Stony Brook Southampton Hospital has managed to keep its care capacity, staffing and equipment supply comfortably ahead of the influx of patients suffering from acute cases of COVID-19, amid some signs of hope that the expansion of the disease in the community may be slowing thanks to social distancing mandates.
In the last two weeks, the hospital has added dozens more beds, tripled the size of its intensive care unit capacity, brought in additional nurses from other parts of the country to ease the stresses on its staff, and has managed to keep its expansion “two steps” ahead of the surge in seriously ill patients over the last week, according to the hospital’s longtime top administrator.
“We’ve been able to keep opening beds faster than we’re filling them,” Stony Brook Soutampton Chief Administrative Officer Robert Chaloner said on Monday. “So we still have beds open in ICU. As our numbers grew, we’ve been able to keep finding additional space.”
The hospital has been able to avoid some of the desperate measures that other hospitals closer to New York City have had to resort to, like using a single ventilator for two patients and has even been able to accept ICU patients from Eastern Long Island Hospital in Greenport, which has a smaller intensive care unit.
“We are pretty happy with the way we’ve been able to stay two steps ahead at this point,” Mr. Chaloner said. “We’re ready for a bigger surge than what we’ve seen. If it does level out, we’re going to be in very, very good shape for the foreseeable future.”
Whether the surge in cases over the last week actually represents the apex that has been predicted to come sometime this month and the number of cases might now be expected to plateau, remains to be seen.
Even though the early part of the week brought with it the deadliest days yet for both Suffolk County and New York State, a slowing rate of new hospitalizations over the weekend into the early part of the week offered some hints that the spread of the disease may be slowing as well.
Countywide new hospitalizations had been lurching upward by more than 100 people every day for more than a week— and by 244 last Thursday, April 2, alone. But since Saturday, the number of new hospitalizations has declined, down to just 26 overnight Sunday and 54 overnight Monday into Tuesday.
While the numbers of new cases confirmed has still been rising steadily, health officials have said that is most likely a function of more and more tests being given, which still does not represent the full breadth of infection in the population because of limitations on who can receive a test.
The glimmers of hope this week were tempered by the escalating deaths: 64 in Suffolk County overnight Monday into Tuesday, according to county statistics, and 731 statewide — both the highest 24-hour totals since the crisis began.
“That is the largest single day increase, and we talk about numbers, but that’s 731 people who we lost,” Governor Andrew Cuomo said on Tuesday. “Behind every one of those numbers is an individual, is a family, is a mother, is a father, is a sister, is a brother. So a lot of pain again today for many New Yorkers, and they’re in our thoughts and prayers.”
The grief surrounding illnesses and deaths has been compounded for the families of those stricken in the last month by the closure of hospitals and nursing homes to visitors to protect against further spread of the coronavirus.
“For the families who are losing people now from COVID-19, and other families, it is especially heartbreaking because they cannot be with their loved ones,” Suffolk County Executive Steve Bellone said last week. “They can not hold them, touch their face, talk to them. The celebrations of the person’s life, the mourning process, has been upended. The anguish these families are going through now is heartbreaking.”
More than 10,000 people have now died in the United States from the virus, more than 5,500 of those in New York State and 263 in Suffolk County.
With the signs of easing infections have come exhortations that the good news should bring renewed resolve in the fight, not decreased vigilance.
Mr. Bellone met the good news of a slowing pace of hospitalizations as reason for a hope — but not relief. If the drastic and economically devastating social distancing measures that have been imposed thus far are, in fact, starting to show dividends, he said, it is reason to stay the course, not start thinking about letting up.
“We’ve talked about the apex, the plateau, and if that’s the case — if we’ve hit that — that’s great,” Mr. Bellone said. “If we have, that means social distancing is working. The staying home, the staying away from one another, the wearing of masks now.
“That does not mean we take our foot off the pedal,” he added. “We need more time and more data. The worst thing that can happen here is we see some positive news … and instead of going down, we start going back up again. We do not want to see that after the sacrifices we’ve made.”
Governor Cuomo also noted that other areas of the world have made the mistake of letting up on quarantine guidance too soon and see their infection rates spike anew.
“There is a real danger in getting too confident,” he said. “This is an enemy we have underestimated from day one. It’s easy to say ‘Yay it’s turning.’ Other places have made that mistake. Hong Kong made that mistake.”
