Hospitals set aside business as usual to combat coronavirus

It is far from business as usual at area hospitals as they prepare their staff, facilities and protective gear for the potential to treat patients who have contracted the new coronavirus.

Edward-Elmhurst Health, for example, is screening all visitors for fever before allowing admittance, limiting visitors to people 18 and older, closing cardiac rehabilitation centers, canceling all elective surgeries and, beginning Tuesday, closing fitness centers across the DuPage County-based system.

Leaders shared these preparations Monday at a roundtable with U.S. Reps. Sean Casten, Bill Foster and Lauren Underwood, during which they called for more supplies and an increase in testing to help take stock of and respond to the COVID-19 virus.

Some of these protective measures — which also include discouraging patients with mild respiratory discomfort from visiting hospitals and doctor's offices — run against the usual grain of providing broad access to a wide spectrum of health care services.

But Mary Lou Mastro, Edward-Elmhurst Health System president and CEO, said all the changes are necessary to address what is expected to be an increase in cases of the virus, for which there is not yet a vaccine.

“What we want you to know is that we are ready,” Mastro said. “We practice emergency preparedness and disaster planning all the time. We have the infrastructure in place and we have been working very, very hard to serve our community and ensure safety.”

The system's two acute-care hospitals, Edward Hospital in Naperville and Elmhurst Hospital, are counting their negative pressure isolation rooms, — which filter air to help prevent the spread of the virus — taking stock of their ventilators to assist patients suffering shortness of breath and finding ways various units can be converted into treatment areas for cohorts of people who may be battling the virus.

The system has 82 negative pressure rooms total at both hospitals, and facilities crews are working to increase the number, Mastro said. New guidance from the Centers for Disease Control and Prevention indicates negative pressure rooms do not need to be used in all coronavirus cases.

At the current rate of use, the system has an 11-week supply of masks and other protective gear to help prevent staff exposure. But Mastro said that estimate is based on the presence of only one confirmed coronavirus patient.

Each hospital has set up a tent outside to test patients deemed “people under investigation” by the Illinois Department of Public Health. Testing in these tents has not yet started.

“This is to manage a surge, in case we have a lot of people coming to our hospital,” said Dr. Sanjeeb Khatua, the health system's lead on COVID-19 virus response. “It also provides an area for us to test people ... in a safer way, where we can manage our supplies in a better way.”

And in case of a broader need for testing people other than those the Department of Public Health identifies, the health system also is examining the possibility of setting up a drive-by testing site.

If 1% of the Naperville population were to contract the virus and need hospitalization during a three- to four-month span, Mastro said, that would result in 1,600 people needing intensive care at Edward Hospital alone.

“That would definitely overwhelm the system,” she said.

That's why doctors are calling for all people to heed the government calls for social distancing and frequent hand-washing. These practices can help prevent the spread of the COVID-19 virus, which is transmitted via respiratory droplets that can travel up to six feet when an infected person coughs or sneezes and via contact with surfaces contaminated by these droplets.

The virus can be transmitted by carriers who do not themselves feel symptoms, and it more severely affects the elderly and people with weakened immune systems.

One problem with current testing procedure is it can take up to three days for hospitals to receive results back from Department of Public Health labs, said Dr. Jonathon Pinsky, medical director of infectious disease at Edward Hospital.

The hospital protocol now is to test patients who show symptoms, such as a fever and a cough. Pinsky said patients with suspected cases must be treated in isolation for days until it is known whether they are infected.

“That puts a lot of burden on our system,” Pinsky said.

Hospitals are working with private laboratories to try to begin testing that could return quicker results. But until that starts, Khatua said, he wants to emphasize civility.

“Our front-line staff is doing the best we can. This is fluid. Things change hour to hour,” Khatua said. “Please treat each other with respect. Be thoughtful and if you see a health care provider, thank them and be nice.”