What suburban hospitals are doing to prepare for coronavirus patients
With a married couple from Chicago having been successfully treated for coronavirus infection at Amita St. Alexius Medical Center in Hoffman Estates, hospitals in the suburbs are sharing knowledge gained from near and far in preparing for the possibility of a more extensive outbreak.
A third patient in the Cook County suburbs was diagnosed preliminarily over the weekend as having the infection. State and county officials were releasing no further information, pending confirmation of the diagnosis by the national Centers for Disease Control.
In preparation for a possible outbreak, the Illinois Department of Public Health is assessing hospitals throughout the state for available space should more people require care for coronavirus infection. The department also is assessing the availability of personal protective equipment — gloves, masks, gowns, goggles and the like — for health care workers.
Health care providers and their individual hospitals, meanwhile, are preparing themselves by implementing infection prevention protocols, screening patients for symptoms and risk factors, and running drills on their response to a positive diagnosis of COVID-19.
“We assembled a team representing infection prevention, emergency preparedness, supply chain and other departments to ensure our facilities are prepared with ample supplies and support to keep our patients and team members safe,” said Dr. Gary Stuck, chief medical officer of the Downers Grove-based Advocate Aurora Health hospitals.
If a major outbreak occurs, infection control and isolation are the primary means of limiting the spread of the disease because effective vaccines and antiviral medications don't yet exist, said Dr. Guy Kochvar, an infectious diseases specialist with Arlington Heights-based Northwest Community Healthcare.
While the availability of protective equipment for staff members has been identified as a priority, patients with symptoms of a respiratory infection also should be given masks as soon as they're identified, Kochvar said.
“This is particularly important during times that we experience high volumes of illness with respiratory viruses such as influenza,” he said.
While many of the protocols in place are designed to prevent the spread of infection to other patients and staffers, Kochvar also explained how those being treated for coronavirus recover themselves.
While 80% of infections appear to be mild and require only limited supportive care with a recovery time of about two weeks, about 15% of cases can be severe and another 5% can be critical, requiring a more prolonged recovery time of three to six weeks, Kochvar said.
“Those critically ill may present with respiratory failure, shock or multi-organ dysfunction,” he said, “and recovery may involve extended time on a ventilator and physical rehabilitation with physical and occupational therapy.”
Northwest Community Healthcare, like other providers, is sharing updates from the CDC and state health department with its staff. Those include screening guidelines to identify potentially infected patients, rapid triage techniques, infection prevention and control measures designed to minimize exposure to health care personnel, isolation procedures and testing procedures, Kochvar said.
It also is staging drills to prepare for the discovery of infected patients.
Those suspected of coronavirus infection will be placed in airborne isolation rooms at the hospital with controlled airflow to minimize the chance of exposure to others, Kochvar said. Potential exposures would be investigated and managed by the health department and the CDC.
Officials at Lisle-based Amita Health said that while they have received inquiries from other local health care providers, the CDC and state health department remain the recognized authorities on care and recommendations.
Officials from Amita and Advocate Aurora Health said their preparedness for coronavirus has been helped by the fact that many of the same infection prevention measures were already in effect for flu season.
Amita officials said the two coronavirus patients at St. Alexius — who were treated there because it's where the wife's primary physician practices — were kept in individual isolation rooms and had no contact with any other patients.
The use of personal protective equipment was required of all staff members caring for those patients.
Under the oversight of the CDC and state health department, St. Alexius remained safe and operating at full capacity during the stay of the coronavirus patients, Amita officials said.
Standard precautions also include placing signs at key entry points outlining symptoms for coronavirus and flu, according to Amita officials. Frontline screening has been put in place to identify anyone who may be at higher risk based on their travel history and contact, as directed by the CDC, they said.
A large outbreak in the U.S. would place “significant stress” on American health care facilities and personnel, Kochvar said.
“We could potentially see cancellations of public gatherings (and) school and business closures, as currently seen in parts of Asia and Europe,” he added.
According to recent estimates, 20% of people infected with the virus develop severe or critical illnesses. The overall mortality rate is believed to be about 2%.
People who are concerned they may have the virus, either after traveling to an area experiencing an outbreak or after contact with a person confirmed to be infected, should call their primary doctor or a local health care facility, Kochvar said. Notifying those staffs by phone before an in-person visit will allow the screening process to begin and prevent unnecessary exposure of others, he said.
Anyone with questions or concerns can contact the Illinois Department of Public Health coronavirus hotline at (800) 889-3931 or email dph.sick@illinois.gov.
The Cook County Department of Public Health also is providing information and updates at cookcountypublichealth.org/communicable-diseases/novel-coronavirus.