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Hospitals have a range of options to adjust for an influx of patients who contract the coronavirus and require hospitalization, a statewide trade group said this week.
These include delaying elective surgical procedures, expediting discharges of patients who are close to going home anyway, and using other areas of facilities for non-critical patients to save patient rooms for people who need isolating, said Michigan Health & Hospital Association spokesperson Ruthanne Sudderth.
“There are all sorts of operational practices that can be adopted to start to increase bed capacity should there be a surge,” Sudderth said. “The system will be tested to a point, but Michigan has outstanding coordination and world-class health systems that prepare for this all of the time. Right now we have no reason to believe that they can’t handle this as it arrives.”
Hospitals are working to quickly adapt to what is a daily evolving and fluid situation with COVID-19 and as they are already somewhat stretched with influenza, said Dr. Ronald Grifka, chief medical officer at Metro Health-University of Michigan Health.
One potential issue is the availability of specialized rooms for patients who need isolation under present U.S. Centers for Disease Control and Prevention guidelines that are changing regularly as the outbreak evolves, Grifka said.
“If they’re not requiring these rooms, that’s going to make a difference in how patients are treated,” he said.
Overall, “we’re in good shape. Certainly there’s going to be some challenges, depending on how many patients we get,” said Grifka, who urges people to “remain calm.”
Sudderth said hospitals have “very specific” plans for crises and emergencies that can lead to a quick surge in patients. They also maintain regular contact with local and state health departments to “drill for these kinds of situations and prepare for them” to increase communication and coordinate a response, she said.
“Hospitals are very well prepared. They do have people on staff whose entire job is to prepare for outbreaks or infections or emergency situations, pandemics and things of that nature,” Sudderth said. “At the same time, it’s hard to anticipate how severe any given outbreak can be. There are always challenges in making sure the public is following instructions in ways that will help providers.”
One public misperception about the coronavirus outbreak is that anyone who gets COVID-19 will require in-person care or hospitalization, according to Sudderth.
“That’s simply not the case,” she said. “There will be people who are more vulnerable who do need critical care or support in a facility, but the overwhelming number of people who get this virus may never know it because they never get symptoms or they get very mild symptoms and they will not need to occupy a hospital bed.”
Sudderth added that the “most important” thing residents who don’t need in-person care can do is stay home and not infect others.
Vulnerable patients include the elderly and people who have a medical condition that makes them more susceptible to an upper respiratory illness.
This week, Gov. Gretchen Whitmer issued a series of “community mitigation strategies,” including for workplaces and those at-risk of severe illness.
The Michigan Health & Hospital Association’s reassurances come amid warnings that the outbreak could overwhelm the U.S. health system
Writing in the Detroit News on Thursday, emergency medicine physician Dr. Rob Davidson warned about the outbreak’s potential impact on small, rural hospitals.
“Should one of the nursing facilities near my hospital become a COVID-19 hotspot, the morbidity and mortality to residents of these facilities would be devastating. For small hospitals like mine, such an incident could potentially cripple our ability to provide essential services,” wrote Davidson, who works at Spectrum Health Gerber Memorial in Fremont and also serves as executive director of the advocacy group Committee to Protect Medicare.
Davidson urged increased testing of health care workers and the public for the coronavirus to “help small communities better brace for the outbreak” and “so we get a true picture of the scale of the outbreak.”
An Indiana University School of Medicine pediatrics professor, Aaron Carroll, had a similar warning Thursday in a New York Times column.
“The big question is how severe is this going to become?” Grifka said. “Our health care system is actually very good. We need to make sure the people who are sick and need to be seen (get seen), and healthy people just need to not panic and overwhelm the system and prevent us from seeing the people that need it.”
Hospitals are urging people who feel symptoms to call their doctor first or use a tele-health service for an initial screening. Hospitals also have used visitor restrictions to limit the spread of COVID-19.
Spectrum Health and Metro Health-University of Michigan Health are not allowing children under 12 years old to visit their hospitals. Mercy Health is not allowing visitors under 14 years old.
Visitors are limited to one person per patient and two for a pediatric or maternity patient. Visitors and family “must be healthy and without symptoms of illness” and anyone who has recently traveled to a country included in a travel warning by the CDC “will not be permitted to visit,” according to Spectrum Health.
Visitors can also expect to undergo a quick health screening at the doors before they are allowed to enter.
“We just want to make sure people coming through our doors are healthy,” said Metro Health spokesperson Jamie Allen.
Like other employers, hospitals are using travel restrictions to protect staff and reduce the risk of exposure “because they’re the ones that really need to be there should the need present itself,” Sudderth said.
Employers can help the situation by “over-communicating about good hygiene practices” and making employees understand what their health benefits cover should they need testing or treatment.
Health insurers have generally agreed to waive copays and deductibles for COVID-19 tests. The Internal Revenue Service this week issued guidance to allow employers with high-deductible health plans to cover related testing and treatment.
As hospitals and health systems help the public understand symptoms to watch for and procedures if they do fall ill, some are reminding residents to remain calm.
“Though COVID-19 is a serious matter, people should not panic. It’s important to take precautions, such as proper hand hygiene, to help prevent COVID-19 and other viruses from making you sick,” Richard Van Enk, director of infection prevention and epidemiology, says on the website for Kalamazoo-based Bronson Healthcare. “As a whole, Bronson is adequately prepared should COVID-19 arise in our communities, and we are keeping a close watch on everything as things progress.”