United Hospital Center-WVU Hospitals had 24 to 48 hours to convert into a COVID-19 testing site, setting up outdoor tents/kiosks for that purpose, training staff and obtaining need equipment, but continuing to offer traditional medical care.
“Adjusting on the fly – being flexible – has had to become first and foremost,” said UHC Nurse Educator Leslie Perine. “Truly, our management and leadership are working really, really hard to make sure we have in place what we need for patient care and incorporate guidelines, but make sure our existing processes aren’t interrupted. We have obviously cut back on surgeries and we are trying to limit doctor visits, but people are still having heart attacks, gallbladders still go bad and people get other infections for which they need care.”
The Test
To get the COVID-19 testing in place, UHC also had to coordinate services with third-party agencies, such as Lab Corp and Quest Diagnostics.
“At that point in time, we were not able to run tests in-house, so we had to make sure we had someplace to send them,” Perine said.
Once swabbing patients – through the nose and deep into the throat, where germs harbor – tests were initially transported to a testing center.
With combined travel time, testing time and reporting time, results have been many times taking multiple days.
“It might take up to eight hours before the lab work is picked up, then taken to where their office is. Then, they have to run the test which usually takes eight to 12 hours and then put things back into the system. This is considered disaster emergency, so positive results are called into the lab and the physician. Those results cannot be put on a patient’s MyChart without advising providers.”
Add the factor that many doctor offices do not have workers in the office answering phones and additional hours are added into the equation.
It was taking four to five days to get results, but that turnaround time is coming down significantly, Perine said.
An Army of Medical Professionals
The additional workload requires an increased work staff.
“We’ve made new hires, and some have picked up extra shifts,” Perine said.
She can’t stress enough just how impressed she is with the UHC staff. The hospital transition has encompassed many reassignments, accompanied by true professional determination.
“I am in education and we have been bringing in, retraining and reallocating from all over,” Perine said. “We might bring someone out of outpatient surgery and bring them in to train them to be bedside nurses in acute care – which is a whole different world.”
Personnel from offices of local physicians – who have reduced or postponed office visits – have come on board to serve as extra sets of hands.
“We are training and making sure we are comfortable before it escalates to a situation where we have to throw people in without proper training,” Perine said. “Everyone has been great – doing anything they are asked to do.”
PPE, Medical Gear
As for gear, the UHC staff is equipped.
“As of right now, we have enough medically-approved PPE (personal protective equipment),” Perine said. “We, as an institution, know this can get ugly. We’ve pulled everything, counted it and are keeping better control of distribution.”
UHC has been keeping check on equipment for weeks now.
“We’re doing a very good job. We are going to be ready. We have had a lot of fabulous people in the community donate to us – nursing schools that have shut down have donated gloves, masks and gowns they use for training students. Career centers have donated, even autobody mechanics who wear masks when they paint, etc. NAPA has made huge donations to us, giving us really heavy, hard plastic face masks. That’s the kind of stuff we use right now to protect everyone.”
As for homemade fabric masks, they have been helpful to personnel transitioning through hallways and even for wearing underneath heavy-duty masks for comfort, Perine said.
(See information about mask sterilization below.)
What Can We Do?
There’s much the public can do to help things continue to run smoothly.
Please only seek testing if you are showing symptoms.
“We truly can’t swab you until you have symptoms. That’s something people need to know,” Perine said. “If you think you have been exposed, stay home. If in two days, you start to show symptoms, that’s when you call (to arrange testing).”
Testing too early can result in a false negative reading and a false sense of security, she said.
If you do meet testing criteria and you are swabbed, stay home until you receive results.
With that being said, individuals can be COVID-19 contagious before showing symptoms. That’s why it is vitally important to social distance, properly wash hands and not touch common objects.
