Ventilator Countdown Set Off by Virus at New Jersey Hospital
Virus Sets Off Spare Ventilator Countdown at New Jersey Hospital
(Bloomberg) -- At a community hospital in the heart of New Jersey’s coronavirus outbreak, time can be counted in spare ventilators.
Six patients are on the devices right now at Holy Name Medical Center in Teaneck. Twenty-one more are at the ready.
That could buy roughly two weeks before the number of severe respiratory cases stemming from the Covid-19 disease exceeds what the hospital can handle, according to its chief executive officer, Michael Maron.
Maron is also tallying personnel and supplies as his facility in Bergen County, outside New York City, braces for an possible explosion in cases. As the number of patients under observation in the area has exploded in the past week, he’s been pressed to make the sorts of calculations now being performed at hospitals around the U.S., assessing stockpiles and probing for potential deficiencies.
The hospital has boosted its number of isolation rooms in the past week. Its supply of surgical masks is a concern, though, and staffing levels could be as well.
“If I have 27 people on ventilators, that means I need 27 qualified, trained nurses to care for them” around the clock, Maron said in a telephone interview Sunday. “That would be an abnormally high number of people to be on ventilators. We’re doing some rapid training on our staff. We can get them in place, and hopefully all of that will work.”
Teaneck, with 41,000 residents, was one of the first U.S. towns to ask its residents to voluntarily quarantine to slow the spread of the coronavirus. Of 98 people with confirmed cases in New Jersey, 18 live in Teaneck.
Health-care workers are fearful that staffing could become an acute problem at New Jersey medical facilities in coming days because many public schools closed last week. Governor Phil Murphy said Sunday that a total shutdown seems inevitable. Some employees will be forced to choose between work and childcare, one nurse, who requested anonymity, said in an interview. Many may stay home, the nurse said, adding that the hospital allows employees to bank sick time that could be used in such circumstances.
The New York region’s health-care industry is doing everything it can to prevent emergency rooms, acute-care facilities and hospitals like Holy Name from being overrun. It is trying to field as many patient inquiries as possible by phone, and discouraging patients who don’t display clear signs of the novel coronavirus from visits.
“We have every reason to believe this is going to continue to spread,” Maron said. “There are some epidemiology models that say we are still two weeks out from the inflection point as to when this thing is really going to hit. If that were the case, then I’m going to have an exponential increase over the next two weeks.”
Outdoor Triage
Treatment for the most acute cases requires so-called negative-pressure rooms, which allow air to flow into isolation areas without contaminating other parts of the hospital. Holy Name, with 321 beds, is rapidly converting conventional rooms into negative-pressure rooms. It added 20 in one day this week, to complement eight in the intensive-care unit and 16 in the emergency unit, Maron said.
Like other hospitals in the region, Holy Name has erected tents outside emergency rooms to test patients who were previously screened by doctors over the phone or in person.
Just a week ago, Holy Name had five people under observation, according to Maron. That rose to 115 by Sunday, including 55 who’ve shown symptoms of coronavirus and the remainder who have come in contact with patients confirmed to have the virus. Testing confirmed that 13 patients have the virus.
The hospital’s already going through as many as 1,000 single-use masks daily and could face a critical shortage within days, Maron said. The New Jersey Hospital Association has promised more masks and nearby Hackensack University Medical Center helped supply them, he said.
Slow Turning
Maron has asked Murphy for help in testing patients who show symptoms more rapidly. Such testing now goes through the federal Centers for Disease Control and Prevention the state health department, and a private company.
“Our government was not designed to be a nimble ship,” Maron said. “It’s an aircraft carrier, very slow. It’s just the nature of the beast.”
The coronavirus patients that Holy Name has seen range in age from their late 20s to their 50s.
“We have not lost anybody yet,” Maron said. “It’s a real testament to our critical care team, and their ability to care for these people. I don’t know that that’s going to last because they are every day right on the cusp.
To contact the reporters on this story: David Voreacos in New York at dvoreacos@bloomberg.net;Neil Weinberg in New York at nweinberg2@bloomberg.net
To contact the editors responsible for this story: Jeffrey D Grocott at jgrocott2@bloomberg.net, Stephen Merelman
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