And medical officials are quick to point out that even if the rate of new hospitalizations is slowing, it is thus far still going up daily, and the long periods of illness many COVID-19 suffers must endure mean that their facilities are going to be facing taxing conditions for quite some time.
“The virus is still lurking out there in the community, and it is still spreading,” Mr. Chaloner said. “If we are at a plateau, it just means we’re getting in the same number of [new] cases that we’re discharging. It doesn’t mean that it’s gone away.”
The hospital has seen successes in treating those who were hit hard by the virus and many have been discharged — including the very first confirmed case in Suffolk County, a 42-year-old man from Southold who worked at Peconic Landing — the senior living complex where nine residents have now died from coronavirus infections — and was brought to Southampton Hospital on March 5. Mr. Chaloner said the man has been discharged and is doing “remarkably well.”
Mr. Chaloner said that the hospital has been using some of the experimental drugs and other treatments that hospitals around the world are using on COVID-19 patients, in hope of finding therapies that help fight off the worst effects of the disease.
In the long run, holding fast will require a continued nose-to-the-grindstone approach.
Keeping hospitals stocked with sufficient supplies of protective garb for their staffs has been a key priority for health administrators and the government officials supporting them.
Suffolk County received 150,000 surgical masks and 200,000 n95 masks from federal suppliers after U.S. Representative Lee Zeldin appealed directly to the White House for more federal assistance to the county last week. The congressman’s office said that Jared Kushner personally pledged to Mr. Zeldin that he would ensure Suffolk County had the supplies it needs to get through the anticipated April onslaught on medical care.
Southampton Hospital has been able to keep itself fairly well supplied with protective gear for its staff, Mr. Chaloner said, although he said the supply of disposable medical gowns is down to a one week supply and have been hard to source — a complaint that has echoed from other hospitals as well.
“Masks — surgical masks and n95s — we’ve got a good supply at this point,” Mr. Chaloner said. “We’re in good shape with that. Gowns is the only thing we’re a little concerned about.”
Mr. Chaloner said that the facility has lost some staff to coronavirus infections, although only a handful, and none have had to be hospitalized.
The hospital this week brought in 20 new “agency nurses” — those organized from other areas of the country to work locally on a short-term basis — to help with staffing and ease some of the workload on fatigued staff. The medical residency program for new doctors that has been employed at Southampton Hospital since it became part of the Stony Brook University system has been a boost to the endurance of staffing as well, Mr. Chaloner said.
The hospital has been able to steadily increase its supply of ventilators and other respiration assistance, through normal chains of supply, government allocations and donations. The hospital received five new ventilators through a donation from Southampton opthimologist Dr. Pete Michalos on behalf of the Hamptons Health Society.
Southampton residents Kevin and Stacy Kotler facilitated the donation of 10 High VNI machines, an oxygen boosting system for patients with moderate breathing difficulty, not requiring a ventilator. The manufacturer, VapoTherm, rushed the systems to the hospital last week.
“[Dr. Jeffrey Russel] the head of respiratory said, ‘We’ll take them,’ and they were on site within 24 hours,” said Mr. Kotler, who until recently had a healthcare technologies investment company.
Southampton Hospital is still administering tests to those who suspect they have the virus and meet the criteria for testing — which is still limited only to those exhibiting symptoms who are healthcare or other essential workers or have been in contact with someone confirmed to have the disease — but the hospital administrator said that testing now will be less critical until it is available on a very broad basis.
For now, anyone who is ill should assume they have COVID-19 and behave appropriately, health officials have said, treating the illness like they would a bad case of the flu — lots of bed rest, fluids and fever reducers — unless they start to have difficulty breathing.
But Mr. Chaloner said that testing will become more important as the spread of infection is gotten more under control and the country starts to look for ways to get the economy rolling again. Using tests to find more isolated cases and track down those they’ve been in contact with will be crucial at that point.
“Because it’s going to be like a forest fire that rages across the land, and then you get sparks, little flare-ups, around the periphery of it,” Mr. Chaloner said. “Once you get the big fire under control, you want to stop all those little brush fires from turning into something. So we have to quickly be able to beat those down. And that’s where testing becomes vital. Rapid testing, at every hospital and every doctor’s office.”