BERLIN – As the number of COVID-19 cases continues to increase in Worcester County, a local hospital is hoping to meet the demands of a predicted surge with additional beds and overflow space.
In recent weeks, Atlantic General Hospital (AGH) has taken several measures to prepare for an influx of patients. Based on state and federal projections, the facility has increased its capacity to meet the demands of an anticipated hospital surge.
“We put this plan in place at the facility about a month ago, to go from our 40 licensed beds up to a capacity for 83 beds,” said Michael Franklin, president and CEO of Atlantic General.
The hospital started to execute its surge plans last month, creating additional overflow space adjacent to the emergency department waiting room, adding additional negative pressure rooms, modifying the airflow in inpatient and emergency room areas, and transforming its post anesthesia care unit (PACU) into a seven-bed ICU ward for patients with COVID-19.
“Where we’ve had to discontinue doing elective cases by the governor’s order, that’s freed up space in the recovery area to create this special expansion of the ICU where we can put all the COVID patients and keep them isolated from the rest of the hospital,” Franklin said.
Franklin noted many of the hospital’s efforts were made possible through partnerships. Royal Plus, for example, loaned AGH 20 pressurized air personal respirator systems for nurses and physicians to wear when treating patients with COVID-19 and six air scrubbers to create additional negative pressure rooms.
“Negative pressure means all the air is taken from the room, filtered and sent out of the hospital …,” he said. “We have an entire floor of the hospital that has negative flow to cohort patients and to protect nursing staff and physicians and the rest of the patients in the hospital.”
Franklin said AGH has also partnered with Berlin Nursing and Rehabilitation Center to open a 16-bed, hospital-staffed alternative care site in the lower level of the nursing home. The area has a separate entrance and exit and will be used as an overflow area to treat low-acuity patient who do not have COVID-19.
“This part of the nursing home had been closed off, but we are renting the space from them on a month-to-month basis …,” he said. “If we get to a point where we need the added capacity, we will move those low-risk patients to that facility and manage them with community-based physicians and telemedicine so hospitalists can consult with those patients.”
While the hospital has taken several steps to expand its capacity, Franklin said efforts were made easier by the hospital’s participation in yearly state-led surge drills.
“Nobody saw this coming to be able to budget for this,” he said. “But we have done this scenario before … We have practiced it and thought about what we can do to expand capacity, what we could do to protect our hospital and make sure we don’t have unintentional spread of a disease, or in this case COVID-19, around the hospital. It shortened our think time for what we needed to do to put things into place that protect the hospital, the patients and the staff.”
As of Tuesday, the hospital had seven patients who have tested positive for COVID-19 and five patients who were awaiting test results, Franklin said. But he noted the hospital has yet to see a big surge in COVID-19 cases.
“I wouldn’t say we’ve had a big surge of COVID-positive patients,” he said. “We’ve had a steady number of COVID-positive patients for about the last two weeks.”
Franklin said AGH’s census is down significantly, as people are staying away from the hospital. But that has created other issues.
“People are waiting longer than they would have to come into the hospital,” Franklin said. “So we’ve seen a ruptured appendix last week that probably would’ve been prevented if they’d come to the hospital earlier. We’ve also had similar problems with kidney stones.”
Officials said people are also canceling appointments with their physicians. Public Relations Vice President Toni Keiser said the health system’s providers offer telemedicine visits utilizing the Follow-My-Health patient portal and continue to see patients in the office when it is appropriate to do so.
“We don’t want people to stay home or disconnect from their regularly scheduled appointment, or any urgent care they may need,” she said. “We want people to be proactive instead of waiting until they are too sick.”
In an effort to reduce the number of people coming to the hospital, AGH has worked with the Worcester County Health Department to convert the Atlantic ImmediCare at 10th Street to a COVID-19 testing site.
“The canary in the coal mine that we have is our test location,” Franklin said. “After the first week we opened it up, we were seeing about eight patients a day on average. We’ve had closer to 20 patients today going to 10th Street to be tested, and we have quite a few on the schedule for tomorrow.”
As the number of cases continue to increase in surrounding counties, Franklin said AGH could see activity ramp up in the coming weeks.
“It shows that it’s knocking on our door …,” he said. “I think there are a number of signals out there showing things are picking up around here.”
Franklin, however, added that AGH is now prepared to handle any surge that may come.
“We are ready,” he said. “We’ve got our umbrella, and usually when I carry an umbrella it doesn’t rain. We’ve got our umbrella, so now we hope it doesn’t rain very hard.”