At Local Hospitals, Providers Prepare for the Worst

A LifeBridge employee at the Northwest visitor desk checks in a visitor. Photo by Carolyn Conte.

COVID-19 is not overhyped, contrary to what some may say, according to Dr. Jonathan Thirman, LifeBridge’s chief medical information officer and medical director.

“It’s important to take very seriously,” he said. “Certainly, the flu has a higher overall mortality rate, but this thing is just getting started. This thing has infected thousands in the U.S. so the fact that the flu has a higher overall mortality doesn’t give me much comfort because the infection numbers are far worse.”

He believes the only way to stop the pandemic is to limit social interactions and prepare for the worst.

So, what exactly are Jewish hospitals doing?

LifeBridge Health hospitals include two Jewish hospitals, Sinai Hospital and Levindale Hebrew Geriatric Center and Hospital. LifeBridge has updated its policies and created spaces to prepare for COVID-19 patients. No visitors under 18 are allowed at Sinai Hospital, Northwest Hospital, Carroll Hospital, and Grace Medical Center, with visitation banned at Levindale. Furthermore, only one visitor is allowed per patient; visitors with symptoms may be screened; visitors with international travel may not visit for 14 days after arrival in the U.S.; and visitation hours are limited as of March 17.

LifeBridge Health hospitals continue to update policies. On March 17, LifeBridge announced that all elective procedures are postponed. Photos by Carolyn Conte.

Two tents outside the emergency departments have been set up at those facilities, one at Northwestern and one in Carroll County. These are “out of an abundance of caution,” according to Tom Jeffers, corporate director of emergency management at LifeBridge Health. Furthermore, the tents would be for testing and not to actually keep the patients.

“Our intent is to keep those persons exhibiting minor symptoms out of the emergency department,” he said.

Jeffers explained that the hospitals have a system-wide, coordinated call to discuss their experiences, needs across the system, get current information out, and find out the needs at each facility. He said the email system is also operating very well.

“We did open our incident command centers at each facility, and they are site-specific commands so they would be working out any issues at the facility. … Each facility is partnered with our local and state health departments so we have routine conference calls with the city and county health departments to keep up with what’s going on and are best procedures for our patients,” he said.

LifeBridge hospitals have undergone training and drills to prepare for similar situations. On Monday, March 9, the staff had a routine Ebola patient drill.

“We have drills year-round … our staff is prepared to respond to say a mass casualty from a vehicle accident, or a mass infection,” Jeffers said.

“We do have equipment stores in house to protect our staff, and we are confident in our preparedness,” he continued. “Our biggest concern is trying to make sure that people are following the [recommended] things, like social distance to help prevent the spread.”

Thirman shared that LifeBridge opened a service March 11 to take calls from patients, in order to prevent them from coming in and spreading the infection. “We’re setting up a service for our patients and our community to give access to screening with a nurse.”

That can be escalated, he said, to a video call and then actual physically meeting.

“We’re drinking from a firehose in the volume of calls,” Thirman said.

The first day, Lifebridge received 35 calls. The second day, during which the JT spoke with him, they had already received 50 and expected at least 70 by the day’s end. Thirman said they are trying to stagger testing, because while he trusts that LabCorp has enough tests, he does not want to use them up.

They may expand the service to nursing homes, and increase the staff if the pandemic continues to grow exponentially.

To determine which patients out of those screenings receive tests, LifeBridge uses an algorithm adopted from the Centers for Disease Control and Prevention guidelines and physician recommendations. The patient is determined to either be low, medium, or high risk. Of the high risk group, doctors have to determine if they are sick enough to come in or if they are stable.

If someone tests positive, doctors collect samples in the patient room and then send it to be tested.

“I’m hopeful for the warming of spring and summer and any treatments that could lessen the impact of this pandemic,” said Thirman. “It’s way past the time to think this isn’t a big deal.”

The Johns Hopkins Biocontainment Unit is the only one like it in the Mid-Atlantic region. “We have several areas in the hospital that can safely provide care for patients with respiratory viral diseases,” said respiratory disease specialist Dr. Brian Garibaldi, who directs the Johns Hopkins BCU.

Dr. Joshua Sharfstein, vice dean for public health practice and community engagement in the Johns Hopkins Bloomberg School of Public Health and a former state health secretary, has been giving advice to state officials and even created a podcast to discuss health concerns.

He said he is very concerned. “There is no reason to believe that what’s happening in Italy couldn’t happen here.” He said he has been stocking up a little on food and dog food, but “mainly checking on my parents because I love them.”

“Everyone has to do their part. Even if you’re not a high risk, don’t pass it on,” Sharfstein said. “People should be acting like it’s up to them to prevent the spread.”

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