As the coronavirus pandemic spreads from big cities to rural areas, will hospitals in these communities be ready for a surge?
“We’re the only game in town, really,” says Dr. Surabhi Gaur, the chief medical officer at Uniontown Hospital. “So if we didn’t step up and do this, nobody was going to do it. We might not live on top of each other as they do in New York City or central Philly or even downtown Pittsburgh. But there is still a risk.”
Clarion Hospital hospitalist Dr. Catherine Cunningham says the pandemic is palpable even in her remote county. The 145-bed Uniontown Hospital has an intensive care capacity for 15. In March, hospital leaders prepared for a rush.
“We took PPE very seriously. We made sure we had equipment, how to roll that out to our employees,” says Dr. Gaur. “We converted part of our perioperative unit. We made those into critical care beds.”
With this expansion, the hospital could accommodate 28 critically ill patients. But even at the worst in the spring, it had only 10 hospitalized COVID patients, five in the ICU. And the summer pattern is different, with a higher percent positive there at 10 percent.
“In the spring, everything was locked down. And this time around, people have been milling around a lot more,” says Dr. Gaur.
Also, the average age of those needing to be admitted is younger — 75 years old in the spring compared to 60 years old now. And the people coming in do not need a ventilator.
The 80-bed Clarion Hospital has a similar observation. It has seven ICU beds and very few COVID patients.
“A total of seven or eight since the whole thing started,” says Dr. Cunningham. “We had a couple of patients in the ICU, but I see now that a lot of our patients, even when they’re positive for COVID, do not seem to be as sick as they were in March or April, and I’m grateful for that.”
Clarion Hospital has not had to transfer any patients and having a partnership and telemedicine availability with Butler Hospital helps. Both hospitals can get remdesivir or convalescent plasma with a call.
“We do have enough (remdesivir) for at least half a dozen (patients),” says Dr. Gaur. “We are part of the consortium through the Mayo Clinic to get convalescent plasma.”
While she wishes she could have a few more staff, even in the middle of nowhere, Dr. Cunningham feels ready.
“We have what we need right now. I’ve never said to anybody, ‘I just don’t have what I need,'” Dr. Cunningham said.
Part of Uniontown Hospital’s strategy is to take on the public health messaging to the community via newspaper and radio.
“We’re very pro masking, we’re very much about making good decisions, you don’t need to be in large gatherings,” says Dr. Gaur. “We want to take on some of that public health burden because we know down the road, it makes our job as hospital leaders easier.”