How suburban hospitals are preparing for looming coronavirus surge

It had been a long night for one of his colleagues at Edward-Elmhurst Health.

Dr. Sanjeeb Khatua ran into the anesthesiologist after a recent shift on a new hospital team with one job: intubating coronavirus patients unable to breathe on their own.

"He was saying it was just so hard because they did three in one night, and normally they do maybe one in a week," said Khatua, the system's chief physician executive. "It really sometimes can be demoralizing because you see these new patients who sometimes can be younger who can deteriorate so quickly, and you're trying to do the best you can."

Hospitals already facing such hardships are preparing for a looming surge in COVID-19 patients. Medical workers are preserving protective equipment supplies by disinfecting N95 masks with ultraviolet light. Hospital officials are getting creative retrofitting spaces in case they have to add capacity.

Edward-Elmhurst potentially could use operating rooms to house coronavirus patients. The system is planning for COVID-19 hospitalizations to climb from 116 total as of Wednesday to 150 to 200 at each campus.

"We expect a bigger surge over the next 10 to 14 days," Khatua said.

Elmhurst has 40 of its 57 intensive care unit beds in use and could add 23 ICU beds if necessary. Edward has 32 of the 46 ICU beds occupied by patients and could add 36.

AMITA Health had filled 227 of 400 licensed ICU beds across 14 hospitals as of Monday, according to spokesman Tim Nelson.

Statewide, 3,680 known and suspected COVID-19 patients were hospitalized earlier this week, Illinois Department of Public Health officials said. Virus patients were using 1,166 of the 2,709 ICU beds in Illinois' hospitals.

Recovering from an infection also can be a long fight. Edward-Elmhurst officials have seen hospital stays last 10 to 15 days or more in some cases, shorter than those in other areas of the country.

"But as time goes on, I think we're preparing for longer stays," Khatua said.

He cautioned that it's difficult to project how many people will end up in the hospital as testing expands.

So hospitals plan for a variety of scenarios, taking into account availability of beds, staffing, pharmaceuticals, and ventilators and protective gear.

Nurses are keeping N95 masks in paper bags outside hospital rooms so they wear the same one in front of the same patient during a shift to prevent exposure to other patients. After use and before storage, eye protection and masks also can be disinfected with an ultraviolet machine.

"At this point, I don't think any health system is ever going to say they have enough (PPE) and they're planning as such," Khatua said. "I think we've got a ton of donations from our community, which has been great. Our team has been procuring supplies from any avenue possible."

As for ventilators, nine of the 42 COVID-positive patients at Edward Monday were relying on the machines to help them breathe. At Elmhurst, 16 of 52 were on vents.

"We obviously have others that are vented that are not COVID-positive, but as of right now we're doing OK," Khatua said. "That doesn't necessarily mean that in two weeks, I'll have the same answer."

The system has 67 ventilators, but it also could possibly use BiPAP and anesthesia machines.

"So if you look at the totality of it, it's anywhere between 125 and 150 different machines that we could potentially use to ventilate patients," Khatua said. "But we have scenario planning for which ventilators we would use for specific patients based off safety."

Khatua commended medical professionals for stepping up in the crisis and developing a playbook that's proved comparable to that of other larger institutions. On a positive note, each hospital has had 51 COVID-19 discharges.

"We're planning for the worst and hoping for the best, and I think the community can feel assured that at least our health system feels as good as we possibly could feel in this type of situation," he said.

Virus numbers

Edward Hospital:

• 59 inpatients with confirmed cases of COVID-19; 18 inpatients with tests pending

Elmhurst Hospital:

• 57 inpatients with confirmed cases of COVID-19; 13 inpatients with tests pending)

Total:

• 116 inpatients with confirmed cases of COVID-19 in the system; 147 with the pending tests.