‘We hope it doesn’t get there,’ but Bellingham hospital planning for coronavirus surge
Planning and preparation at Bellingham’s St. Joseph hospital continues in earnest for a potential surge in COVID-19 cases that hospitals around the world have seen during the coronavirus pandemic, PeaceHealth officials say.
The officials spoke to The Bellingham Herald Saturday, March 28, in response to concerns raised earlier this month by longtime Bellingham Emergency Department doctor Ming Lin over the hospital’s testing and screening procedures, how well the hospital is protecting its caregivers on the front line and how prepared it is to face the pandemic.
Lin said Friday, March 27, that he was fired over his public criticism of the hospital.
TeamHealth, a national physician services firm that contracts with PeaceHealth’s emergency department and employs Lin, says Lin was not terminated, but Lin told the Associated Press he doesn’t believe he will be working in Bellingham any longer. PeaceHealth officials did not directly answer The Herald’s questions about Lin’s status at St. Joseph hospital, instead referring questions to TeamHealth.
But officials did insist they are taking steps to prepare for a potential coronavirus surge in Whatcom County.
“Obviously, we hope it doesn’t get there, but we want to be prepared in case it does,” Chief Nursing Officer Roseanna Bell told The Herald Saturday.
Managing a surge such as other hospitals have seen during the coronavirus pandemic requires proper space, supplies, equipment and staffing.
“As the medical director of the Emergency Department at PeaceHealth St. Joseph Medical Center, I want to reassure the local Whatcom community that the Emergency Department has the equipment, supplies, personal protective equipment (PPE) available that we need to take care of whomever presents to us for care,” Dr. Worth Everett said in a statement emailed to The Herald.
“Our preparations have been ongoing for many weeks and continue as information becomes available about emerging best practices and how they fit into our physical plant design of our ED and hospital.”
Bell said St. Joseph hospital already has increased the bed space for intensive care from the normal of 24 ICU beds to more than 40 using alternative spaces. The hospital also has plans to add 60 additional ICU beds if the situation requires.
In the emergency department, Bell said the hospital has two separate spaces and is finalizing the readiness for more outside the building with one tent up and the ability to set up a second should the need arise.
Bell said the hospital has 90 open beds for patients in the hospital, and over the past week and a half the ER has averaged an “unprecedented” 90 fewer emergency patients per day.
Should a potential surge in illness exhaust all the hospital space, Bell said Whatcom Unified Command is planning for a potential field hospital, and PeaceHealth would collaborate with Whatcom Unified Command to provide care outside the main hospital.
Nationally, there have been many concerns about a potential shortage of ventilators to help treat high numbers of people suffering from the respiratory illness.
Bell said Bellingham has, “a high level of ventilatory support, and we’re in the process of ensuring we have a dramatic increase if it becomes needed.”
Because of its connection to the medical community, Whatcom Unified Command also has asked PeaceHealth to create a database of healthcare providers in the community, Chief Executive, Northwest, Charles Prosper told The Herald. The database will identify, bridge communications and help utilize anyone with healthcare skills, including those who work outside PeaceHealth, retirees and any others who may be able to assist.
“We’re trying to add additional manpower coming from the community,” Prosper said. “This is absolutely the time for the people of this community to come together to respond.”
Another large concern at other hospitals has been a lack of personal protection equipment (PPE), such as masks, gloves and gowns, to protect caregivers from exposure to the illness.
The Washington State Nurses Association, which represents 900 nurses at St. Joseph hospital, said in a statement released Saturday supporting Dr. Lin said that it has filed a complaint with the Washington State Department of Labor and Industries over what it believes is the hospital’s failure to provide a safe work environment.
“Our members on the front lines at PeaceHealth St. Joseph Medical Center in Bellingham report that they have run out of proper gowns to care for suspected and positive COVID-19 patients, are being directed to re-use and share personal protective equipment (PPE) without proper cleaning per manufacturer guidelines, are being given one surgical mask per day and being told to keep it in a paper bag between patients, and other unsafe measures,” the association said.
Prosper said PeaceHealth has a “stable” supply of personal protective equipment and is working to add to its reserve, though it is asking care workers to conserve when possible to help prepare for a potential surge in COVID-19 cases.
“Caregivers and physicians currently have the PPE they need to care for COVID-19 patients, i.e., patients who require special precautions,” Dr. Sudhakar Karlapudi said in a statement emailed to The Herald Friday. “However, given the national shortage with PPE we are using a preservation strategy, recommended by the CDC and supported by our Infection Preventionists, to help ensure that we can meet the need long term, i.e., should we receive a surge of COVID-19 patients.”
Karlapudi went on to report that the hospital is working to secure and/or manufacture more personal protective equipment from local and worldwide sources, while Whatcom Unified Command is collecting community donations.
CDC guidelines permit N-95 masks to be reused by the same caregiver for non-COVID patients in airborne isolation, Karlapudi reported, citing patients with tuberculosis or measles as examples. Karlapudi also wrote the CDC preservation guidelines also allow one caregiver to use one surgical mask for eight hours of work.
“There are stories of no masks, no gowns, no beds, and no equipment that unfortunately exist in other parts of the nation,” Dr. Everett’s statement read. “For right now, that is not the case in our emergency department and our hospital. We also acknowledge that there may come a time when there are real shortages and have worked on conserving strategies now in anticipation for that day.”
