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Hospitals across Massachusetts are taking some dramatic steps to prepare for an expected surge in patients with COVID-19, the illness caused by the coronavirus.
They're trying to avoid what's happened in Italy, where hospital intensive care units are overrun and staff are overloaded and getting sick.
Steve Walsh, president and CEO of the Massachusetts Health and Hospital Association, held a conference call Friday morning with hospital CEOs from across the state. He later spoke with WBUR's Jack Lepiarz about hospital capacity.
"Capacity statewide is at about 74% right now — so not full. But certainly we want to be able to take care of the patients that come through the door that need our services."
Jack Lepiarz: Are there any hospitals that are being hit especially hard that are maybe above that level, or hospitals that are well below that level?
"We really don't get into specifics about hospital by hospital, but we still have some capacity within the system."
Seventy-four percent — how does that compare to normal capacity?
"That's about where you would be in a regular cold and flu season. So it's not up. It's not down. It's more kind of preparing for if there is a surge of patients that have seen exposures in the coming weeks. I want to make sure that we can handle it."
How much of a concern is it that capacity could break down in Massachusetts?
"Well, it's always a concern. This is an unprecedented event. We haven't seen anything like this in this country since the Spanish flu of 1918 ... St. Louis was a major city with the least number of deaths. And that's because they did exactly what we're trying to do now, which is have people stay home and make sure that we are preparing adequately.
"So we're trying to look at really three phases: the testing phase now — understanding exactly how many people are infected and making sure that we can get people tested that need it, which has been a bit of a hurdle that in the last couple of days we're hoping that we've broken that logjam; getting the protective equipment that we need ... to protect our workforce on the front line as patients are coming in; and then undoing some of the federal regulatory barriers that might make it difficult for caregivers to do their job in a time of crisis."
You mentioned testing there. There has been a lot of frustration about testing. People who think they should be tested say hospitals are turning them away. Hospitals say patients are flooding emergency rooms with symptoms that don't meet the criteria for testing. So how do we find the right balance to keep ourselves safe, but also avoid unnecessarily straining the system?
"Hospitals will always treat patients that come through their door. I think that what you're seeing is, really, the health care community trying to deal with some of the misinformation. If somebody is feeling sick, if somebody is showing signs, call their primary care physician. [If] you don't have a primary care physician, call the hospital. Call a clinic. Talk to somebody first. Because if you really do have symptoms and then it ends up being a positive case, you've now walked through the doors of a health care facility and potentially affected the people that you see all along the way.
"So we really want to hear from a patient first, assess the situation, which is why we've been pushing tele-medicine. And then we'll let patients know if they need to be seen or tested and then where to go. You've seen some of the hospitals that are trying to set up facilities just outside their doors, either in tents, in separate locations, so that we can minimize the exposure to the public, to other patients, and to our caregivers who we're going to need as this crisis unfolds."
I've seen some estimates showing Massachusetts — and other states, as well — won't have enough ventilators to deal with very sick patients, given that this COVID-19 is a respiratory virus. What's the plan in Massachusetts? Is there a way to share these machines or transfer sick patients if it comes to that point?
"Our health care leaders collaborate as well as anybody. It's what they do. And they're they're not in a state of panic. They're in a state of calm and understanding and preparing for what might come. And ventilators may be something that we need down down the road, but we're looking at beds and equipment, at personal protective equipment, at ventilators, at pulmonologists, at all the things that you might need in a crisis, and preparing.
"But right now, as I said, the best thing we can do now is what we've been advised by government to do, which is work remotely. Stay at home and limit the ability [of the virus to spread].
"The folks responding positively to all of these closures — this unprecedented closure of the NBA, NHL, Major League Baseball, the Metropolitan Opera — that's a spirit of community. When people are actually accepting the disruption in a way that puts the public health first, the more of that we see over the coming weeks, the best chance we will give our caregivers to be able to meet the demands of the patients when they come through the door."
Any other logjams, supply shortages, that you're concerned about or anything else you want people to know?
"Right now, the major concern really is personal protective equipment, PPEs. We want to make sure that we have enough caregivers to treat patients as they present. And in order to do that, we have to be able to equip the caregivers with the necessary tools to do their job."
And what's the status on those PPEs?
"We've asked the federal government; we heard more [are] coming. We are trying to identify what we have now; we've done some surveys. And we'll just keep pushing that. That is the most important concern at this time."
What's your status in terms of staffing? I have heard some experts express the concern that if we have a situation where hospitals start to get strained, there won't be enough internists to care for COVID-19 patients. Is there an ability to ramp up? And what's our situation right now?
"We're looking very carefully right now to how to back-fill the workforce, what licensing requirements we would need to relax to make sure we can get caregivers here from other states or be sharing them from hospital to hospital to make sure that we are collaborating to have enough caregivers in every facility to meet the demand. And that's what we're working on and working hard at."
This segment aired on March 13, 2020.
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