Hospitals Prepare for Onslaught of COVID-19 Patients

Illinois hospitals are postponing elective surgeries, reconfiguring their emergency rooms and making extra space in their intensive care units as they prepare for a spike in patients who have the novel coronavirus. 

“We are seeing new cases pop up in Illinois every day and in Chicago and so we think that we are getting to the point where within the next few weeks, we’re anticipating more and more cases,” said Dr. Benjamin Singer, a pulmonary and critical care doctor at Northwestern Memorial Hospital’s medical intensive care unit. 

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While there’s no way they could have prepared for exactly this, the chief medical officer at Rush University Medical Center says they’ve run simulations and drills of similar scenarios. Rush also has a forward triage area designed to react to viral outbreaks or other “black swan” or bio-containment events like a potential case of radiation or anthrax. 

“No one asked for the global pandemic to come to their neighborhood,” Rush’s Dr. Paul Casey said. “Really that’s what we’re here to do, is to be able to serve our communities, take care of people when they’re sick. So we’re trying to do everything we can to plan, stay ahead of this, make sure that we can take care of people at capacity.”

That’s why hospitals are asking patients to wait to have any unnecessary surgeries. 

“Now’s a good time to hold off on those surgeries and try to postpone them a little bit until some of this clears,” Casey said. “Cause we really want to only have traffic in the hospital and people coming to the hospital that really need to be here at this point. Again, this social distancing and quarantining is really what’s going to give us our best chance to not outpace the resources we have to be able to take care of the patients we need to take care of here.”

Rush has transformed what’s typically the ambulance bay into a forward triage center, where patients are steered into tents. Anyone with flu-like symptoms, a fever and cough are sent to a special waiting area where chairs are distanced far apart and where attending health care professionals wear protective gear. Patients who test positive for COVID-19 or who are presumed to potentially have it and need emergency care are moved to a “negative pressure pod” – a section of the hospital “where the air doesn’t mix with the rest of the air in the hospital, it’s independently exhausted outside,” explained Casey. “And that’s really out of an abundance of caution.” 

Before going to Rush or any emergency room if you’re felling unwell, physicians stress that you should first call ahead so health care professionals can take precautions. 

Most cases of the coronavirus symptoms are mild, and won’t require attention from doctors or a need to go to the emergency room. 

Hospitals are putting telemedicine capabilities into overdrive, to attend to both patients concerned they have COVID-19, or who have other needs that can be dealt with asynchronistically.

“We use our video visit platform, on, where patients can get a video visit consultation from home, so they’re not at risk of exposing themselves to other things nor at risk of exposing staff, other patients, to things as well,” said Casey.

Some of the most severe cases will require intensive care treatment. At Northwestern, critical coronavirus cases will be treated in an intensive care unit corridor split from other ICU patients. 

“We’re trying to free up as many ICU beds as possible across the hospital in anticipation that they will be filled,” Singer said. 

In critical cases, he says many patients will be on mechanical ventilators or life support machines, similar to other types of ICU respiratory care.  

Singer says the novel coronavirus is “part of a large family of viruses.” 

Most coronaviruses cause something like what we think of as the common cold, though others have been severe (think coronaviruses like Sudden Acute Respiratory Syndrome, SARS, and Middle East Respiratory Syndrome, MERS). 

The coronavirus that causes COVID-19 (so-called because that’s the year it first emerged) “infects the respiratory system so the lining cells of the respiratory system from the nose all the way deep into the lungs … the virus can infect those cells and that causes a reaction that can make people quite sick,” Singer said.

Hospitals are also prohibiting most visitors, for the protection of patients, medical staff and visitors themselves.

Follow Amanda Vinicky on Twitter: @AmandaVinicky

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