Dose of reality: Local health care providers respond to growing health crisis

While most are urged to stay at home, hospital staffs are on the front lines, fighting a rapidly growing virus pandemic.

Hospital leaders are faced with a new reality due to COVID-19, a respiratory illness that has infected more than 250 Hoosiers as of Monday.

A new reality

Despite dealing with a new normal, hospitals are not wavering from what they are trained to do: care for patients.

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"We have to stay calm. We treat patients every day," said Dave Dunkle, president and CEO of Johnson Memorial Health. "We have to be ready for more patients, but at heart, we’re just doing what we do every day."

Right now, visiting a hospital looks a lot different. Everyone who enters the building has to be screened for COVID-19 symptoms, such as a fever, a tell-tell sign of the virus.

Hospital staff who are covered head to toe in surgical robes, masks and gloves meet incoming patients at the door; only their eyes are visible. They ask questions about health history, symptoms and scan for a fever before the patient can even enter the hospital.

People come to the doors of Johnson Memorial Hospital in Franklin and Community Hospital South in Indianapolis almost every day wanting to be tested for the virus, hospital officials said. Most, however, are sent home with mild symptoms, Dunkle said. 

"The majority of people with upper respiratory symptoms do not have COVID-19, though I think that’s the first thing everyone thinks of," he said. "A lot of people, they need that reassurance."

Johnson Memorial had its first patient test positive for COVID-19 on Saturday, but the patient’s symptoms were mild enough to quarantine at home, Dunkle said. The hospital did not have any patients admitted for the virus as of Monday.

Community Hospital South has admitted several patients to the hospital while they await test results for the virus, and they have had patients who tested positive, said Dr. Randy Lee, physician of internal medicine and a Community Health Network executive.

"We have patients in our network who are showing up testing positive, and (it) sometimes takes several days before test confirmation," Lee said.

The hospital is as prepared as it can be with a 24-bed COVID-19 unit for patients, and they are ready to turn all their rooms into areas for patients with the virus, if needed, he said.

At Johnson Memorial, they are working on plans to add more beds, Dunkle said.

"We have to prepare for the next steps. You know, is this the lull before the surge?" Dunkle said.

Hospital workflows have changed, but no one is working over their scheduled hours, said Anita Capps, chief nurse executive at Community Hospital South.

"It’s definitely a conscious effort to stop and think about what you’re about to do, what room you’re about to enter," Capps said. "Ensuring you have your protective equipment on so that you are not only protecting yourself, but other patients in the building that are not impacted by the virus."

Despite the uncertainty, Capps said her team is still doing its job to take care of all patients. 

"Even though people may have some anxiety around the unknowns of this virus, we’re really pulling together and just rolling up our sleeves," she said.

Plans in place

Hospitals have plans in place for these types of public health emergencies.

The virus is serious, but people shouldn’t panic about hospitals overfilling, Dunkle said. 

If a hospital is full, a patient will be transferred to the nearest facility with available space, similar to what hospitals do during flu season, Dunkle said.

"Hospitals go into diversion during flu season; hospitals get full," Dunkle said. "This stuff happens."

Most hospitals have plans to use other areas for isolation if needed, he said.

For example, hospitals can use surgical units or outpatient areas if a surge of COVID-19 patients occurs. Those areas are not being used as much now that hospitals are limiting elective surgeries, Dunkle said.

Physicians from other areas in the health network, such as family practice and outpatient doctors, are also available to come in if additional staff is needed.

Low supplies, even fewer tests

One of the biggest concerns in health care right now is that there aren’t enough COVID-19 tests, hospital officials said. Most hospitals are left with a fraction of the tests they actually need, and waiting on the state to send more.

"We’ve requested multiple more times than what we’re actually being allowed to test," Lee said.

Neither Lee nor Dunkle could say how many tests the hospitals had left.

"You can’t test everybody who has a fever or everybody who thinks they might have COVID-19 right now. I understand it’s frustrating," Dunkle said.

The main message health care officials want to send to the public is to continue to social distance and take the virus seriously, Lee said. 

"We’re not going to escape this thinking life is going to go on like it was two weeks ago," he said. "The healthcare providers in this state and in this nation have had an elevated state of urgency like I have never seen before."

Hospital leaders are also learning how to ration and evaluate supplies each day, said Nichole Goddard, vice president of operations at Community Hospital South.

"It is something we are struggling with, and we have to figure out every day how we need to adapt to our new reality," Goddard said. 

Local hospitals are running out of essentials, such as masks, ventilators, gloves and cleaning supplies, but the staff is working efficiently with what they have, Dunkle said. The main issue at Johnson Memorial is the ability to restock cleaning supplies, he said. 

"Suppliers have already reached out and said, ‘Hey, we can’t give you your normal supplies,’" Dunkle said. "We know that our supply chain has been affected, so we are rationing."

Limiting foot traffic, but continuing to help

Right now, innovation is paramount if local healthcare leaders want to continue to serve patients with illnesses other than COVID-19.

Johnson Memorial Hospital has become a respiratory care center. The hospital’s satellite offices in Greenwood and Whiteland are for non-respiratory illnesses only, so people can still receive care without worrying about being exposed to the virus, Dunkle said.

Also, to avoid foot traffic at local doctor’s offices, local physicians have increased telehealth, where people can call their doctors with non-emergency issues for over-the-phone evaluations or to get a prescription filled, Dunkle said. 

Those who are really sick with other illnesses should not avoid seeking medical help or coming to the hospital due to COVID-19 fears, he said.

"It’s better not to come in if you can put it off, but the last thing I want is for somebody who needs care to not get the care they need," Dunkle said.

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"We’re not going to escape this thinking life is going to go on like it was two weeks ago. The healthcare providers in this state and in this nation have had an elevated state of urgency like I have never seen before."

— Dr. Randy Lee, physician of internal medicine and a Community Health Network executive

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