Help us fund local COVID-19 reporting in our community

NHTI unveils new overflow patient bed area for Concord and Lakes Region hospitals

  • The dorm rooms in Langley Hall on the campus of NHTI were stripped down to just the beds in anticipation of their needed use during the COVID-19 virus outbreak. GEOFF FORESTER—Monitor staff

  • Wilder Joseph of the NHTI puts on his safety mask upon entering Langley Hall on campus where the student dorm rooms are being converted into overflow rooms for the COVID-19 virus space. GEOFF FORESTER / Monitor staff

  • A window into an outer office of the Wellness Center is sealed up as the NHTI building is being converted into a surge facility in preparation of overflow from medical facilities around the area. GEOFF FORESTER—Monitor staff

  • The 150 cots from FEMA line the Wellness Center gym Friday.

  • NHTI public information officer for the COVID-19 project Shannon Reid walks through one of the plastic sheet dividers in Sweeney Hall on campus Friday. The Hall is sealed up in anticipation of it being needed for a surge in cases. GEOFF FORESTER photos / Monitor staff

  • Wilder Joseph of the NHTI mantainence staff walks past the truck full of trash and the pods stuffed with furniture from Langley Hall on campus where the student dorm rooms are being converted into overflow rooms for the COVID-19 virus space. GEOFF FORESTER—Monitor staff

Monitor staff
Published: 4/4/2020 10:59:54 AM

The beds face north and south, alternating throughout the gym. Some are green with futon padding. Others are blue and thin, like pool loungers. There’s an IV hook attached to each of them, a sign that incoming patients could have medical needs beyond a simple place to rest.

A second floor window allows hospital staff to observe from above.

Eight weeks ago, this gymnasium hosted presidential hopefuls, with supporters and cameras packed into an MSNBC candidate forum days before voting day. This week, it’s filled with hospital beds in preparation for a surge of patients infected with COVID-19.

As state and federal officials work to set up flexible facilities for the expected spike in coronavirus cases, New Hampshire Technical Institute is racing to do its part. For more than a week, maintenance staff, firefighters, National Guard service members and hospital officials have trickled in and out of the abandoned NHTI student center, carting beds, affixing plastic sheet entranceways and ventilation systems.

The plan is basic: transform the gymnasium at Sweeney Hall and the Langley dormitory into a makeshift hospital in two weeks. NHTI is one of 14 facilities across the state created to absorb additional COVID-19 patients that can’t be placed in the state’s hospitals. Altogether, it will provide nearly 300 beds.

The results are still to be seen. The hospitals in the Concord and Lakes Region aren’t sure how many extra beds they’ll need if a surge in COVID-19 patients hits. But they hope the flex center at NHTI will be enough to absorb the worst of it.

“It’s going to be extremely challenging,” said Dr. Christopher Fore, the associate chief clinical officer at Concord Hospital. But, he added: “All of this has been a dynamic, moving target.”

Concord’s flex facility is meant to handle two distinct populations, Fore says: those with minimal medical needs that test positive COVID-19 and can’t go back in the hospital and others who should be quarantined at home but can’t be.

The dorm will house people in that second category – people that meet the discharge criteria but have nowhere to go because they should be in long term care. That building can house around 115 patients, Fore says. The hospitals are not planning to double up any of the rooms.

“That will likely be some socially vulnerable people, but primarily people from long-term care facilities that can’t go back,” Fore explained.

NHTI has been pulling out the stops to get it done. Dorm rooms have been cleared and deep cleaned. Trucks with window fans and furniture sit in the empty parking lots.

Getting the beds into the gym took days of set up work, aided by the National Guard and the Concord Fire Department.

“We’re a support agency,” said Concord Fire Department Interim Chief Guy Newbery. “We assisted in the initial set up on Saturday, the planning phase, the incident command pieces. And now we’re just tracking and getting updates.”

To construct the facility, hospital officials have been using national guidelines. Staff will be wearing droplet and contact protection. They’ll also making sure there’s plenty of airflow.

As far as ventilation, the guidance is clear: air should enter on one side of the building and leave through the other.

It’s not an ideal set up, medical professionals admit. Ideal would be to have a “negative pressure room” for each patient, where air is removed from the room without mingling elsewhere. But under the circumstances, the ventilation should still make a difference.

Staff at the facility will be diverse, including employees from the Concord Regional Visiting Nurse Association, which has offered hospice services for hospital patients.That generally means those with a prognosis of six months or less, CEO Beth Slepian said.

“It may be clients who are already on hospice who contract the disease,” Slepian said. “It may be community members who have special needs and just require the services.”

The Concord VNA has 400 nurses and administrative staff, many of whom are continuing to make home visits throughout the crisis, Slepian said. Its presence in the flex area will likely be light – potentially just a hospice nurse and a spiritual care provider, she added.

The Concord spot is one of more than two dozen in New Hampshire, Gov. Chris Sununu announced Friday, expanding the total number of hospital beds in the state to nearly 5,300 overall.

But not all of the beds will be at the same level. New Hampshire’s flex facilities are coming online as hospitals still clamor for ventilators, machines necessary for certain high-priority patients.

Those ventilators, such as they’re available, are going to the hospitals themselves. No one expects them in the flex areas.

“This will be medically unsophisticated,” Fore said. “This will not be like being in a hospital. This will be a safe alternative to no other options.”

Providers are working at it. Concord Hospital has a plan to increase its 28 ventilators to 48 in coming days. Franklin and Lakes Region General Hospital are both sitting on 11 ventilators and an additional eight anesthesia machines that can be converted to work like ventilators, according to Cass Walker, the hospitals’ vice president of administrative and support services.

The bigger goal is to remove certain infectious patients who don’t need further care from the hospital setting.

“Hospitals are a terrible place to be if you have a contagious respiratory pathogen because they’re full of the most vulnerable people that you don’t want to infect,” Fore said.

By moving non-high-priority patients to NHTI, the hospitals can split their space and resources between non-COVID patients who need emergency care and COVID patients who need close monitoring and ventilators.

In drawing contingency plans, hospitals are in the dark on the one number that matters: how many people are going to get sick.

“We certainly need to be prepared for a surge,” Walker said. “What the numbers are going to, be we have yet to know.”

But Fore and others say that the mitigation measures the state and its residents have taken appear to have had an effect at lowering New Hampshire’s hospitalization rate.

The key, Fore said, is whether there will be resources to keep up.

“What we need going forward is PPE,” he said, referring to personal protective equipment like masks and gowns. “That will be the ultimate limiting factor of if we are successful or not. If we have PPE we will succeed. If we don’t have PPE, we will fail.”

Slepian, of the Concord VPN, agreed. “We’re hoping for the best and we’re planning for the worst,” she said. “If we land in the middle, it will ease our resources a little bit, but not enough.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com, at (603) 369-3307, or on Twitter at @edewittNH.)




Concord Monitor Office

1 Monitor Drive
Concord,NH 03301
603-224-5301

 

© 2019 Concord Monitor
Terms & Conditions - Privacy Policy