Social distancing matters. Here is how to do it and how it can help curb the COVID-19 pandemic.
EVANSVILLE, Ind. — A psychological threshold was crossed with Vanderburgh County’s first confirmed coronavirus case Thursday, leaving health professionals to take a hard look at their readiness for an outbreak — just in case.
For weeks, rumors bordering on hysteria — rumors of secret cases in hospitals, doctor’s offices, even the county jail — sprouted like weeds in an untended garden. But this is real. Coronavirus really can touch Vanderburgh County.
And now local hospitals and the Vanderburgh County Health Department are doubling down on the social distancing and hand hygiene mantra that they call the best hope to quell an outbreak.
Because, some of them admit, they couldn’t keep up if that happened.
“We would be overwhelmed rapidly,” Health Officer Dr. Kenneth Spear said Friday.
The Health Department doesn’t provide primary care, but it does do investigations. Spear and Administrator Joe Gries said they would turn to local health departments where fewer cases exist and to the Indiana State Department of Health for help.
Dr. James Porter, president of Deaconess Health System, pointed to a worrisome sign.
“We’ve had a number of patients now present for care that we have a pretty high degree of clinical suspicion that they are presenting with signs and symptoms of coronavirus,” Porter said on Facebook Live Thursday night.
Porter estimated that as many as 20 percent of people who test positive for coronavirus likely will require hospital care. Five percent may need intensive care unit-level care.
“(If there were) 20,000 people infected, you know, a lot of people end up needing hospital care,” he said. “If those all came at once, we couldn’t handle it. We would be overwhelmed.”
Using Porter’s projection that 20 percent of infected persons could require hospital care, with 20,000 testing positive for coronavirus that would be 4,000 people. The number requiring serious care would be 200. Though it has hospitals in Newburgh and Evansville, Deaconess could draw patients from surrounding areas as well.
Slowing the spread of coronavirus through social distancing, self-quarantine and other precautions is the only hope of keeping a potential explosion of new patients to a manageable trickle, Porter said. The virus thrives on person-to-person contact, and it can be spread by people who don’t even know yet that they have it.
It is a mantra to which Porter and other health professionals across the country have returned again and again.
In a Facebook post earlier this week, Porter sounded an even higher-decibel alarm.
“Reports from physician colleagues in Italy and France are dire, and we are a couple of weeks behind them on the same path!” he wrote.
“If we don’t act now by staying home, keeping our kids home, keeping our distance from everyone, and reducing the opportunity for this highly contagious and lethal virus to spread, we will certainly wish we had. This is MUCH worse than the flu! If you are in the same space as someone shedding this virus without the necessary Personal Protective Equipment, YOU WILL LIKELY CATCH IT! And it appears to be around 1% lethal!”
Older people and those with chronic conditions are the most vulnerable, Porter warned, but coronavirus also has killed individuals in their 30s.
“Folks that’s 1 in 100, 10 in 1,000, 100 in 10,000 DEAD! YOU DON’T WANT THOSE ODDS!!! People you love will suffer and die if we don’t stop the spread. Hopefully it isn’t too late,” he wrote.
Hospitals make assurances
Are Deaconess and Ascension St. Vincent Evansville ready for a larger outbreak of coronavirus, should it come?
A new Harvard Global Health Institute study suggests shows that some regions of the country will suffer shortages of hospital beds if coronavirus continues to expand its reach and if nothing else is done to increase hospital capacity.
In the Harvard model’s “moderate” scenario — 40 percent of adults being infected over a 12-month period — most hospital regions would have to free up or bring in additional beds for coronavirus patients.
Among the study’s region-specific findings: If 40 percent of adults in the Evansville region were infected over 12 months, the region would have to empty or add the equivalent of 39 percent of its occupied hospital beds. The Indianapolis region’s number is 70 percent.
The Harvard numbers don’t factor in measures hospitals can take to ramp up capacity fast during an emergency, such as canceling elective operations and expediting patients with less critical problems. Hospitals also could turn for help to military and veterans hospitals and relicense retired doctors and nurses.
