By Steve Ritchie
As the number of COVID-19 cases quickly grows in Oregon and throughout the country, government leaders and public health authorities have focused their attention on the readiness of hospitals to deal with an influx of coronavirus patients.
With 43 confirmed cases of COVID-19 in Marion County (as of March 25), Our Town contacted our two regional hospitals, Legacy Silverton Medical Center and Santiam Hospital in Stayton, to find out how prepared the facilities are for the ongoing pandemic.
The short answer seems to be it depends on the number of cases that land on their doorstep. As of March 25, 75 people had been hospitalized out of the 266 confirmed cases of COVID-19 in Oregon, a rate of approximately 28%. If the number of cases grows exponentially and the hospitalization rate stays around 28% this will be a huge challenge. However, if the social distancing and stay home measures work, the number of cases could stay relatively low. In that scenario, local hospital administrators are confident they can handle a small surge of patients.
“Any American acute care hospital can take care of a COVID-19 patient, (but) it becomes a problem when you are caring for 30 of them,” said Dr. Steve Vets, Emergency Room Director for Santiam Hospital. “We will never be fully prepared for a disaster of this scale, but we are blessed to have a little period of warning to prepare.”
Dr. Vets said that while he was confident that Santiam Hospital can manage a patient in respiratory failure, a major coronavirus patient influx would exceed the hospital’s resources.
“These patients are very resource intensive and one or two on a normal day is OK, (while) three or four is taxing to our hospital. If you are treating 10+ patients in respiratory failure, we will have a very, very challenging situation. Further, if a patient then progresses to multi-organ failure, it will exceed our capabilities.
“It is likely we will have no place to transfer them. The prognosis in that situation is poor to begin with (and) in a mass event those people will die.”
Oregon Governor Kate Brown has publicly stated that on a statewide basis hospitals do not now have an adequate supply of personal protective equipment (PPE), including surgical masks, gloves, gowns, and Tyvek suits to handle the anticipated increase of COVID-19 patients. PPE is critical to keep hospital staff from being exposed to the coronavirus.
“My most limiting factor is staff,” Dr. Vets said. “Any staff illness will have impact. I am concerned about my staff’s safety and how fatigue will affect them.”
Asked about possible PPE shortages at Silverton and other Legacy hospitals, spokesperson Vicky Guinn referred to a March 20 Legacy Health statement which noted that “Legacy Health currently has adequate personal protective equipment at this time to handle its CURRENT patient load. We have been working with suppliers since January to ensure adequate supplies of PPE…
“Given reports of PPE shortages in other areas, Legacy Health is engaging in conservation efforts designed to minimize future shortages, as well as using alternative PPE. One reason for canceling non-emergent medical care is to help preserve PPE.”
Dr. Vets said Santiam Hospital PPE supplies are “better then some, but not great.” Santiam Hospital, like Legacy Silverton Medical Center, has also postponed elective surgeries. This will help alleviate a possible future PPE shortage.
Both hospitals have also put restrictions on visitors. Legacy Silverton suspended routine visits to hospital patients on March 17, and the suspension will last indefinitely. However, the new policy does permit each patient to have one screened and approved visitor during their stay. To be approved, the designated visitor must be at least 16 years of age and in good health. Pediatric and end-of-life patients are permitted two designated visitors.
Guinn added that Legacy is “screening all patients who come to our campus, and that includes the emergency departments.” Those needing emergency care are asked to call ahead to the ER if possible.
Dr. Vets stressed that “the scale of this (coronavirus) is the real problem. The virus is bad, but there are worse. History is full of worse pandemics, small pox to name one. But this is a scale (of a pandemic) that the world has not seen in 100 years… I am deeply concerned.”
But he also sees hope in this crisis and wants people to realize how they can help avoid the worst outcome.
“We are not helpless to this pandemic,” Dr. Vets noted. “Frankly, the public at large will affect the pandemic more though social distancing and hygiene than any hospital. Our collective action will change the course of this pandemic. Social distance, wash your hands, and, if you get sick, self quarantine.
“We will get though this together. Americans who lived through the Great Depression, World War II, and the Spanish flu pandemic all faced similar dread at the coming struggle. It will be day by day but it will pass.”
