CORONAVIRUS

Hospitals reallocate staffing, supplies in event of COVID-19 patient surge

Officials confident any patient who needs care will receive it

Pramod Dwivedi, Linn County Public Health Director (left) steps aside as Dr. Tony Myers, Vice President of Medical Affai
Pramod Dwivedi, Linn County Public Health Director (left) steps aside as Dr. Tony Myers, Vice President of Medical Affairs at Mercy Medical Center, answers a final question during a press conference to address the COVID-19 virus with other Linn County officials at the Cedar Rapids Public Library in Cedar Rapids on Monday, March 16, 2020. (Liz Martin/The Gazette)

Based on their estimations of the impact COVID-19 could have in Eastern Iowa, hospital officials are confident in their capacity to handle the expected surge in the demand for care following a potential outbreak.

But to ensure staffing levels and equipment remain at a manageable rate — or to “flatten the curve” — Iowa City and Cedar Rapids health care officials say it’s imperative Iowans engage in precautionary behavior and limit contact with others.

The health care officials spoke Tuesday at a news conference sponsored by Linn County health agencies at the Cedar Rapids Public Library, in downtown Cedar Rapids.

Hospitals always have dealt with “surges” — increases in patient volume beyond normal operating capacity. But many national public health experts are concerned that a veritable tsunami of COVID-19 cases in the United States in the coming weeks would overwhelm health care systems.

Patients with COVID-19 can be treated in any hospital in Iowa, as facilities have the capacity to care for patients with respiratory viruses, said Dr. Tony Myers, chief medical officer for Mercy Medical Center.

But the issue with the current COVID-19 pandemic is a matter of timing, said Dr. Dustin Arnold, chief medical officer for UnityPoint Health-St. Luke’s Hospital. He likened it to influenza, which has about 2 million to 5 million cases and results in as many as 650,000 deaths per year.

While there is a broad impact of this virus, it doesn’t happen all at once.

“What if all 2 million people get sick in a seven-day period? That’s what we’re trying to prevent,” Arnold said.

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By implementing certain measures — such as canceling large public events and encouraging self-isolation among those at risk — the impact of the novel coronavirus could be controlled. This has been described by national public health officials as “flattening the curve.”

These steps, in addition to contingency plans that can be implemented in health care facilities in a short amount of time, should guarantee any patient with COVID-19 who needs the care will find it.

“If you need a critical care bed in the Corridor, you will get it,” Arnold said.

Preparing for staff surges

Area hospitals have been in frequent conversations with one another to prepare for an outbreak of the novel coronavirus, or COVID-19, which has now sickened nearly 30 Iowans across the state.

Cedar Rapids hospitals — Mercy Medical Center and UnityPoint Health-St. Luke’s Hospital — have announced joint decisions in connection with COVID-19 preparedness in recent days.

On Tuesday both hospitals, as well as Physicians’ Clinic of Iowa and Surgery Center Cedar Rapids, notified the public their facilities were postponing non-life threatening, non-urgent surgeries and procedures in an effort to conserve supplies and reallocate staffing to the needs of COVID-19 affected patients.

Across the Corridor, hospitals have plenty of beds in negative pressure rooms and equipment to treat COVID-19 patients, Myers said.

The University of Iowa Hospitals and Clinics did not attend Tuesday’s news conference.

But the issue now comes down to creating adequate staffing levels capable of caring for these potential cases.

The decision to postpone non-urgent procedures and surgeries frees up staffing capable of caring for patients, including clinicians such as anesthesiologists who have training in operating ventilators.

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“Those people have a high level of technical skill, and they’re used to dealing with sicker people,” Myers said.

The Cedar Rapids hospitals say they also have enough mechanical ventilators on hand for all expected patients, which would be used to help patients with the most severe cases of the respiratory virus breathe properly. Officials also are making efforts to conserve personal protective equipment, or PPEs, such as masks and gowns that would protect staff members from infection.

increasing bed count ‘significantly’

In the event of a surge, Gov. Kim Reynolds declared a statewide public health disaster emergency Tuesday that waives Iowa’s hospitals’ requirement to obtain a certificate of need — a regulatory process to prevent redundancy of services among health care facilities — to operate with an additional bed capacity than their current operating levels.

This provision is limited to treatment of individuals affected by the public health emergency.

St. Luke’s has ability to increase bed capacity “significantly,” almost up to 200 percent of what the hospital has on a daily basis. Arnold added that the hospital can convert its operating rooms to critical care beds as necessary.

Mercy Medical Center has the ability to create “large areas” of negative pressure units, which are used to contain airborne contaminants within the room and prevent its spread, Myers said during the news conference.

“We can convert two floors of the hospital to negative pressure, which increases the bed count by hundreds of percent,” Myers added.

Mercy Iowa City has not increased its bed capacity, but has “the ability to convert our largest inpatient unit to a unit that would just take care of (COVID-19) patients if we need to do that,” spokeswoman Margaret Reese said during the conference.

The hospital has enough ventilators and personal protective equipment at this time, she added.

But if the admission rate goes beyond what an individual hospital can handle, officials say patients can be transferred to an available bed at a nearby hospital. If there’s an urgent need for supplies at a nearby hospital, local facilities would be willing to share, Myers said.

While hospitals have elected to postpone non-urgent cases, Myers said officials would not discharge non-COVID-19 patients from the hospital any sooner than they would need to be.

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Under the governor’s directive, in addition to closing bars, restaurants and other public spaces, the proclamation suspended regulatory provisions limiting or restricting telemedicine services.

In addition, any individual with a medical license that lapsed within the past five years is able to care for patients affected by the COVID-19 outbreak in Iowa for the duration of the proclamation, which will remain in effect until 11:59 p.m. on April 16, unless the governor terminates or extends the provisions.

“These are unprecedented times and the state of Iowa will do whatever is necessary to address this public health disaster,” Reynolds said in a news release.

Gazette reporter Erin Jordan contributed to this report.

Comments: (319) 368-8536; michaela.ramm@thegazette.com

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