Local hospitals increase capacity to prepare for COVID-19 patient surge

Mary Jo LaPosta

The Enterprise — Michael Koff

“Why are nurses reacting in a unique way?” asked Mary Jo LaPosta, senior vice president of patient care and organizational excellence and chief nursing officer at Saratoga Hospital. “Any time protection is challenged, nurses react.”

As the governor continues to push for more COVID-19 testing in New York State, local hospital leaders said on Tuesday, after two weeks of aggressive community testing, they are now testing only health-care workers and hospitalized patients.

New York is currently testing more than 16,000 people per day, Governor Andrew Cuomo said on Tuesday morning, more than any other state and more than China and South Korea on a per capita basis. Cuomo said that reducing density and increasing testing is the most effective way to reduce the spread of the coronavirus.

New York has nearly half of the nation’s confirmed cases, 15 times higher than any other state. Cuomo announced on Tuesday that New York has 20,875 confirmed cases.

A positive test for COVID-19 does not change the management of a case for a patient who is not admitted to a hospital, said Dennis McKenna, president and chief executive officer of Albany Medical Center, at a press conference on Tuesday afternoon.

At an Albany county press conference Tuesday morning, the county’s health commissioner had said she hopes more testing kits will be made available from the federal government so that community testing could pick up again.

McKenna said that patients with COVID-19 symptoms — a fever, cough, and shortness of breath — should quarantine themselves for two weeks, stay hydrated, and take anti-fever medication.

The numbers from Albany Med, McKenna said, are typical of the other hospitals represented at the press conference. Albany Med tested 1,642 people in two weeks, with results still pending from 50 tests; 79 — or about 5 percent — came back positive, which he called “a very reassuring number.”

Of those with confirmed cases, 11 were hospitalized, McKenna said, and six patients are still in-house. About 14 percent of those who tested positive required hospitalization. Generally, what hospitals are seeing, McKenna said, is about half of the COVID-19 patients are in beds on hospital floors while the others need to be in an intensive-care unit.

The people requiring hospitalization, McKenna said, are usually elderly with underlying comorbidities. Albany Med has had health-care workers test positive for COVID-19 and reduced, with health-department guidance, the 14-day quarantine to seven days, being sure the workers wore protective gear when they returned to work.


Preparing for surge

Cuomo said last week that, when the pandemic reaches its peak in New York State, 110,000 hospital beds and 37,000 intensive-care-unit beds will be required but New York has just 50,000 hospital beds and 3,000 ICU beds.

Consequently, Cuomo has had the Army Corps of Engineers identify sites where dormitories and other buildings can be converted into hospitals and has also required hospitals across the state to come up with surge plans, increasing their capacity to handle sick patients.

He signed an executive order on Tuesday requiring all hospitals to increase capacity by a minimum of 50 percent, with a goal of increasing capacity by 100 percent.

The Federal Emergency Management Agency has started to build a 1,000-bed temporary hospital in the Jacob K. Javits Center in New York City, set to open next week. This is in addition to the four sites selected by the Army Corps of Engineers that will create temporary hospitals in downstate New York with a total capacity up to 4,000.

At Tuesday afternoon’s press conference, leaders from the Albany Med Health System, including Columbia Memorial Health and Saratoga Hospital; Ellis Medicine; St. Peter’s Health Partners; Glens Falls Hospital; and St. Mary’s Amsterdam described their surge plans. 

They also described measures they have taken to screen both hospital staff and the limited visitors allowed, for instance, to be with a dying patient. Staff in Albany Med is being limited to essential health-care workers while staff of nonclinical departments are being set up to work from home, said Fred Venditti, executive vice president for System Care Delivery and Albany Med’s hospital general director.

“There are still people that feel we are overreacting,” said Steven Hanks, chief clinical officer of St. Peter’s Health Partners. “We are in support of the governor’s increase of at least 50 percent.”

Across its system, St. Peter’s has 702 acute-care beds and will be adding 663 beds using extant facilities. St. Peter’s will increase its ICU beds from 48 now to 150, Hanks said.

Added staff will come from retired health-care workers or from outside New York State, Hanks said, noting that St. Peter’s is part of Trinity Health, which has 94 hospitals across 22 states.

“It’s not histrionics, not panic … In the last seven days, New York cases were up by a factor of 15,” Hanks said. While elective surgeries have been postponed, Hanks said, all essential services will be provided.

David Liebers, Ellis Medicine’s vice president and chief medical officer and an expert in infectious diseases, said that Ellis’s plan will increase beds by 65 percent “essentially overnight” and double the hospital’s ICU capacity.

“The COVID epidemic I think will challenge us,” he said. “I think we’re up to the challenge.”

“Why are nurses reacting in a unique way?” asked Mary Jo LaPosta, senior vice president of patient care and organizational excellence and chief nursing officer at Saratoga Hospital. “Any time protection is challenged, nurses react.”

Nurses, she said, believe in science and believe in dogma; the regulations from the Centers for Disease Control and Prevention were dogma but, as changes are made daily, nurses question if the modifications protect. Rumors start, she said, when staff members don’t work closely together, and fear confronts science.

LaPosta also said that staff at Saratoga Hospital is being moved from their usual tasks of community screening, testing, and performing nonessential surgeries to work instead in fighting the pandemic.

“The majority of health care today is not in the hospital,” she said. “The majority of health care today is in the community.”

“Phase One Surge, done,” said LaPosta. “Today, the governor asked us to jump higher — not 50 percent but 100 percent.”

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