Canceling elective surgeries could free up typically expensive — and highly sought-after — ventilators, of which the country has an estimated 160,000. Hospitals also could try to tap into the federal government’s strategic stockpile. The Pentagon already has offered to chip in 5 million respirator masks and 2,000 ventilators to help fight coronavirus.
In a Monday phone call with state governors, President Donald Trump recommended they consider buying more ventilators and respirators themselves.
Deaconess and Ascension St. Vincent have not responded to questions about their bed and equipment capacities, but they have issued assurances they are ready.
An American Hospital Directory, Inc. database of hospital beds indicates Ascension St. Vincent Evansville has 438 staffed beds and Deaconess Midtown Hospital has 547. The database, last updated in 2018, offers no figures for Deaconess Gateway.
Ascension St. Vincent Evansville has not made its leaders available to answer questions, but a spokeswoman sent the Courier & Press a statement Friday asserting it “has the equipment needed to respond to the COVID-19 pandemic.”
“Since we are a national system, Ascension has the ability to make intra-hospital inventory transfers across the state and country, when appropriate. We have a national, statewide, and individual command center structure in place that is addressing all future capacity needs of all our hospitals across the state, including Ascension St. Vincent Evansville. We have also implemented all CDC recommended conservation measures, in the event of any supply chain disruption,” the statement says.
Deaconess sent a similar statement Friday, attributing it to Porter.
“Right now we have adequate equipment, supplies and staff to care for patients, and we are actively making changes to maximize that ability and to procure additional supplies in anticipation of large numbers of patients,” it said.
“We are following experiences from others who have experienced high volumes, as well as guidance from our peers and government agencies. Deaconess is as prepared as we can be and we believe ahead of many areas which had less time to prepare.”
Spear, a former special advisor to the President of St. Mary’s Medical Center, said the local hospitals are “working day and night to be ready.”
“I think they’re doing a good job,” the health officer said.
The first local patient
Health Department Administrator Gries said his agency’s investigation into the circumstances of the first local coronavirus patient’s infection is up and running.
“If we receive more cases, we will have more and more staff dedicated to that process,” Gries said.
Porter praised the individual on Facebook Live, saying he or she — the person’s age and sex are not known — “did a lot of right things.”
“They contacted us through Deaconess Clinic LIVE and did a virtual visit so they were able to receive the information that they needed to be tested without having to be seen face-to-face with a doctor or a nurse,” he said.
“Then they were directed to a drive-up testing, where someone in good personal protective gear was able to obtain that sample safely. And then went back home to be self-isolated and now quarantined.”
The individual “seems to be doing OK,” Porter reported.
When contacted by the Courier & Press about the patient on Thursday, Gries said the Vanderburgh County Health Department had not yet been notified of the positive test result. It was a curiosity in an otherwise hectic day.
The longstanding protocol for reportable communicable diseases, Gries explained Friday, calls for ISDH to contact the hospital that took a patient’s specimen — if ISDH performed the test. The hospital would then contact the local Health Department, making it the last to know in the initial chain of disclosure.
The chain apparently is a little murkier when a private laboratory does the testing.
The lab has the responsibility to report results back to the hospital, Gries said, then possibly the state — and the local Health Department would be told by the state or even the hospital itself.
News organizations were never in the chain of disclosure and fell a little further out of it on Thursday with a pronouncement by Deaconess.
“It won’t be our practice to send press releases with further diagnoses,” a Deaconess statement said, adding that the hospital system had its reasons for notifying news outlets of its first positive result.
“In this case, we were also able to add information about pre-screening triage processes that protect patients and health care workers,” the statement said.
Safety measures. That’s what it all came down to for Spear, too. He took one last opportunity to pound home the theme that avoiding an outbreak requires people to practice social distancing and hand hygiene.
“If we’re successful at our efforts, nobody will really recognize it because we won’t have an explosion of cases,” Spear said.
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