Hospital balancing COVID/non-COVID operations under ‘new normal’ conditions
CONWAY — As cases of COVID-19 continue to rise in the Mount Washington Valley and across New Hampshire, Memorial Hospital has reinstituted masking and other protocols and restarted its drive-thru testing operations.
“We’re back to full masking. We’re back to our meeting restrictions. We’re back to Zooms. We are back in a COVID posture here at the hospital,” said Memorial Emergency Preparedness Coordinator Will Owen at a weekly community meeting the hospital held last Friday to update the community and answer questions about the pandemic.
“I feel like I’m in ‘Groundhog Day,’” Owen said, referring to the 1993 movie where the character played by Bill Murray lives the same day over and over again.
Hospital President Art Mathisen said: “We’re super busy, maybe as busy as we’ve seen the hospital for a long time. Even during what is a very busy time for most of us in the valley, it even seems busier now.”
Much of what is keeping Memorial busy is not COVID-related, Mathisen said, noting it’s important that the hospital continues to provide routine care.
“I’ve had some of my really long-standing good providers come to me and say, ‘Please, we cannot shut down again. We cannot not see our patients when they need the care they need,’” Mathisen said.
People putting off care over the past 18 months may account for the increase in patients the hospital is seeing now, he said.
“Right now, we’re able to balance the two canoes, the COVID canoe and the non-COVID,” he said.
There were a couple of days recently when over 100 patients were seen in the emergency department. That’s two to three times the usual number of patients, Mathisen said, adding, “We don’t see numbers like that very often.”
The hospital is also busy with in-patients, both for COVID-19 and other medical needs.
Owen said the hospital is averaging one to three COVID-19 patients per day out of 15-18 beds in the hospital. Most of those patients are middle-aged.
As of Wednesday, there were 2,524 active COVID cases in New Hampshire (70 in Carroll County), with an average of new cases per day approaching 300. Through most of June and July, there were fewer than 50 new cases reported each day.
“Our transmission is 194 per 100,00 in the last 14 days; that puts us in the high level. The entire state is high right now,” Owen said last Friday. “Things are ramping up. If you look at the numbers, they are going in the wrong direction on a pretty steep incline.”
Owen said some of the increase is due to the Delta variant, which has spread rapidly in New England.
“In late June, about 30 percent of cases were attributed to the Delta variant. We are now in the high 80s to low 90s,” he said.
Owen said the variant is two to three times more contagious than the original strain of COVID-19. “And the evidence is pointing toward it’s affecting the younger populations more,” he said.
Unlike earlier in the pandemic, many local COVID-19 in-patients are staying at Memorial.
“I think we’re definitely in a better place with our protocols and what we’re comfortable keeping,” said Memorial Chief Nursing Officer Kris Dascoulias.
In the early days, she said “there was so much unknown as to how to treat these patients and what to expect” that the hospital was quick to transfer those patients to higher-level facilities.
“Now, I think we’re seeing there is a patient population that is not critically sick but needs hospitalization, needs close monitoring, might need some oxygen, definitely not super comfortable at home, that we can manage,” she said, adding there are protocols for when to send them to a higher level of care.
That is important, Memorial officials said, as hospital beds fill up around the state.
“Most of the hospitals in MaineHealth (under whose umbrella Memorial falls) and in New Hampshire are almost completely full as far as in-patient beds. And the number of positives right now is much greater than when this all started,” Mathisen said.
“The concern is we’re already running at capacity, and we haven’t really surged yet,” Owen said. “We’re concerned if these COVID numbers go up with how busy we are with non-COVID — what do we do?”
Dascoulias said that Memorial has developed good relationships with other hospitals in southern New Hampshire and is taking in some patients from them as well as transferring patients to them.
Owen said drive-thru testing at the hospital has been very busy as well since restarting Aug. 9.
“The first day, all the appointments were taken, which was very surprising to us, but what it told us it that it was time,” Mathisen said.
Owen said the hospital is keeping the same hours, 7 a.m.-3 p.m., Mondays-Fridays, as before but is increasing staffing to do more tests. Testing must be scheduled in advance by calling (603) 356-0673.
The hospital had shut down drive-thru testing July 5 and ended its Code White operations on July 16. But Mathisen said the hospital is not ready to move back into emergency operations, referred to as Code White.
“The difference now for us is we know a lot more than we knew 18 months ago, when this all started,” he said. “What we all feel strongly about here is when we shut the hospital down … we feel like people that didn’t get the (non-COVID) care that they needed and ended up being more sick.
“Having this increase right now is our new normal,” he added.