Surge expected in 2-3 weeks

The surge of COVID-19 cases are expected to hit Kentucky in about three weeks, and Dr. Eric Guerrant said Ephraim McDowell Health is prepared.

Guerrant is medical director of the EMH emergency department. He said the hospital has been preparing since the beginning of March and is ready for COVID-19 when it arrives.

“Some of the highlights we have in place are that we have outfitted a wing of the hospital to manage only COVID-suspected or COVID-positive patients. For any that require intensive care, the hospital has created an isolated intensive care unit from one of our recovery units that has been fully outfitted to care for COVID patients,” Guerrant said. “The hospital has worked diligently to conserve our personal protective equipment, and we have an adequate supply at this point and it allows all of our associates and patients to be protected and deliver care in a safe manner. At this time, we’re pretty much through the planning phase and we’re ready to go.”

EMH President and CEO Dan McKay echoed Guerrant’s comments on preparedness.

“Today, we’re better prepared regarding PPE than we ever have been. That can all change depending on how fast patients come through. The more they come through, the more (PPE) we’ll burn through. Right now, we have supplies going out two weeks, so I feel really good about that.”

As of press time 13 cases of COVID-19 have been confirmed in Boyle County, but none of those have been patients at EMH. Guerrant said there has been one person from the community that required hospitalization, but that person was not a patient at EMH. Other local confirmed cases are being monitored closely by the health department. He added that when a patient does require hospitalization, it is typically around day nine or 10 of their illness.

The model followed by most hospitals is one provided by the University of Washington, according to Guerrant. He said right now, the date predicted for a surge in cases for Kentucky is around April 22.

“That’s what we expect, but that can vary if we develop a cluster from poor social distancing, but you can count on that probably being in the next two or three weeks,” he said.

When a surge does come, EMH’s area facilities are prepared to accommodate approximately 300 patients. 

“We feel that we have adequate space for the surge we’re going to see,” he added.

Guerrant said one simple piece of advice is best when it comes to being safe from COVID-19.

“Stay at home,” he said. “Only go out when absolutely necessary. Social distancing is effective, but the more we stay at home and eliminate any temptation for other contact the better off we are going to be.”

The city of Danville recently placed a limit on the number of people permitted to enter grocery stores and other essential businesses that remain open during the pandemic, and Guerrant said that “very likely will be pivotal in keeping our numbers down.”

For anyone needing medical treatment but nervous about seeking care, Guerrant said EMH has the capability of providing urgent care outside of the emergency department. A tent has been erected in the parking lot of the emergency department, and he said measures can be taken to care for people in their vehicle if necessary.

 

Steps taken to by EMH to prepare for COVID-19

• In very early March EMH began to develop flow patterns with regards to testing patients and began looking at the process of treating those who were hospitalized with COVID-19.
• On March 6, visitation limits were put into effect for ICU Units and hospital visitations.
• Respiratory clinics were created to test possibly infected COVID-19 patients so that they were not mixed with other patients at our primary care clinics and emergency rooms.
• Social distancing was requested in EMH facilities and discussions were initiated to identify those who could work from home.
• Patient education and screening criteria were established.
• By mid-March, visitation was suspended at all hospitals and the Ephraim McDowell Commonwealth Cancer Center.
• Meetings were held by phone rather than in person.
• Suspected COVID-19 patients were not allowed to have visitors.
• Recovery 3 Unit was converted to a COVID-19 patient unit.
• Daily calls were established for SLT, medical staff leadership and board leadership.
• A COVID-19 specific site was added to the EMH website and intranet site created for associate information.
• A call center for screening was established for associates and patients.
• Hospital entrances were restricted and those allowed in with patients had their temperatures taken before being allowed in. Those with temperatures over 100.4 were not allowed entry.
• All associates were given guidelines on PPE use with specific patients.
• A COVID-19 patient unit was established on the fifth floor.
• Nightly COVID19 update calls with providers were established.
• Non-essential associates were instructed to stay/work from home.
• Temperature checks for all associates were implemented prior to entering.
• Mask usage was required for all associates in hospitals.
• All associates who travel out of state are required to quarantine for seven days.
• Telehealth was established for patients not wanting to come to clinics.
• A drive-thru clinic was set up at Walk-in and Primary Care.
• An ER triage tent was set up in the ER parking lot.