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'Plan for the worst but hope for the best' - How one local hospital is gearing up for the 'surge'

El Camino Health CEO Dan Woods discusses what's being done to prepare for potential wave of COVID-19 patients

It's a logistics puzzle that might stump just about anyone: How should a hospital prepare to handle an unknown number of very sick people over an unknown span of time?

That's the question that El Camino Health's CEO Dan Woods is working to answer, even while COVID-19 continues to claim lives in Santa Clara County.

El Camino's Mountain View hospital was the site of the first COVID-19 related death in Santa Clara County on March 9. As of March 27, there were 574 confirmed COVID-19 cases and 20 related deaths reported countywide.

Figuring how to prepare a facility for a potentially large influx of COVID-19 patients – a scenario that other hard-hit hospitals in New York and Italy have likened to a war – without knowing how many people will be impacted, how severely ill they will become, and over what time span, is a difficult task.

The hospital has been busy looking at a number of different models and projections to see how fast the virus will spread, Woods said in an interview Friday.

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One of the biggest variables in how bad the pandemic gets is how the community behaves in response to the shelter in place orders, he said.

"It all depends on the success of the shelter in place," he said. "If it's successful, we might peak out in a week, or we might have already peaked."

And if it's not?

"Then the peak might not happen for months down the road," he said. "You may end up seeing other situations with high degrees of people positive with COVID."

When there is a high rate of transmission, he said, everybody gets sick at once.

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To use internet-speak, when something "goes viral," it undergoes exponential growth, he said. "The same concept of exponential growth happens in the transmission of the virus. If you're compliant with shelter in place, it breaks that chain," he said.

"If anybody saw the difference that sheltering place makes, it's absolutely amazing."

So far, the hospital's approach has been to plan for the worst and hope for the best, he said.

Planning for the worst

It was roughly two and a half weeks ago that Woods, at El Camino Hospital Board's last meeting on March 11, made a public statement calmly explaining that the hospital has negative pressure rooms that filter air many times to contain infectious diseases, and that the hospital routinely deals with highly infectious diseases such as tuberculosis. The hospital had already been preparing for weeks, he said, and the Centers for Disease Control and Prevention had interviewed an infectious disease nurse at the hospital about the hospital's policies and procedures for contagious diseases, he added.

Since then, the number of confirmed coronavirus cases has exploded to more than 100,000 across the U.S.

The hospital is using several different models to try to predict how many patients may be coming to the hospital's emergency room needing medical help, he said.

The hospital has also erected tents to prepare for a surge in COVID-19 patients, though the tents are not currently in use, according to hospital spokesperson Jennifer Thrift.

Hospital staff members have been keeping a close eye on their stock of personal protective equipment, and how fast it's being depleted, Woods said. They also have orders pending for new equipment and are also accepting donations of new and unopened containers of the following: gloves, isolation gowns, hard goggles, disposable eye shields, shoe covers, nurse caps, germicidal disinfecting surface wipes, Clorox disinfecting wipes and masks. More information here.

While the hospital has also been proactive in limiting visitors, it is allowing patients a single visitor to witness a birth or a death. The decision to continue to permit visitors under those limited circumstances was done in consultation with a number of sources, he said, but comes down to a desire to permit families to be with their loved ones at such important times.

Hospital administrators are talking frequently with county public health officials, Woods said. Local hospital CEOs have weekly calls with the county health department. El Camino has sent two nurses who have experience at field hospitals to work at the 248-bed federal medical station that is being set up at the Santa Clara Convention Center, he said.

Hoping for the best

Keeping morale up among staff members at the hospital has been another challenge, he said.

"Each health care worker is being asked to do tasks they haven't typically done before," he said.

One step the hospital took to reduce uncertainty for front-line providers was to have a Q&A session between hospital employees and an infectious disease specialist. Employees have also undergone training in how to use personal protective equipment, he said.

One thing the hospital won't do is set policies for how to handle a scenario in which there may be too many patients with COVID-19 than can be treated with ventilators. Elsewhere, such as in Italy, physicians have been faced with wrenching decisions about whom to provide with life-saving treatments.

Woods said it's not a kind of decision that should be decided through a policy.

"Those policies should never exist," he said. "That's a clinical decision. It's a medical decision."

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'Plan for the worst but hope for the best' - How one local hospital is gearing up for the 'surge'

El Camino Health CEO Dan Woods discusses what's being done to prepare for potential wave of COVID-19 patients

by / Mountain View Voice

Uploaded: Mon, Mar 30, 2020, 2:06 pm

It's a logistics puzzle that might stump just about anyone: How should a hospital prepare to handle an unknown number of very sick people over an unknown span of time?

That's the question that El Camino Health's CEO Dan Woods is working to answer, even while COVID-19 continues to claim lives in Santa Clara County.

El Camino's Mountain View hospital was the site of the first COVID-19 related death in Santa Clara County on March 9. As of March 27, there were 574 confirmed COVID-19 cases and 20 related deaths reported countywide.

Figuring how to prepare a facility for a potentially large influx of COVID-19 patients – a scenario that other hard-hit hospitals in New York and Italy have likened to a war – without knowing how many people will be impacted, how severely ill they will become, and over what time span, is a difficult task.

The hospital has been busy looking at a number of different models and projections to see how fast the virus will spread, Woods said in an interview Friday.

One of the biggest variables in how bad the pandemic gets is how the community behaves in response to the shelter in place orders, he said.

