COVID-19 challenging hospitals

The Alabama Hospital Association (AHA) warns of a shortage of ICU beds as the state’s hospitals are continuing to see very serious issues as cases of COVID-19 continue to surge statewide. For several consecutive days, the state has had fewer than 200 ICU beds available, impacting not only patients with the coronavirus but also those in need of intensive care for other reasons.

DeKalb Regional Medical Center CEO Patrick Trammell described the coronavirus situation in DeKalb County as “a fluid situation” because census and bed availability information fluctuates as patients are admitted or discharged.

“Our patient volumes and acuity levels change by the hour,” Trammell said. “We are closely monitoring staffing and equipment levels as volumes change during this time.”

During a recent press conference announcing the extension of Alabama’s mask mandate, State Health Officer Dr. Scott Harris said several of the state’s hospitals had inquired about setting up temporary “pop up hospital” facilities as a last resort.

Trammell said DeKalb Regional has “created additional capacity if a patient surge occurs at the hospital. As always, should patient acuity or capacity levels become a concern, we work closely with public health officials and other regional hospitals to facilitate quick access to the most appropriate level of care for patients.”

As expected, the local hospital has begun caring for patients testing positive for coronavirus as cases have increased in the community. Asked for a specific number of patients, he said the number of hospitalized patients can greatly fluctuate, “and this number may change in the coming days.”

He asked for the community’s help to stop the spread of the coronavirus by modifying their behavior during the public health crisis.

“We need people to act responsibly, because they can spread illness to vulnerable people. Also, even small changes in the numbers of acutely ill patients in any community can overwhelm hospital resources. People should conduct daily activities as though they will come in contact with infected people or will potentially infect people. We urge community members to follow CDC guidelines and wear a mask, wash your hands, practice social distancing and stay home if you feel sick,” Trammell said.

He said the hospital “generally, [has] been forced to use alternatives to normal supplies at times. For instance, the state of Alabama was able to coordinate procurement of several thousand laundered - as opposed to disposable - protective gowns, which will augment our supply of disposables. Also, certain bleach-based disinfectants are in short supply, so we have used effective alternative chemicals in some instances to maintain our disinfection and infection prevention standards.”

The hospital has tested hundreds of people each month, typically receiving results within three days.

“[Turnaround time] varies significantly based on the activity in the community, but our best success has been with a local testing company. Some testing companies have turnaround times of up to 10 days,” Trammell said.

On Friday, the Alabama Department of Public Health COVID-19 Data and Surveillance Dashboard reported 19,231 new cases from statewide testing conducted in the last 14 days. The number in DeKalb County is 310 new cases in the last two weeks.

More than 11,537 Alabama hospitalizations since March 13 are attributed to the coronavirus, and ADPH estimates 37,923 cases in Alabama are presumed recoveries. The dashboard showed 1,219 cases of COVID required ICU care, with 658 of these being serious enough to require the use of a ventilator. Data shows 5,621 of the state’s reported 94,827 total cases have involved healthcare workers.

Trammell acknowledged that it is hazardous work treating COVID patients, but he said the hospital has not had to bring in additional or replacement personnel from other places.

“Though we follow strict screening and work restriction protocols for all staff, including plans for those potentially exposed to infectious agents, healthcare workers are at higher risk of exposure to infectious agents than the general public since we care for sick people. Patient safety and the higher exposure risk are reasons we are diligent in using appropriate personal protective equipment at all times,” he said.

Trammell stressed the importance of keeping appointments for necessary surgeries, wellness and preventative exams, management of chronic conditions, high-acuity maintenance care (cancer, heart, etc.) and other procedures.

Although DeKalb Regional initially delayed elective medical and surgical procedures in accordance with the State mandate issued at the start of the COVID disaster declaration in mid-March, the facility resumed these procedures with appropriate screening processes in place once they were approved to proceed safely.

“In any overwhelming disaster, we would consider delaying elective care to focus resources on the acutely ill, [but the hospital has] taken extensive precautions to protect patients and staff, and by delaying care, you risk serious complications and even death. As always, go to the emergency room if you have a life-threatening emergency,” Trammell said.

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