New York has thus far managed to fend off new spikes in the number of coronavirus cases, thanks to strong social distancing protocols (and compliance), and maybe a bit of luck. Whether the state’s luck and fortitude will last, or if the epidemic will explode here anew again, remains to be seen.
But if a second surge does come, the South Fork’s local hospitals say they are better prepared to take on a new surge in cases than they were the first time around.
At Stony Brook Southampton Hospital and Peconic Bay Medical Center, administrators say that the tense and tragic days of April and early May taught many lessons, the hard way, but have left in their wake a medical community that is much better at diagnosing COVID-19 cases, triaging patients, treating the worst symptoms, protecting their staff and other patients and being ready to take on steep increases in new cases.
Elective surgeries and other non-emergency medical care have resumed at both hospitals as the need for a focus on COVID-19 care has waned. But both have also kept the equipment and space they need to expand dedicated infectious disease treatment areas at the ready and would be able to ramp up their emergency and critical care bed capacity much more quickly than it took to do so in the early spring.
“We are maintaining 30 percent extra capacity today,” Stony Brook Southampton’s chief administrator, Robert Chaloner, said last week. “We’ve left all the equipment in place. We can flip that in a couple of nights and have all those beds ready.”
The hospital has more than four times as many ventilators as it did when the pandemic began and double the capacity of oxygen it has stored at the hospital.
At PBMC, the hospital was able to fairly easily expand into a new emergency unit that it had just cut the ribbon on in early March, as well as utilize vacant space in an unfinished wing of the recent expansion. As numbers climbed, the hospital devised a strategy for expanding its care space into the former Mercy High School building, which it purchased for future expansion. It never had to do so, but CEO Andrew Mitchell said that all of those options now lay in wait should a new surge, worse than the first, arise.
At Stony Brook University, a mobile hospital capable of admitting 1,000 patients was constructed by the U.S. Army Corps of Engineers in April — one of five such hospitals set up around the metropolitan area. The facility was never opened or staffed because the region got the outbreak under control, but the facility remains in waiting, and will remain at least through the winter, part of an agreement New York State and Suffolk County officials worked out with the White House, County Executive Steve Bellone said recently.
The hospitals say they — like the medical community as a whole nationwide — will also be much better at treating patients sick with COVID-19 now. Many lessons have been learned about ways to approach treatment that greatly improved outcomes.
“The profession as a whole knows better how to initially treat COVID patients now,” Mr. Mitchell said. “We understand, for instance, that there is an anti-coagulation need for these patients from day one. … We know more about the need to protect and support the kidney. These are all things we learned on the fly, but now we have a better understanding and better armament.”
Testing has improved greatly, though processing times have once again slowed to a snail’s pace thanks to the surges elsewhere in the country and the logistics of shipping tests to far away labs.
To smooth its own process, Stony Brook Southampton has invested $500,000 in a new diagnostic testing machine and renovations to its laboratory that will allow the hospital to process most of the tests it administers in-house, and at far faster return times than it can currently. The machine is expected to be in place by September 1.
Supplying protective equipment to staff members is still something of a concern. The depth of international supply chains are still uncertain and, unlike in April and May, the number of cases is surging across the country now, not just in the New York metro area. One of the most daunting and scary challenges for hospital staffs in the first surge was the shortages of PPE, especially N95 masks and protective gloves and gowns, and the hospitals say they are now building up stockpiles of supplies that they hope will be enough to carry them through another surge.
Southampton used 125,000 masks and 180,000 boxes of surgical gloves during the first surge.
“That was the biggest surprise for us early on — stuff we just took for granted,” Mr. Chaloner said this week. “It was always there when we needed it. Suddenly when it started running short and we couldn’t get our hands on it, that was frightening, frankly. We never ran out, but we had a couple moments when we were pretty close.
“So a lot of our focus now is on building up supplies,” he added. “I’m not overly confident that the supply chain issues have been fixed in this country … so we want to be well supplied.”
Mr. Mitchell said that Peconic Bay Medical Center and the Northwell Health system had been well supplied with stores of PPE before the outbreak in New York, and are continuing to build stores for the next rainy day.
Peconic Bay Medical Center, which participated in a “load balancing” program with other Northwell Health hospitals on Long Island, treated more than 400 COVID-19 cases. It currently has a handful of patients in its COVID wing, and has gotten new patients in need of hospital care as recently as last weekend. Stony Brook Southampton has four COVID-19 patients in its dedicated wing currently.
The next surge, if it comes in the fall and combines with seasonal flu, which hospitalizes tens of thousands of people per year already, could account for a much higher load on hospitals.
But the understandings of how to approach the treatment of COVID-19, from the training of nurses and other staff before the first patient walks through the door, to the most critcal care of patients suffering the worst effects of a respiratory attack that is still not fully understood, lead hospitals to say they know they need to be more on top of the game.
“We’re preparing every day as if there is going to be another surge,” Mr. Chaloner said. “Our clinical results were superb here, and we had to learn as we went. Now our knowledge base is vastly improved.”
“We don’t want a surge to happen,” he added, “but I feel confident that if it hits us, we’ll be ready for it here.”