University Medical Center is preparing for a surge of coronavirus patients in the coming weeks.
UMC's CEO Mason VanHouweling said the hospital is working in unconventional ways to expand bed capacity by 150 percent. That means things like mobile tents or other alternative care sites.
At the same time, other patients must be seen and cared for.
How is the state’s only public hospital managing it all?
Dr. Luis Medina-Garcia is an infectious disease physician at UMC. He told KNPR's State of Nevada the hospital, like others in town, is doing its utmost to be prepared.
“Currently, all the hospitals in town are preparing to the best of their abilities for a worst-case scenario surge plan," he said.
That plan includes optimizing bed space and staffing levels to be ready for an increasing number of patients.
“At UMC, we’re trying to maximize our bed space and our nurses to provide more care and I know that every other hospital system in the valley is doing the same,” he said.
One of the big concerns is the staff and keeping them healthy. Two nurses at the hospital have already been diagnosed with the coronavirus. Medina-Garcia said often nurses work at more than one hospital, which means if they get sick, staffing levels at two places can suffer.
“We’re working very hard with our employee health to make sure that every worker stays healthy precisely because it would be difficult to scramble and find people to fill in their shoes should they be out of commission,” he said.
As the outbreak spreads in Nevada, Medina-Garcia admits it is very possible that more health care workers will contract the illness. In New York, health care workers have died from COVID-19.
“It is one of the risks that we run in the work that we do, which is why the stay-at-home orders are so, so important to slow the spread of the virus so that we can have less exposure to our health care workers, and in return, remain able to provide the care to patients when they become sick and they seek hospital care,” he said.
Besides staffing concerns, hospitals and health care workers around the country have raised alarm about the lack of personal protective equipment or PPE.
Medina-Garcia said early on in the outbreak UMC started using PPE conservation strategies that still comply with CDC guidelines but may not be what doctors, nurses and others who work in a hospital might be used to.
Now, instead of changing gowns, masks and other gear when working inside a coronavirus ward, workers use the same gear until they leave, he said. Gloves are the exception because workers need to wash their hands.
“At UMC, we have sufficient PPE to have our health care workers give the care that the patients need and to keep our workers safe, but we do take measures to make sure that lasts,” he explained.
While the hospital is preparing for the worst, at this point, there is no way to accurately predict exactly what "the worst" will look like. Medina-Garcia said modeling is imperfect because of the lack of testing.
He said the peak number of patients could be two to three times higher than right now but it is difficult to tell.
Currently, because of a shortage of testing kits, only people who are showing symptoms are being tested so they can be directed to care.
Medina-Garcia said everyone at the hospital is struggling with stress in an environment of unknowns.
“This is a worldwide crisis and the levels of stress are obviously high across the board. When you’re fighting an invisible foe and when there are so many things that are unknown, it is very difficult to manage those levels of stress,” he said.
Medina-Garcia said UMC's solution to fear is facts.
“The antidote to fear is information and preparedness," he said.
The hospital is reviewing as much information as possible and modifying any protocols to keep patients and staff safe.
“We’re trying to make knowledge our shield against fear,” Medina-Garcia said.
While the doctors, nurses and other staff at area hospitals are doing what they can to prepare, Medina-Garcia asked that the general public do what they can to help them.
“We... ask for your understanding and cooperation in staying home as much as you can and keeping yourself healthy and safe,” he said.
Dr. Luis Medina-Garcia, infectious disease specialist, University Medical Center