be a ‘Twindemic?’
A global pandemic has raised public awareness about virus transmission and the importance of handwashing, mask-wearing and social distancing and avoiding crowds. Surge and scenario planning are key to health system readiness.
Safety and preparedness. They’re two lessons all of us have learned during the COVID-19 pandemic. Now, with influenza season on the horizon and the pandemic ongoing, many people will take their personal safety and preparedness plans to the next level. Health systems are no different.
We sat down with Richard Webster, president of Thomas Jefferson University Hospitals, to learn how Jefferson Health and other systems will handle potential surges and keep people safe–both inside and outside of hospitals this fall and early winter.
How are hospitals preparing to handle a potential surge of flu and COVID-19 cases?
Well before COVID-19, Jefferson conducted regular surge and disaster/emergency planning for major Center City Philadelphia events, such as the 2015 visit of Pope Francis. We have also used our experience managing through H1N1 in 2009. As part of these exercises and experiences, we review and revise our staffing models and develop high-level plans to manage an influx of patients. When the COVID-19 pandemic hit, we reviewed and revised those plans and put them into action. For example, as the number of COVID-19 cases at our hospital increased in March and April, we expanded Intensive Care Unit (ICU) capacity into a non-ICU area. We also developed four to five additional levels of surge planning that we can deploy if needed. These plans include using our operating rooms, procedural areas and recovery rooms to care for additional inpatients. This puts us in an even better place to handle surges this fall than before the pandemic.
Will elective procedures, cancer treatments, emergency care and other hospital services continue in the event of a surge in COVID-19 and flu cases?
The added safety measures we put in place early in the pandemic will help us keep all our services open—and protect patients—this fall and winter. We now perform COVID-19 testing for every patient who is admitted or who will undergo a procedure at our hospitals. We have the capacity to run our own COVID-19 tests and get results within hours—and sometimes within 15 minutes—by using point-of-care testing. We screen everyone who comes through our front door. Our ability to screen and test all patients puts us in a much safer place and enhances our ability to provide all medically necessary services in a time-sensitive manner. It will be important for us to provide these services to our community, as we know that some patients delayed seeking care during the pandemic, which may put them at risk for complications of disease progression.
Will COVID-19 and flu patients be separated from healthier patients?
We will take every precaution to ensure patients who are tested for COVID-19 or the flu remain separate from other patients. During the height of the pandemic, Jefferson did designate specific units for COVID-19 patients. In past flu seasons we’ve posted signage asking patients with flu-like symptoms to wear masks inside our Emergency Rooms and other areas. We also learned, through COVID-19, the benefit of using outdoor locations for testing and screening. And we found great value in telehealth. We will continue to use telehealth as the preferred way to get patients with COVID-19 or flu-like symptoms care remotely, in the safety of their own homes, and direct them to a drive-up testing location as needed. We now have more than 1,000 physicians trained to use telehealth for their patients.
If I or a loved one am seriously impacted by suspected flu and need to go to ED, what can I expect when I arrive? Will I initially be treated as a possible COVID-19 patient until I am tested?
It is critical that people seek care if they are sick or concerned about symptoms they are experiencing. Jefferson has a strong telehealth program, JeffConnect, and a network of urgent care centers that individuals can access if their symptoms are mild. If you do go to our ED, you will be screened as part of the initial assessment, and based on your history and physical exam, a care plan will be developed that may include COVID-19 testing.
Will personal protective equipment (PPE) continue to be used to protect staff and patients?
Yes. Every staff member who interacts with a patient wears a facemask and face shield or eye protection. This helps us protect our staff, our team and our patients from potential COVID-19 spread. All visitors are also required to wear facemasks inside our hospitals. We also ask patients to wear a face mask if they are outside their room or when one of our caregivers enters their room.
Do you foresee any shortages of PPE or ventilators?
No. During the COVID-19 pandemic, representatives from every Jefferson hospital and our academic partners—including our infection control, clinical and finance leaders—worked with our Supply Management Team to coordinate the ordering, vetting and stocking of PPE. We were never once at risk of running out of face masks, N95 masks, isolation gowns, gloves, disinfectant wipes or other PPE. Since the pandemic began our leadership has made a commitment to keep a six-month inventory of supplies on hand at all times, and we’ve accomplished that. We also purchased additional ventilators. And as our clinicians have treated more COVID-19 patients, they’ve found other modalities that are just as effective as being put on a ventilator, which has decreased the need for them.
Are there reasons why the predicted surge of COVID-19 and influenza cases might not materialize?
I’m an eternal optimist. COVID-19 has raised everybody’s awareness regarding the transmission of viruses and the importance of self-care, handwashing, mask-wearing, social distancing and avoiding crowds. I think that has really prepared our community to handle potential risks this fall. I also believe more people will be open to getting a flu vaccine this year to take better care of themselves. And that people will know the symptoms of respiratory diseases and stay home if they experience any of them.
Can Jefferson Health hospitals be 100% sure they are prepared?
There’s always room for improvement, but we routinely run surge capacity scenarios. We treated the largest number of COVID-19 patients in the City of Philadelphia at our main hospital campus. And we had very few, if any, documented cases of a patient actually contracting COVID-19 from another patient or staff member. Those numbers support the fact that community members should feel safe coming to Jefferson.