Peconic Bay Medical Center Was A Lifeline For ‘Overrun’ Hospitals To The West During COVID-19 Surge

Andrew Mitchell

Through the height of the coronavirus surge in April, Peconic Bay Medical Center in Riverhead was a critical lifeline for hospitals on western Long Island that were overwhelmed by the deluge of COVID-19 patients — and now continues to be a relief valve for some of those hospitals’ non-covid patients in need of urgent surgeries.

At the peak of the outbreak, the hospital housed more than 100 COVID-19 patients, both from the large region the hospital serves — a population of some 250,000, including much of western Southampton Town — and from Northwell Health-affiliated hospitals on western Long Island, where the surge was among the most severe in the state.

“Those hospitals were literally overrun, so Northwell did what they call load-balancing, to be able to provide the proper levels of care,” said Andrew J. Mitchell, the president and CEO of the hospital in an interview this week. “What we saw during the event was, virtually every ICU bed and a significant portion of the medical-surgical beds were all being used to treat a very large number of COVID patients. And we stayed like that for what felt like forever, those three or four weeks.”

Mr. Mitchell, who grew up on Long Island, said that when the coronavirus pandemic exploded across the globe, Peconic Bay found itself in a strikingly serendipitous situation: having just completed work on a new 60,000-square-foot, 16-bed intensive care unit, the Corey Critical Care Pavilion — they did the ceremonial ribbon cutting in January — but not having yet decommissioned its former 12-bed ICU. The hospital was able to more than double its intensive care supply without having to scramble to do very much more than open the doors and turn on the lights.

“It was completely fortuitous,” Mr. Mitchell said on Tuesday. “Three years ago, we, of course, had no idea we’d be in this situation now.”

In what may seem like another stroke of brilliance, the hospital also had a cavernous empty area built as part of a recent addition that was kept in reserve, space that was presumed would one day become part of the emergency room as the hospital grew. So while other facilities had to pitch tents, Peconic Bay was able to create new treatment areas under its existing roof.

The hospital administrator also credited the Northwell Health network with having mobilized its epidemic response in January, allowing its hospitals to stockpile protective equipment and other supplies.

As the outbreak has waned — the hospital is down to about 25 patients suffering from COVID-19 currently, and Suffolk County saw its lowest number of new confirmed cases yet on Tuesday, just 150 — Peconic Bay has begun welcoming surgeons and their patients from many of the same western hospitals, where high numbers of COVID-19 patients are still dominating the care facilities and forcing extreme precautions.

There have been lingering effects of the epidemic, some not even directly related to coronavirus. The hospital has seen influxes of patients suffering from serious illnesses and health complications that appear to have been allowed to worsen because they had feared coming to a hospital sooner. Like other hospitals, Peconic Bay has seen a rash of patients with heart issues who had deferred seeking treatment last month because of fears about the outbreak. The hospital had two heart attack patients arrive at its emergency room less than five minutes apart one night last week.

There were lessons, too, in caring for the most severe COVID-19 patients: turning patients onto their stomachs intermittently seemed to pay the biggest dividends by easing their ability to take deeper breaths. The use of bipap machines and high-flo oxygen machines proved good alternatives to ventilators in some cases.

Mr. Mitchell said that Peconic Bay has not seen any cases of the newly identified symptoms in young children that are thought to be caused by the disease as well.

The hospital has now sequestered its COVID patients in an isolated ward far from its critical care and surgical units and the rooms and other facilities that had been transformed into COVID-19 treatment rooms as the hospital scrambled to increase its bed space from 120 beds to more than 200, have been sterilized (with remote-controlled robots that blast beams of ultraviolet light to kill germs) and are ready to be put back into service when the current ban on non-emergency surgeries is lifted. The hospital is well below the 70 percent occupancy threshold the Centers for Disease Control and Prevention have set for a hospital to begin offering non-emergency surgeries and care again.

“We are ready to go,” Mr. Mitchell said, though he acknowledges that the heavy toll COVID-19 exacted on western Suffolk hospitals is likely not going to allow the more lightly affected East End resume more normal activities like some the upstate counties will.

Like administrators at Stony Brook Southampton Hospital, Mr. Mitchell said Peconic Bay is now looking into an uncertain future with regard to the coronavirus and COVID-19 disease, trying to gauge how it will need to position itself for what could be second and third waves, and beyond.

“I think the new normal is that all hospitals will have to be capable of adjusting their facilities to accommodate increased numbers of patients either until the disease burns itself out or we have a vaccine,” he surmised. “In many ways, this reminds me of what we went through back in the HIV days. We had to learn how to care for those patients, how to prevent the spread and today HIV has become a treatable disease. We’re starting to learn that with COVID as well.”

The New York health system was hit harder by the virus than any other in the country and the toll on lives and the rattled nerves of medical staff was high, but the veteran administrator said that the system adjusted well and in large part was able to absorb the surge of a disease that has killed more than 21,000 people in less than two months.

The lessons learned about how the onslaught was met will be a key to the system setting itself up for whatever the future brings.

“The ability of the New York hospital system to rapidly expand capacity in innovative and creative ways was certainly instrumental in being able to handle the surge,” Mr. Mitchell said. “We were very nimble and we’re going to need to have that level of nimbleness until we have a better understanding of the disease pattern. This is not going to be a straight line. This will ebb and surge depending on circumstances and we will need to be ready to adjust and react for several years.”