"It all depends on the success of the shelter in place," he said. "If it's successful, we might peak out in a week, or we might have already peaked."

And if it's not?

"Then the peak might not happen for months down the road," he said. "You may end up seeing other situations with high degrees of people positive with COVID."

When there is a high rate of transmission, he said, everybody gets sick at once.

To use internet-speak, when something "goes viral," it undergoes exponential growth, he said. "The same concept of exponential growth happens in the transmission of the virus. If you're compliant with shelter in place, it breaks that chain," he said.

"If anybody saw the difference that sheltering place makes, it's absolutely amazing."

So far, the hospital's approach has been to plan for the worst and hope for the best, he said.

Planning for the worst

It was roughly two and a half weeks ago that Woods, at El Camino Hospital Board's last meeting on March 11, made a public statement calmly explaining that the hospital has negative pressure rooms that filter air many times to contain infectious diseases, and that the hospital routinely deals with highly infectious diseases such as tuberculosis. The hospital had already been preparing for weeks, he said, and the Centers for Disease Control and Prevention had interviewed an infectious disease nurse at the hospital about the hospital's policies and procedures for contagious diseases, he added.

Since then, the number of confirmed coronavirus cases has exploded to more than 100,000 across the U.S.

The hospital is using several different models to try to predict how many patients may be coming to the hospital's emergency room needing medical help, he said.

The hospital has also erected tents to prepare for a surge in COVID-19 patients, though the tents are not currently in use, according to hospital spokesperson Jennifer Thrift.

Hospital staff members have been keeping a close eye on their stock of personal protective equipment, and how fast it's being depleted, Woods said. They also have orders pending for new equipment and are also accepting donations of new and unopened containers of the following: gloves, isolation gowns, hard goggles, disposable eye shields, shoe covers, nurse caps, germicidal disinfecting surface wipes, Clorox disinfecting wipes and masks. More information here.

While the hospital has also been proactive in limiting visitors, it is allowing patients a single visitor to witness a birth or a death. The decision to continue to permit visitors under those limited circumstances was done in consultation with a number of sources, he said, but comes down to a desire to permit families to be with their loved ones at such important times.

Hospital administrators are talking frequently with county public health officials, Woods said. Local hospital CEOs have weekly calls with the county health department. El Camino has sent two nurses who have experience at field hospitals to work at the 248-bed federal medical station that is being set up at the Santa Clara Convention Center, he said.

Hoping for the best

Keeping morale up among staff members at the hospital has been another challenge, he said.

"Each health care worker is being asked to do tasks they haven't typically done before," he said.

One step the hospital took to reduce uncertainty for front-line providers was to have a Q&A session between hospital employees and an infectious disease specialist. Employees have also undergone training in how to use personal protective equipment, he said.

One thing the hospital won't do is set policies for how to handle a scenario in which there may be too many patients with COVID-19 than can be treated with ventilators. Elsewhere, such as in Italy, physicians have been faced with wrenching decisions about whom to provide with life-saving treatments.

Woods said it's not a kind of decision that should be decided through a policy.

"Those policies should never exist," he said. "That's a clinical decision. It's a medical decision."

Comments

widespread testing
Old Mountain View
on Mar 30, 2020 at 3:44 pm
widespread testing, Old Mountain View
on Mar 30, 2020 at 3:44 pm
19 people like this

Without better testing for this disease, we all of the projections are just wild guesses. We need widespread testing now, not just people who are already seriously ill. Why is this taking so long? Countries that seem to be beating this disease have had widespread testing programs in place for months, so it is certainly doable if the country has the will to do it.


Trump fired the national pandemic team
another community
on Mar 30, 2020 at 6:01 pm
Trump fired the national pandemic team, another community
on Mar 30, 2020 at 6:01 pm
25 people like this

> it is certainly doable if the country has the will to do it

This country certainly has the WILL.

What we lack is leadership at the very top. Current leadership has been lying about test availability for over a month.

You know, the guy who said he didn't want the cruise ship passengers disembarking because they hurt "my numbers".


Stupid Question
Bailey Park
on Mar 30, 2020 at 6:35 pm
Stupid Question, Bailey Park
on Mar 30, 2020 at 6:35 pm
12 people like this

El Camino Hospital Board for years now has been paying its CEOs north of $800,000 a year with the Voice reporting operating profits last year at 142 millions of dollars.

Web Link

My stupid question is why these geniuses never had a plan for a pandemic or a stockpile of respirators and masks?

Thanks for nothing.


Gary
Sylvan Park
on Mar 30, 2020 at 6:51 pm
Gary, Sylvan Park
on Mar 30, 2020 at 6:51 pm
26 people like this

Not just local overpaid corporate bigwigs. But President Donald John Trump on down. Trump is on tv right now bragging about one military ship for a few non-virus patients that just reached New York! Unbelievable. Incredible. Con-man Supreme.


Benefit of the Doubt
Old Mountain View
on Mar 31, 2020 at 9:46 am
Benefit of the Doubt, Old Mountain View
on Mar 31, 2020 at 9:46 am
11 people like this

@Stupid Question - If you read the article you will see that they ARE managing Personal Protective Equipment like respirators and masks. They haven't run out, and it sounds like they are doing a good job of managing this. Stockpiling only works if the items don't expire, or if you rotate through the expiring equipment.
I think we should all be more concerned with keeping in line with the shelter-in-place. It sounds like the models they are looking at says that if it works this whole thing will go away more quickly.


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