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COVID-19: Local hospitals plan for patients


As of Tuesday evening, when this article was submitted, there have been 141,728 confirmed COVID-19 cases globally with 4,098 deaths for an average mortality rate of almost 3 percent. In Italy, where peak cases have overwhelmed medical resources, the death rate is more than three times higher than the global average at 9.9 percent.

Pennsylvania had 1,127 known infections and 11 deaths at noon Wednesday. Bucks County had 86 confirmed cases, while neighboring Montgomery County, with 172 confirmed cases and one death, is the current hotspot in Pennsylvania. Gov. Wolf ordered all non-life-sustaining businesses across the commonwealth to close physical locations as of March 23. Food establishments can operate only through carry-out, delivery or drive through.

At 55,041 cases, the United States is fast catching up to Italy and currently is ranked third in confirmed global cases by country. The mortality rate is 1.4 percent with 790 deaths reported.

Some epidemiologists fear that Italy, caught unprepared for a tidal wave of critical cases, is a model that the United States will follow. While Italy has peaked at 6,600 new cases per day, the United States has now outpaced that at over 10,000 cases per day, with 163 deaths reported in a single day on Tuesday, March 24, according to data compiled by Johns Hopkins University.

And while President Trump has expressed “a beautiful timeline” that could see the country “reopen” with packed church pews for Easter services, epidemiologic models defy such optimistic projections with an exponential rocket-like trajectory of new cases.

“We’re encouraging compliance with the state government and Department of Health to minimize contact with others, exercise smart hygiene, and remain cognizant,” state Sen. Steve Santarsiero said last week. “If the system gets overloaded and inundated with sick people, the mortality rate can rise. That’s why mitigation now is so important.”

Dr. Scott Levy, vice president and chief medical officer at Doylestown Hospital, said that Doylestown enjoys the enviable position of being a community hospital favorably benchmarked against academic tertiary care facilities. Citing high-end clinical work, research and cutting-edge medicine, Levey said, “It has come to fruition now at a time with an unanticipated crisis.”

The intensive care unit, or ICU, has recently been moved to its own floor and has a closed COVID unit. Levy stated that having COVID cases on one floor helps preserve personal protection equipment (PPE). But he said that the biggest daily obstacle is equipment, an issue of supply that the hospital has never had to think about before.

Levy stated that each COVID patient would be assigned a single nurse while staffing levels permit. That would further conserve PPE, since a nurse rotating between two patients would require changing gear. He stated that Italy, due to the overwhelming strain on resources, was not able to do that, and would not predict down the road if similar stresses would change that protocol.

The use of teams isolated from one another would also preserve personnel, so that if one team had to quarantine because of an exposed worker, another team could take its place.