Steamboat hospital admits 1st COVID-19 patients, continues to prepare for a surge
STEAMBOAT SPRINGS — According to a recent study by the University of Washington, Colorado will hit its COVID-19 peak resource use April 17.
Of course, every community within the state looks different.
“If you include both confirmed positive patients and patients who have pending COVID-19 tests, we have about 65 patients at our hospitals in northern Colorado including a few at (UCHealth) Yampa Valley Medical Center,” said UCHealth communications specialist Lindsey Reznicek on Thursday. “These numbers change regularly, which is why we cannot provide specific numbers.”
And to prepare for a possible surge in patients, the hospital continues to run drills in every part of the facility.
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“Part of surge planning is considering what we can do within the capacity of the hospital itself and what we can do systemwide,” said Dr. Laura Sehnert, emergency medicine physician and chief medical officer at YVMC in Steamboat Springs. “We know we are a small facility and have limitations, but we have a lot of great resources throughout the state.”
On a daily basis, and even multiple times a day, said YVMC President Soniya Fidler, said the hospital evaluates supplies across the entire system on a daily basis, and even multiple times a day, to identify where there are needs and where there are surpluses.
“We’re seeing a critical need for more (intensive care unit) beds and ventilators,” Reznicek said. “Every day, UCHealth hospitals have more positive patients and more on ventilators, helping them breathe. Our hospitals — and Colorado overall — need more ventilators. This piece of equipment will save lives.”
According to the University of Washington report, Colorado has a bed shortage of 3,703 beds overall, an ICU bed shortage of 762 beds and a need for an additional 1,052 invasive ventilators.
Fidler said the hospital currently has about 10 ventilators, with plans in place to support more than 10 patients who need breathing support, if and when that need arises.
Dr. Jesse Sandhu, a physician owner at the Steamboat Emergency Center, said they have one ventilator, which can support two patients at a time. He described the plans in place to transport stabilized patients to other area hospitals with available ICU beds and ventilators, to keep their one ventilator available for emergencies.
Fidler said the hospital feels confident about its current supply of personal protective equipment.
“But it is something we are constantly monitoring, and we are in conservation mode,” Fidler said.
As the hospital put out a public call for new, unopened commercially-produced PPE, Fidler said the community has been generous in its donations.
Sandhu has been very active in finding out where there are additional supplies of things like N95 masks and getting those to the health care providers most in need. He also has helped law enforcement identify people who are hoarding lifesaving supplies and price gouging. It’s keeping him busy, he said, while Steamboat’s health care community is not, at this time, overwhelmed.
Across the UCHealth system, “equipment and resources are constantly being evaluated and moved between hospitals to help with each facility’s current needs related to caring for its patients,” Reznicek said.
In addition, she said UCHealth has plans in place to increase ICU capacity.
At the hospital in Steamboat, one wing of the patient care unit has been converted to handle additional ICU patients. But, those ICU beds need ventilators, Reznicek noted.
Triage tents were recently erected outside the emergency room at the hospital to provide a place where patients with COVID-19 symptoms can be quickly assessed, while keeping them away from other patients and health care workers. The tents have two rooms where patients can be seen in isolation.
Depending on what happens, plans are in place to respond to every threshold met in terms of resource usage and patient numbers, Fidler said. Each threshold triggers a new plan.
The Routt County Emergency Operations Center is also heavily involved in the surge planning process and has identified potential locations to house patients if the need arises.
Because of the state of emergency, the Steamboat Emergency Center is authorized to operate as overflow, Sandhu said. They have nine hospital beds and two rooms that can house patients on ventilators. Everyone who works there is also trained on the ventilator, he added.
While Routt County has a relatively small number of positive COVID-19 cases at 24 as of Thursday, it has the eighth-highest per-capita rate statewide.
And, testing criteria continues to be extremely restrictive.
In a county with a population of 24,874 people, 321 have been tested.
No one can accurately estimate how many cases the county actually has, because everyone who has symptoms or known contact with a positive case cannot be tested right now. And, studies are showing that asymptomatic people may make up as much as 25% to 50% of all cases and may be responsible for as much as 70% to 80% of the spread.
The key now is to buy time until there are more tools available like mass testing, and eventually, treatment and a vaccine, Sandhu said. And social distancing and quarantining the sick — whatever they are sick with — is one of the best, and only, tools the country has at present to slow the spread.
And hygiene — keeping hands washed and surfaces cleaned, Sandhu said. That goes within households as well, he noted, especially as evidence is showing COVID-19 can be spread through “fecal oral transmission.”
Sandhu said he believes Routt County has not missed that crucial window when testing and containment can still keep the community’s health care system from being overwhelmed.
“The biggest problem right now, and why we are losing the war, is because we are fighting an enemy we can’t see,” he said.
Early and aggressive testing makes the invisible enemy visible, he said, and has shown highly effective in countries like South Korea.
In Denver, Sandhu said he is hearing the system is overwhelmed with low supplies of PPE and ICUs at 70% or 80% capacity.
UCHealth recently began in-house testing in Denver, and Sandhu said the emergency center is on a waitlist for an FDA-approved machine that can produce test results in about five minutes.
Everyone is sharing resources, Sandhu said. At this time, it isn’t about business, and it isn’t about making money.
“It’s about taking care of the community,” he added.
And Sandhu urges the community not to get a false sense of security even if local numbers aren’t increasing exponentially. That is all the more reason to continue adhering to the guidelines and public health orders in place, he said.
“We implore the community to help us in that surge planning,” Sehnert said.
For those not in need of immediate care, there are many resources in the community outside the hospital, she added, as well as the virtual visit options.
At the same time, Sehnert and Fidler want people to “not be scared to come to the hospital if you need care. It is a safe environment. There are lots of other areas of care that people still need, and we are here for you.”
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