“This is spreading quickly and aggressively,” Perine said. “We are not in a position anywhere close to situations conveyed by national news and part of the reason is that we were proactive and have truly tried to shut things down. But if we don’t listen to what we have been told to do, our elderly population – and individuals with heart disease, diabetes, chronic lung disorders, asthma – is the group most at risk. If we do not shut down this spread, a large group of our population will get very sick and we will see a higher percentage of death rates. At that point of time, we will be overwhelmed. Even though I am very confident of what we have now, I don’t know that if we see a massive surge, we will have what it takes to sustain long-term.”
COVID-19 is Aggressive; Take it Seriously
Keep in mind that if you test positive for the virus, you will need to advise everyone you have been in contact with during recent days. Also keep in mind, she said, that if you are hospitalized, you will not be permitted visitors. That goes for the elderly and children, too.
“Think about that – being diagnosed and placed in a room where the only people allowed to visit are staff and they are dressed like aliens,” she said. “I can’t even imagine having a loved one – including a child – in the hospital and not being able to visit them.”
Though it was at first believed that children were unlikely to contract COVID-19, some are being diagnosed. Though there is a target group most at risk, no one can be count out as a possible victim.
Perine said in her many years of nursing, she has never seen a disease as aggressive as COVID-19.
“You can see someone going from OK to not OK within hours. It happens very suddenly,” she said. “That’s the scary part of this. Once it takes hold, it takes hold very, very quickly.”
The six-feet rule is based on COVID-19 droplets being large and not traveling any further than six feet.
“They are not tiny, little droplets that get into the air and go on forever. That’s why social distancing is so important,” she said. “Stay that far away from each other. Don’t sit on chairs or get closer than that to people’s things.”
The virus only lives 14 days; thus the 14-day self-isolation period for travelers and others who have been exposed.
The Bottom Line
The bottom line, Perine said, is stay out of people’s faces, limit contact and keep your distance.
“It will decrease the amount of people this disease is spread to and lower our counts,” she said. “Yes, this is scary and yes, it’s new, something we’ve never faced before. But I am not at all worried that we don’t know what we’re doing. People are stepping up, being moved into positions they have never been in before. They are smiling and saying, ‘Put me where I need to go; whatever you need me to do.’ It has been amazing to watch them.”
As the hospital staff is doing, Perine advises everyone to keep your head and stay calm. If you are out in the public, go home and immediately wash hands and sanitize anything to be brought into the house. It’s not a bad idea to completely change clothes and toss worn clothing into the laundry. One cannot be too cautious, Perine said.
Remember, to request and determine need for testing, you must first call your physician or the Coronavirus Hotline, 1-800-887-4304.
Editor’s Note: Photo of testing site is courtesy of a reader. All other photos are courtesy of UHC.
More inside information, courtesy of UHC Chief Quality Officer Mark Povroznik:
The photos attached will give you a glimpse how nearly overnight UHC operationalized N-95 mask disinfection utilizing Pulsed Xenon ultraviolet light. A concept idea that was born during Ebola, but never utilized, is now fully functioning. A game changer during a time of shortening supplies and need for high quality masks. A classroom was emptied and a design was outlined. Like a football game huddle on center field, once the game plan was outlined, all players set themselves in motion. Engineering assembled shelving racks from Lowes to precise requirements to focus the UV energy between 1 and 2 meters off the floor. Each rack encircled the robot within 1 meter distance from the center. A simple clothes line assembly was formed using the shelving poles, heavy gauge wire and employee badge clips for clothes pins. A complete protocol was written to assure safety and to maximize efficiency. Masks are received in brown bags for dirty and returned in clean white bags or plastic. Once the masks are hung, 5 minutes of pulsed Xenon is all that is required. Given the shelves are on wheels, they are quickly rotated and a second 5 minutes is delivered to the back side of the mask. The system started disinfecting 168 masks per hour, but has the potential to disinfect upwards of 8,000 masks per day. Masks have been certified to be recycled up to 6 times. The surgical staff have become the operations team assuring all dirty and clean processes are adhered to. Just one method of ingenuity while we tackle the challenges of Covid-19. It’s been a true team effort, Povroznik said.