Each member of the team donned a different color vest – similar to the ones construction flaggers wear – revealing their titles and functions inside the command center, like “Hospital Infrastructure Branch Director” and “Deputy Operations Chief.”
The 11-member team sat in a rectangle around foldout tables in what could have easily been mistaken for a conference room at Concord Hospital. The walls were covered in hospital floor plans and emergency procedures, clear indicators that this was anything but a routine staff meeting.
In the wake of the COVID-19 pandemic, Concord Hospital activated its Incident Command Center nearly three weeks ago to lead and manage response and preparedness measures related to the outbreak. The team of experts seated this past Thursday with laptops and phones within an arm’s reach were ready to sprint into action should a patient with the virus need critical care.
“It’s hard to believe we’ve only been up and running now for a short time; it feels like a lifetime ago,” said Mike Melody, director of safety and emergency preparedness. “We’re trying to keep up with this new virus, and we know we’re in this for the long haul; this is not a quick sprint, and so we’re bracing for that and preparing as much as possible.”
The team at the helm Thursday had a combined 200-plus years of professional experience but with backgrounds as diverse as hospital management to treating infectious diseases.
“We cycle people in and out for sanity sake,” Melody said with a chuckle as he helped introduce each person’s key role.
While the hospital activated the command center just this month, the experts’ planning for COVID-19 began long before. And with many referring to the spread of COVID-19 as an “unprecedented incident” worldwide, those plans are still evolving at the local, state and federal levels on a daily basis.
“Since the first week of January, we’ve been planning for the arrival of COVID-19,” said Dr. James Noble, medical director and infectious disease specialist. “As the pandemic has evolved since then, there are almost as many new questions arising just as we’re finding answers to the old ones.”
Noble said once the virus spread throughout continental Europe the U.S. really began take notice and fear the potential for a fast-moving outbreak in the states. He said one clear lesson has been learned so far and that is that social distancing is effective, and must continue to reduce transmission of COVID-19 cases.
“It’s just as possible for Italy and China as it is possible for this hospital to be overwhelmed,” Noble said. “While we feel prepared, we clearly want to promote social distancing and restrictive measures of that nature.”
Hospitals nationwide are grappling with a medical supply shortage that has forced nurses and doctors to reuse masks and/or make their own. In many areas, hospitals have sought community donations of the N-95 mask, which filters out 95% of airborne particles, opposed to the looser-fitting surgical masks. Additionally, some of the chemical ingredients used in COVID-19 tests are in short supply, and that has meant a delay in results.
In Concord, officials at the command center said they’re most concerned about the shock to the supply chain and whether it’ll recover in time. COVID-19 hampered production of the masks in China, which is a global supplier.
“We planned ahead and did have a pandemic inventory,” Melody said.
During the Ebola virus outbreak several years ago and the H1N1 influenza epidemic before it, the hospital stocked up on personal protective gear for staff and is now using those medical supplies during this pandemic, he explained.
But that doesn’t mean that they aren’t in search of more every day to ensure they don’t run out. Donations from local construction companies have helped the hospital amid the global shortage.
Further, the hospital previously received federal grant funding to assist in the conversion of regular rooms to high-pressure ones, which will likely prove key if the number of critical COVID-19 cases increases, officials said.
Access to COVID-19 test kits ebbs and flows but that has not caused any major concerns yet because within a few days the supply replenishes, Noble said.
But doctors are also being selective in who they test.
“People who have expressed the greatest urgency to be tested are the people who are not symptomatic,” Noble said. “We’ve tried very hard not to accede to those requests.”
Officials agreed that people who report a fever, tiredness, dry cough and trouble breathing must take priority. Noble said the last thing officials want is someone with no symptoms who tests negative to then ease up on social distancing guidelines, interact with the vulnerable population and potentially three days later fall ill.
Concord Hospital has one testing site and hopes to open a second. Those allowed into the undisclosed location must have a doctors’ note and an appointment.
Last week, the hospital announced it was delaying elective procedures and surgeries in preparation for the possible onslaught of COVID-19 patients. It has also sharply limited visitors, suspended all volunteer programs and cut off public access to its cafeteria in an effort to decrease the likelihood of transmission. By delaying certain procedures, the hospital has freed up space that it can convert to a different use should the need arise in the future, officials said.
While new restrictions are in place at hospitals across the country, Melody said the decisions made recently at Concord Hospital weren’t made lightly.
“We need to make sure staff feel safe and that they are safe because if we’re not doing that we’re not doing our job,” he said.