Duke Health, Durham’s largest health care provider, is the Bull City’s front line for treating people who become seriously ill from coronavirus.
As the threat of a surge in hospitalization looms, Duke University and Duke Regional hospitals will need enough beds, adequate supplies and effective strategies to limit spread and save lives.
System leaders have a plan, Duke Regional Hospital President Katie Galbraith told the 9th Street Journal in an interview.
“This is something that we have been preparing for and planning for — for this type of event — for years,” said Galbraith.
So, how is Duke Health gearing up?
A Harvard Global Health Institute study made in collaboration with ProPublica that compares available hospital beds to potential needs projects that the Durham area’s supply could fall well short of demand.
In the study’s moderate scenario — where 40% of adults contract coronavirus over 12 months — the sickest coronavirus patients will take up 3,060 hospital beds. The study says the Durham hospital region typically has 1,130 beds available.
Even under normal conditions, Duke Health’s hospitals operate near full capacity. So Duke Health, which has a third hospital in Raleigh, has been preparing to expand bed capacity if needed since news of the highly contagious coronavirus first emerged, Galbraith said.
“As soon as we started getting reports out of China about coronavirus, we started really focusing on our planning specifically for this area,” she said.
Duke Health is prepared to add 500 beds to the just over 1,500 beds across the system’s three hospitals, according to Galbraith. Hospital systems across North Carolina can increase capacity because North Carolina is in a state of emergency.
“We are looking at different locations for beds within our hospital,” Galbraith said, adding that out-patient locations such as the system’s Ambulatory Surgery Center are potential sites for Duke Health bed expansions.
Duke Regional Hospital was treating two hospitalized COVID-19 patients on Friday morning, said Galbraith, who did not know how many COVID-19 patients were hospitalized across the system.
Other measures to ensure Duke Health has adequate capacity to accommodate COVID-19 patients include rescheduling non-critical surgeries, procedures and appointments; and scheduling virtual visits to free up space.
Supplies manageable, but concerning
Duke researchers made headlines this week after developing a new method to decontaminate coveted N95 respirator masks so that they can be re-worn. The masks, an essential tool in protecting health care workers, are running low in hospitals across the country.
The new method has helped Duke Health hospitals. “Right now we are managing well with what we have,” said Galbraith.
But supplies might not last.
“We are certainly concerned given the amount of supplies being used not only here locally, but across the country,” Galbraith said. “We’re concerned about the possibility of interruptions in the supply chain.”
According to Galbraith, Duke Health staff are working to secure more personal protective equipment.
“They’re reaching out to suppliers and have been working since the pandemic was emerging,” said Galbraith.
Supplies are coming from the community, too. Duke Health announced this week it would welcome donations of N95 masks, which are more protective than standard masks; surgical and looped masks; and unopened boxes of gloves. The donation site is open from 8:30 am to 4:30 pm at 100 Golden Drive, Durham.
Without proper supplies, health care workers everywhere are at greater risk of contracting coronavirus.
“The safety of our team members and our patients is our top priority,” said Galbraith.
Changes to testing
Galbraith confirmed that Duke Health is now using it’s own COVID-19 test. The test, which has been under development throughout March, went into use this week.
“We are running some tests in house and we still are using commercial labs for some tests as well, which gives us broader capacity,” she said.
The combination of in-house and commercial testing allows the system to confirm which patients who have COVID-19 symptoms have coronavirus infection, Galbraith said. But in step with state guidance, Duke health care staff discourage people with mild symptoms from seeking testing.
New guidance to hospitals from the North Carolina Department of Health and Human Services says patients with mild symptoms consistent with COVID-19 do not need testing for and should be instructed to stay home to recover.
Widespread testing likely wouldn’t change treatment guidance and could unnecessarily expose health care workers and other patients, the department said.
Duke Health is offering only limited testing, according to the system’s COVID-19 web page
To inhibit spread, Duke Health has also banned visitors to its hospitals, with few exceptions.
Stay at home
You’re a part of Duke Health’s strategy, too, Galbraith said.
“I’m proud of our leadership role in this, but it’s not Duke alone,” Galbraith said. “We are going to need everyone to work together and to comply with a stay at home order, which is not easy for people, to get through this as a community.”
North Carolina Gov. Roy Cooper announced on Friday that a statewide stay-home order goes into effect on Monday. Durham’s stay-home order started Thursday.
“Hospitals have been calling for the stay-at-home order,” Galbraith said. “We’re supportive of that and feel that order is supportive of us, as a healthcare system.”
Galbraith pointed out that “flattening the curve” — slowing the spread of coronavirus to prevent a surge in critically sick people — will prevent Duke Health from being “completely overwhelmed.”
Galbraith listed other ways Durhamites can help hospitals too.
“Supporting first responders and health care workers. Offering to do chores for them, to make a meal for them, to help with child care,” she said.
Top photo: The novel coronavirus, called COVID-19. Photo from CDC.