ASHLAND Never-ending battle. Exhausting. Anxiety-producing.
Real.
All of the above were used to describe the medical community’s view on the world’s war against the nasty novel coronavirus.
As of Tuesday, King’s Daughters Medical Center housed 15 COVID-19 patients; that’s the most the facility has had under its care at any given moment since the pandemic’s onset in March. According to Jamie Ward, senior director of clinical services, KDMC is capable of accommodating 47 COVID patients — two units feature 28 and 17 beds, respectively, plus there are two COVID beds in the Intensive Care Unit.
As Dr. Stacy Caudill, hospitalist and chief medical officer, reminded, KDMC serves a wide-ranging tri-state area.
COVID vs. flu
Caudill pointed to a common theme among those who doubt the virus’s ferocity and longevity.
“I think what is so tiring is the length of this disease,” she said. “The average time somebody would have the flu would be five to seven days. With COVID, the first couple of days you get in contact with somebody who has it, you have no symptoms at all but you are transmitting the disease. You really don’t test positive until Day 5. And often times, you’re doing OK until a week later, and you start getting really sick, your oxygen levels start dropping, and you require hospitalization.”
“These people may take weeks to recover,” offered Dr. Traci Sanchez, a pulmonologist and intensivist. “The vast majority of patients do fine, but it’s that subgroup that keeps us anxious.”
Coronavirus patients can develop any number of problems, ranging from blood clots to heart damage. Specialists from a slew of backgrounds have proven useful in helping treat patients at KDMC, Sanchez noted.
Supply and support
The difference between five months ago and present day is slim when it comes to COVID-related supplies on hand.
Katie Arnett, the Supply Chain director, said KDMC “got a jump early on” as it rigorously prepared as if it was the next hot spot.
To this point, it’s never been quite a hot spot, but it’s gotten considerably warmer over the last few weeks.
“We don’t have a moment where we let our guard down,” Arnett said. “We want every single area (of the hospital) to be as safe and up to standard as possible.”
Doctors, nurses and other medical workers who have direct patient contact carefully go through a checklist when suiting up before entering a unit. They wear goggles because, as Caudill remarked, it’s possible to contract the virus through the eyes. N-95 masks are constant pieces of attire as well.
It’s impossible for every single hospital to remain virus-free.
“We’ve had some very close colleagues that we’re friends with who have gotten sick,” Caudill said. “They were wearing all the appropriate PPE. But we don’t know that their exposure was here at work. It could’ve been at the grocery store or somewhere else.”
Caudill and Sanchez both said they change clothes before going home.
“I don’t touch my daughter until I shower,” Caudill said.
Sanchez said her off-work routine is simply going home and getting cleaned up.
“That’s de-stressing for me,” she said.
Caudill said she’s attempted to remain socially active all while maintaining physical distancing — a term that Ashland psychologist David Meade prefers, according to KDMC spokesperson Tom Dearing.
Caudill belongs to a bunch of blogs, she said, and is in a Facebook in which health care providers talk about what has and hasn’t been effective in combatting COVID in their hospitals.
Caudill stressed the importance of expressing support for the workers who dig deep into the grueling grind every day.
“The hospitalists, I do think they get a little depressed,” she said. “It feels like a never-ending battle. In the beginning, there was a lot of support for health care workers, political workers, and so on. Now, a lot of people are saying it’s not real. You’re sitting here and you’re seeing these patients and it’s like, it’s real. When we leave work at the end of the day, sometimes it’s exhausting to look at social media.”
Sanchez, visibly tired yet alert, mirrored Caudill’s comments.
“This is not a fake illness,” she said with a sigh. “This is real.”
Added Arnett: “These guys and gals are my heroes.”
Arnett’s thoughts are echoed throughout the hospital halls.
“Everybody from (CEO) Kristie Whitlatch to the janitors are very supportive,” Caudill said.
Test and treat
Symptoms of COVID-19 have been well-documented, but they’re also plentiful. Among them are shortness of breath, loss of taste and/or smell, sore throat, fever of 100.4 degrees or higher and body aches.
Shortness of breath, Caudill said, may merely entail “feeling tired” for a young person.
KDMC has utilized multiple different tests, most prominently a PCR (polymerase chain reaction) test. It’s an oral swab.
Caudill said the hospital’s false positive rate has been “pretty low.”
With its in-house testing, KDMC has helped other surrounding medical facilities. Tests can yield results as quickly as within two hours.
When oxygen saturation falls below 94%, as reflected by a pulse oximeter, hospital treatment is necessary, according to Caudill. KDMC has formed a COVID Task Force to help pinpoint the best treatments for patients.
Caudill said KDMC has experienced success with Remdesivir.
“It is what has emergency approval from the FDA to kill the virus, sort of like Tamiflu does for the flu,” Caudill said. “But then after you kill the virus, there’s another stage to COVID where you have this diffuse inflammatory response and there aren’t great ways to treat that.”
KDMC has partnered with Mayo Clinic to set up plasma donations, Caudill noted.
Not just COVID
Although it’s the driver along this pandemic path, COVID-19 is far from the only issue with which KDMC physicians and nurses are dealing. Ward said other diseases and ailments have taken a back seat, in the collective eyes of society, but that shouldn’t be the case.
“We saw a bunch of patients waiting to come in because they were worried about contracting COVID,” Ward said. “They would wait several days even though they’re having chest pain, symptoms of a stroke or appendicitis. We saw complications we hadn’t seen in years. If you have a medical emergency, please come to the ER.”
“Health care shouldn’t stop,” Arnett added. “We don’t shift focus away from that, we just have a couple more lanes on the highway open, so to speak.”
Still, COVID-19 should be taken as seriously as other problems.
“I was in training when HIV hit early on,” Sanchez recalled. “The flu season of 2009-10 was difficult, too, but still not quite like this. Nothing quite like this.”
Ward said she is very proud of the work KDMC has done, from Whitlatch’s transparency and leadership to the nitty gritty in the COVID units.
“Across the board, we’re protecting our patients,” she said.
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BY THE NUMBERS
• Average tests per day: 400 (as many as 800)
• Process time: 15 minutes to 2 1/2 hours
• Machines: Five. Two high throughput analyzers (adding a third soon) run a combined total of 188 tests in about two hours
• Trained technicians: Five (and there will be more)
NOTE: The above statistics were provided by Shawn Boggs, executive director of diagnostic services at KDMC
