PPE.”
That, unfortunately, has been an issue. Hospitals have been burning through supplies as patient workload climbs.
“Every hospital is struggling,” Roberts said. “Do we have enough intensive care beds? Do we have enough intensivists? Do we have enough nurses capable of this? Is our workforce going out sick at a rate that makes it hard to keep staffing?”
The public, however, has been coming through. Salem State University President John Keenan the institution is rounding up “all of our personal protective equipment from campus — from chemistry labs, nursing offices, occupational therapy” and passing it on to hospitals and areas of need.
Cormier said Beverly has seen “incredible generosity in donations of much-needed medical supplies.”
“A local construction company donated 600 masks to us,” he said, adding that Windover Construction was behind the gift. The hospital also got a healthy stock of face shields from the Ford Motor Company.
Food has also been a popular donation, as businesses and residents look to feed and caffeinate exhausted doctors and hospital staff. But those donations, at times, can also present issues with concerns about contamination.
“There are a couple of local business folks who are trying to organize food support for the hospital,” Roberts said. “Otherwise stuff gets dropped off in the emergency room and people get nervous about that since it’s a pandemic.”
HOW TO HELP
For Beverly Hospital and Addison Gilbert Hospital, visit giving.laheyhealth.org.
For North Shore Medical Center, visit nsmcgiving.partners.org/covid19response.