Local healthcare providers brace for COVID-19 surge

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An N95 face mask, a piece of personal protective equipment that the CDC recommends for treating patients who might have COVID-19. (File Photo)
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By Missy Schrott | [email protected]

As the number of COVID-19 cases in Alexandria continues to climb – there were 14 in Alexandria and 1,277 in the DMV as of Thursday – healthcare providers suspect that number will continue to rise.

While some medical facilities are operating with plenty of available beds and sufficient supplies, other practices are struggling and putting out calls to the community for help.

As the primary hospital in the city, Inova Alexandria Hospital is currently well stocked, but preparing for a surge of new COVID-19 cases.

“Currently, I think what we’re experiencing is the calm before the storm,” Dr. Rina Bansal, president of Inova Alexandria Hospital, said on March 20. “We are licensed for 303 beds. We run close to capacity around 250 beds because we do have private rooms. This morning, we were in the 150s.”

As of March 20, Inova had tested between 80 and 100 people for COVID-19, Bansal said. But as the hospital anticipates an increase in cases in the city, leaders have been preparing to expand capacity

“I think when you think about capacity, there’s two [ways to increase it.] One is [to] decrease patient use and the second is increasing beds,” Bansal said. “By stopping elective surgeries, we have basically increased capacity because the surgical units will not have patients now who are here electively.

“The other way to increase capacity is really to access other areas of the hospitals that we don’t normally use for inpatient care, i.e. the operating rooms, the pre-op area … and many other areas that can be used safely and staffed appropriately to achieve capacity,” Bansal said.

Bansal said a multi-disciplinary team at Inova has been closely following the coronavirus outbreak and response guidelines from the Centers for Disease Control and Prevention.

“It’s a multi-disciplinary team, including clinicians, nurses, operational leaders, specialists, … you name it, we have it,” Bansal said. “This entire team is actually continually monitoring the CDC guidelines as well as the current situation from a supply perspective, from a protecting perspective, from a staffing perspective, as well as looking at models that are predicting what is about to come.”

From a supply standpoint, Bansal said Inova has adequate personal protective equipment for its staff. However, other local healthcare providers are struggling to obtain needed medical supplies.

“The traditional medical suppliers that we use … had no supplies left at all. We couldn’t get any masks, any gloves or isolation gowns, which are also very important for us to be able to see people in person who might have the coronavirus,” Dr. Matthew Haden, owner of Modern Mobile Medicine, a local house-call-based practice, said. “We’ve really been sidelined and had our hands tied by not having the proper equipment and there was just no resupply going on. Basically, they’re out of stock and we’re just waiting, waiting, waiting.”

Smaller practices throughout Alexandria are experiencing similar issues.

“The normal supply chain that we go through, it’s difficult to get the medical supplies,” Dr. Vivek Sinha, founder of Belleview Medical Partners, said. “I’ve spoken to a few other of my colleagues out and about in this area … and we’re all looking for the same things. We’re all looking for the appropriate PPE because to properly see multiple people, PPE should be one-time use.”

Haden put out a call to the Del Ray Business Association requesting supplies.

“N95 masks are frequently used in construction, remodeling, home building, anybody who’s working as a contractor generally has those, so I figured that’d be an easy route to get my hands on a few,” Haden said.

The call was effective, and Haden was able to get masks and gloves from local businesses.

Dr. Thomas Smirniotopoulos, a local pulmonologist, said that after running out of N95 masks once, his team is being selective about when to use the PPE that they have.

“We went over policy of when to put a mask on, which was basically to decide if a person had a high risk for having COVID-19,” Smirniotopoulos said. “We’re being rationed our supplies by the medical supplier, but they are giving us what we need. … We’re okay for now.”

While there is no formal collection or drive for supplies, Haden recommended that people with extra PPE contact either their local healthcare provider or the Alexandria Health Department.

“People shouldn’t be stockpiling the masks and gloves and things that are needed,” Haden said. “It’s fine to have a small supply for your family if you’re going out to get groceries and things, if you want to wear masks, but people shouldn’t be stockpiling.

“I’ve heard that patients ordered two cases of N95 masks, and now they’re just sitting at their house. That’s not helpful to the situation. So don’t stockpile masks and if you have some extras and you know a practice that’s in need of them, reach out to them or maybe even contact the health department to see if they can find a use for them,” Haden said.

Besides the shortage of medical supplies, smaller private practices reported that, similar to Inova, they were experiencing fewer patients than normal.

“The volume of patients we’re seeing is lower than usual because there are people less certain that they should go out. We’ve had a lot of cancellations,” Smirniotopoulos said. “Basically, mostly we’re hearing about stuff and not actually seeing it. We know that there are cases of people who are sick with this. We haven’t had any yet so far.”

While they may be experiencing fewer in-person visits, several healthcare providers are keeping busy with telemedicine, a practice that both small and large operations have begun to expand upon during this time.

“I’ve been staying very busy with telephone calls, texting, portal messages, any way to screen people,” Haden said. “My telemedicine app has a screening questionnaire specifically for COIVD-19 so we’ve been sending that around to some of our patients to help give them some reassurance that they don’t have symptoms or don’t have risk factors for it.”

Several local physicians have put out notices to their patients alerting them not to come in if they’re feeling sick and sharing details about care they can provide virtually.

“What we’re seeing is healthcare in general has to switch over to a little bit of a telemedicine or telehealth component right now,” Sinha said. “Because we’re finding that, if there’s a situation where we don’t have to examine the patient, where we really need to just talk to the patient, ask questions, see how they’re doing on certain medications, allow the patient to ask questions, we’re realizing that it’s actually safer to do that virtually, rather than seeing them face to face.”

As physicians continue to shift to telemedicine, train their staff, build their stock of PPE and adapt to information that seems to be shifting in real time, many agree the pandemic will likely get worse before it gets better.

“There’s such a massive influx of need and the surge that people talk about is what we’re seeing,” Sinha said. “The concern is that we’re going to see the surge much, much more, and that’s what we’re really, really concerned about. It’s bursting at the seams right now, but it has the potential to get significantly worse.”

Bansal said she remains confident that Alexandria is equipped to deal with the outbreak as it escalates.

“This really is bringing our entire team together, and I think it’s times like these that tell you if you have a good team or not, and I am truly glad to have an amazing team,” Bansal said. “Alexandria’s a tremendous community. I’ve gotten so many emails, calls, from various groups and areas of people wanting to help. Keep yourself safe, social distancing, hand hygiene and having those around you do the same. The less people getting sick, the better we will be able to serve our community.”

The Inova website has regular updates about how the hospital is dealing with COVID-19. Visit inova.org/covid19 for more information.

(Read more: Nationwide test kit shortage limits COVID-19 testing in Alexandria)

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