Leaders in Prince George’s County, the “epicenter” of Maryland’s COVID-19 outbreak, received a sobering assessment of challenges facing frontline hospital workers and administrators as they scramble to treat more patients.
During a briefing for the County Council that stretched more than two hours, top officials from several health care organizations described unprecedented steps they are taking to accommodate a patient surge that could last well into next month.
And they expressed concern about their ability to keep nurses, technicians and doctors healthy — and free from burnout — during what promises to be a grueling period.
With 2,356 cases of COVID-19 infection and 72 deaths as of Tuesday morning, Prince George’s accounts for nearly 25% of the state’s coronavirus caseload and nearly 24% of the fatalities. As of Tuesday, five of the 10 zip codes in Maryland with the highest number of known cases were in Prince George’s County. (With a population just over 900,000, the county is home to 14.9% of the state’s residents.)
“Prince George’s County is the epicenter for the state,” said Dr. Joseph L. Wright, interim President & CEO of University of Maryland Capital Regional Health.
“So we have had to activate a very aggressive surge plan that we have been sharing with the county as well as our colleagues in the other health systems.”
Said Shital Desai, Physician-in-Chief at Kaiser Permanente: “The outbreak of COVID-19 across the world and here in this region has required all of us to make major changes in the way that we live and work.”
For many hospitals, COVID-19 patients account for more than half of their census and that share is expected to grow. The looming demand has forced administrators to come up with imaginative solutions.
Perhaps most dramatically, the University of Maryland Medical System is reopening the former Laurel Regional Hospital, which will have three floors dedicated solely to COVID-19 patient care. Several Prince George’s hospitals are erecting tents and modular units in their parking lots.
One is converting a former nursing home into a mini-hospital.
“(We are) literally changing the walls of our facilities, drilling monitors in order to increase our bed capacity,” said Min Goodwin, interim Chief Operating Officer and Incident Commander at UMCRH.
Hospitals are also stocking up on equipment and supplies, reusing supplies where possible, converting private rooms to multi-patient rooms, hiring additional respiratory therapists and scouring for more ventilators.
“We are tackling this from a staffing, from a bed and medical equipment standpoint, from a pharmaceutical standpoint and from a PPE equipment standpoint,” Goodwin said, “making sure that we have Plan A, Plan B and Plan C, so that we are at the ready to the furthest extent possible, for any surge needs that we are facing for the next several weeks.”
Administrators said they have considerable fears around the heath of their staff, the emotional toll of losing patients, and the discipline required to follow safety protocols for weeks on end.
Many hospitals in Prince George’s are experiencing a COVID-19 mortality around 10%, more than three times the state’s average.
“It’s the length of time that we will be in this surge,” said Wright. “The projection that we’re operating with suggests that we will be in this through May 20. It is going to be a long, long surge. And the thing that really concerns me is how sick these people are (and) the protracted nature of this condition in our community in particular.”
County Councilmember Jolene Ivey (D), a former state delegate, called the briefing “pretty terrifying.”
“Some of it was kind of scary to hear. Things that we had not heard before,” she said afterward. The impending surge “just means the beginning of a long period of misery, and it looks like that misery is going to last us a good month, if they’re correct. And that’s with everyone doing what they’re asking us to do.”
Hospital officials told the Council, which was meeting as the county Board of Health, that they are tracking several metrics very closely. Among them: the percentage of patients who need to be moved from a standing unit to the ICU, the average length of patient stay and the rate of staff illness.
Not all of the news was grim.
- Paul R. Grenaldo, the President of Doctors Community Health System, said many hospitals received payments through the federal CARES Act on Monday;
- Desai reported that a dramatic increase in the use of tele-health has resulted in a huge decrease in the use of personal protective equipment;
- Kaiser Permanente is offering child care grants for workers and providing hotel rooms for personnel who are exhausted or can’t go home because a relative is ill or is considered vulnerable to illness;
- COVID-19 tests results, which recently took a week, are now back in hours — and the testing infrastructure continues to expand.
Several council members and hospital administrators expressed concern that racial minorities and lower-income persons are disproportionately represented among coronavirus victims. And they vowed to continue to press for great resources and awareness of the role status plays in the U.S. health care system.
“We’ve allowed ourselves to disinvest, particularly in communities of color, with respect to health and human services,” said Deputy Chief Administrative Officer George L. Askew, a physician and the top health adviser to County Executive Angela D. Alsobrooks (D).
“Those disinvestments are killing people.”
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