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Area hospitals say they are prepared for potential flood of covid-19 patients

Employees from Holy Cross Hospital in Silver Spring gather for a memorial to covid-19 victims on Monday. (Holy Cross Health System)

With coronavirus infections again surging in the region, area hospitals say they are far better equipped to handle a flood of covid-19 patients than they were when the pandemic first exploded this spring.

Hospital officials said they have more information on how to treat covid-19 patients, have sufficient personal protective equipment, and are taking steps to address staff burnout.

“We believe that our best preparation has been our experience,” said Steve Motew, the chief physician at Inova Health System, which includes five hospitals in Northern Virginia.

While hospitalizations have skyrocketed in other parts of the country, including in the Upper Midwest, the number of patient admissions for the coronavirus has yet to surge in the greater Washington area, except for pockets including Southwest Virginia and parts of Western Maryland.

But positive case rates have begun to climb across the region. The seven-day rolling average of new coronavirus infections Saturday in D.C., Maryland and Virginia was 2,563 — a record high for the region since the start of the pandemic.

The seven-day average for hospitalizations was 1,707 patients, lower than the average of 1,948 in August and the peak of more than 3,300 in May.

Hospitals in the District, Maryland and Virginia never disbanded the covid-19 emergency preparedness teams they assembled this spring. Those teams have been working closely with local and state health officials to monitor case rates and map out possible surge scenarios for the winter, when flu cases spike as well.

“The scenarios that we have worked through essentially say if we had as many patients as we had at the peak in the spring, plus the kind of patient volume with flu that we normally have in an average year, and all the other care that is normally demanded of our hospitals, would we overstrain the resources?” said Bob Atlas, president of the Maryland Hospital Association. “And the answer is that we have that covered.”

Officials at hospital associations in the District and Virginia agreed that they were prepared for a surge.

Hospitals say they are drawing on lessons learned from surges in the spring and summer. Hospital stays are generally shorter — in part because testing is more robust and because drugs such as remdesivir can reduce the severity of covid-19. And staff members aren’t immediately hooking people up to ventilators anymore, which means that equipment is less in demand.

“For many health-care providers, the idea of taking care of patients in the midst of a pandemic was a frightening thing to think about,” said Glenn Wortmann, the section director of infectious diseases at MedStar Washington Hospital Center. “But now that we’re months into this, I think most have become more comfortable with it.”

Hospitals have been stockpiling personal protective equipment, and some have partnered with local vendors to avoid a repeat of national supply chain issues seen earlier, said Julian Walker, a spokesman for the Virginia Hospital and Healthcare Association.

Atlas, of the Maryland association, said the resilience of hospital employees is “probably the biggest constraint” that medical facilities are facing eight months into the crisis.

To address staff burnout, hospitals are offering time off, counseling and child care. They have also stepped up training for new nurses, who may not have treated patients during the pandemic.

Holy Cross Health held memorial services at its Silver Spring and Germantown facilities this week, planting trees to honor lives lost to the pandemic and inviting employees to place stones in memory of those they knew who died.

It’s a “physical place where they can go in the future and sit in silence and reflection and pass off grievance,” said the Rev. Kirtley Yearwood, the health system’s chief mission officer.

If hospital cases explode, officials said, they also will be able to utilize some of the alternate care settings and field hospitals that were set up this spring. Several, like the District’s alternative care site at the Walter E. Washington Convention Center, were never used.

“It gave us a little sense of relief that in the event that we did have a surge, that it was there for us,” said Jacqueline Bowens, president of the D.C. Hospital Association.

Virginia could execute its plans for field hospitals and alternate care facilities in Northern Virginia, the Hampton Roads area and Richmond, if needed.

At the start of the pandemic, hospitals throughout the region canceled elective and non-urgent procedures to save capacity for covid-19 patients — and because people feared catching the virus if they went to a hospital.

But officials in the District and its suburbs said they hope to avoid having to do that again. They have built up capacity to educate the public on how hospitals safely segregate covid-19 patients from other patients so they will not be afraid to seek care for other medical issues.

“We’ve taken the point of view that covid is going to be with us for some period of time that’s not measured in days or weeks but likely months or years,” Motew said.

In hard-hit Southwest Virginia, however, where virus-related hospitalizations are soaring, Ballad Health on Monday paused non-emergency elective procedures that require an overnight stay.

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