With warnings of a possible holiday surge of COVID-19 cases and many hospitals and health systems across the country overwhelmed with patients, University of Virginia Health System officials are preparing for the worst and hoping for the best.
Officials are advising doctors, nurses and hospital staff that sudden changes in schedules and assignments could occur if the virus strikes hard at Central Virginia. They’ve also built up stores of protective gear in the past six months and are now preparing to give vaccine shots to those working in the COVID wards and those who are high-risk.
The first of the vaccines are expected to arrive within a week. Appointments for staff members to get their shots are now being made.
“We’re feeling well prepared, as prepared as we can be,” said Wendy Horton, UVa Medical Center chief executive officer. “We’re not seeing a surge, but our COVID numbers are ticking upward and we’re looking at what we need to do and adjust so we have as many options to us as possible.”
“We’ve learned a lot locally and around the world about patients’ needs and how to treat them, what works and what doesn’t,” said Dr. Reid Adams, chief medical officer at the medical center. “If our numbers aren’t doubling every day or week, we’re able to redirect and move staff around to handle COVID patients. If we see increases, we can move staff trained to treat COVID patients but we will still need to staff those non-COVID wards. If a surge hits, we may have to delay some procedures.”
Last week, U.S. Centers for Disease Control officials, using nearly two dozen forecasting models, predicted more than a million new COVID cases could be diagnosed across the country between Thanksgiving and Dec. 15.
Reid said UVa COVID unit beds will available to Central Virginians. If the beds are not filled by locals and the hospital has capacity, it will offer beds to patients in other Virginia communities that are struggling to provide care, much as it did this spring.
“We try to help out anybody we can, but if our own numbers get higher it makes it harder to help,” Reid said. “We have to look at it day-to-day. We are a local hospital and we take care of those in area first, if we can.”
Reid said the region has been lucky in that cases have remained low and the hospital system has not been slammed by a large number of patients in a small amount of time.
“One of the struggles everyone has had is staffing and we’ve been lucky that we haven’t had the same situation as they’re having in Texas, Wisconsin and Michigan,” he said. “We haven’t been in a situation where we wear our staff out and we don’t want to be in that situation.”
The CDC predictions are best estimates combined with educated guesswork. They’re used by health districts and medical officials to create worst-case scenarios and prepare for them.
“We are continuously evaluating our processes and services to meet the demands of the COVID-19 pandemic and, lately, the increase in cases,” said Kathryn Goodman, spokeswoman for the Thomas Jefferson Health District, which includes Charlottesville and Albemarle, Greene, Fluvanna, Louisa and Nelson counties.
The health district provides COVID testing, collects statistics, does contact tracing and will administer vaccines when they are ready for the public.
“We are working to alter staff job duties and assignments and overtime as needed. We will make changes to our services and adjust schedules accordingly for COVID-19 testing and vaccination purposes,” Goodman said. “We are working on plans to ensure we have adequate staffing and support in place for when it’s time to distribute COVID-19 vaccines.”
UVa Medical Center will follow CDC guidelines approved last week to provide vaccines first to medical staff treating COVID patients and then to people at risk of severe illness or death should they contract the virus.
Officials for Sentara Healthcare, which owns Sentara Martha Jefferson Hospital in Albemarle County, said they will also follow the CDC guidelines.
“Vaccine distribution will include emergency department staff, ICU’s, COVID patient units, respiratory unit staff, cleaning and food service employees who interact with patients, and others,” Sentara officials said in a statement. “The COVID-19 vaccine will be optional for all employees.”
Both Sentara Martha Jefferson Hospital and UVa Medical Center routinely provide vaccinations for employees and will use the current organizational structure to get the shots into employees’ arms.
“We’re starting with high-risk caregivers for COVID patients and we’re making sure to get all of the healthcare team members who work with those patients,” Horton said.
Horton said that as vaccine supplies roll in, the medical center will expand vaccinations to other healthcare workers and persons at risk.
Personal protective equipment, known as PPE, proved hard to come by in the early days of the pandemic but officials at both hospitals say they have stocked up on the gear and found ways to treat patients without using as much gear.
“Before the COVID-19 pandemic, normal PPE usage among isolated patients amounted to 27 pieces of PPE per patient, per day,” Sentara officials said. “This rate of consumption was unsustainable due to supply chain uncertainties.”
With new protocols that limit the number of staff entering and exiting patient rooms and using one staff member to perform several procedures during one visit, Sentara officials said only six pieces of PPE are used per patient, per day.
Similar efforts have been made across the country and at UVa.
“We’ve built up our supplies of PPE in case of a surge to guarantee we’ll have supplies,” Horton said. “We’re making sure we have the right equipment and adequate numbers.”
Kroger Health, the grocery chain’s healthcare division, announced Tuesday that it is offering COVID testing through its pharmacies, using rapid antibody tests. The tests show if a patient has been previously infected with the SARS-CoV-2 virus, which causes the COVID-19 disease.
Approved by the U.S. Food and Drug Administration, the tests involve a finger-prick blood sample, much like devices used to test blood sugar levels.
The tests sell for $25 and usually provide results within 15 minutes. Individuals who believe they may have had COVID-19 but are not currently experiencing symptoms are eligible for the test.
The tests are not used to detect an active infection, only to indicate if a person may have previously been infected.
Hospital officials all said that the best way to keep beds open and COVID in control is to follow CDC guidelines in social distancing, not traveling, staying out of large groups and wearing masks. Recent studies show wearing mask protects both the wearer and those nearby by limiting the amount of virus the wearer exhales or inhales.
“Those are efforts that everyone can take that can make a big difference in limiting the surge and the number of people hospitalized,” Horton said. “It really does make a difference.”