The state’s second largest hospital, Kent Hospital, is geared up for a surge in COVID-19 cases, more than doubling its intensive care unit beds from 15 to 35 and is preparing to increase the personal protective equipment (PPE) available for its staff.
Also, to address an anticipated increase in people with respiratory issues that may or may not be related to the virus, the hospital is erecting a third tent on the property. This will house a primary care physician who will evaluate cases.
One of the tents, which has been operational for about 10 days, is designated for COVID-19 tests as directed by the Rhode Island Department of Health. The other tent serves as an extension of the emergency department, thereby providing greater separation between patients. In some cases, people arriving at the emergency department are evaluated in their vehicles.
Usually at this time of year, the hospital is busy with patients suffering from the flu. That isn’t the case now, which leads Judith Thorpe, MSN, RN, chief nursing officer, to believe the precautionary measures being taken against COVID-19 have served to stem the spread of common colds and the flu.
The Kent staff is seeing current conditions as “the calm before the storm.”
“[I] do feel a surge is going to happen. I’d be very happy if it doesn’t,” Thorpe said.
Looking at the models, Paari Gopalakrishnan, MD, MBA, chief medical officer, projects Kent could see a 20 to 30 percent increase in patients – bringing the hospital census from a level of 170 to 200 patients to as many as 260 patients, with the greatest pressure being on the ICU. To plan for that, the hospital is expanding its ICU to 35 beds and transferring nurses working in other units of the hospital to train with those now staffing the ICU.
“Most people who get COVID-19 are not going to be hospitalized,” Gopalakrishnan said. Most, he said, would be classified as “PUIs,” or persons under investigation, and discharged to their homes. This week has seen the greatest number of PUIs – anyone with a cough, fever and shortness of breath is a suspect – and positives with a total of 15. Most test negative.
The third tent that Shannon Sullivan, vice president of operations, said would be up in a few days will be the equivalent of a general practitioner’s office. Staffed by the Care New England Medical Group, it will address respiratory symptoms. She said the patients may be referred to Kent by their own physician who may be overtaxed by patients or concerned about evaluating a potential COVID-19 patient in their office. She said patients would be subject to the same co-pay as their own physician and if necessary chest X-rays could be performed on a portable unit.
“It is safer for us and for them not to go into hospital,” she said, adding: “The message is that we want to take care of you in a variety of different venues.”
It’s a matter of staff, too.
Gopalakrishnan said the hospital is seeking to mobilize as many providers as possible. He said the hospital’s 130 student resident doctors are being redirected from electives they are working on to the hospital in anticipation of the surge.
In addition, said Thorpe, the hospital is educating and training its nursing staff on the protocols to handle COVID-19.
She stressed the importance of ventilators, calling them critical. Without offering numbers, she said through rentals and what the state has provided the units at Kent have “significantly increased.” Furthermore, she said, the state has an overview of the demand for ventilators and will direct them to where they are needed.
“At this point we have well over enough,” she said.
What about PPE, which includes gloves, masks and clothing?
Thorpe said the demand internationally for PPE has exceeded the supply. “I’ve never seen anything like it.”
In an effort to ensure sufficient supplies, nursing school students have been stopped from taking care of any patients thereby reducing the demand for PPE.
“We feel very comfortable to keeping our staff safe with what we have,” Gopalakrishnan said. “Right now our staff and hospital have the protection they need.”
Hospital President and CEO Robert Haffey applauded the hospital staff for working seven days a week in preparation of the virus.
“We are prepared as we can be,” he said.