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In an effort to be ready for the predicted increase in patients needing treatment for COVID-19, the disease caused by the novel coronavirus, South Peninsula Hospital is quickly constructing an alternate care site at Christian Community Church in anticipation of overflow from the main campus.
Reminiscent of a field hospital and looking out of place among the basketball hoops of a church gymnasium, the alternate care site is being stood up quickly out of metal sheeting and thick, draped plastic.
“Three weeks ago, we weren’t really thinking about any of this,” said Dr. Todd Boling, medical director of the Alternate Care Site Leadership team. “And so, I’m kind of proud, or I am proud, of how it all sort of happened on short order.”
The hospital has been working to expand its capacity for treating COVID-19 patients along with the regular patients every hospital treats, which includes both making more room within the hospital and establishing an alternative care site. The site, made possible by a standing memorandum of understanding with Christian Community Church, is specifically designated for COVID-19 patients determined to have a moderate form of the disease. This means they need hospitalized care and possibly oxygen, but do not need to be in an intensive care unit.
The hospital was finishing work this week on turning a gym inside Christian Community Church into a 40-bay treatment unit using metal and electrical materials purchased by the hospital, along with copious amounts of protective plastic.
Each of the 40 bays will contain a bed, a monitor, a small side table, and other regular trappings of an inpatient room. The hospital is also looking for loans of oxygen concentrators, which would also be put in those rooms. The machines are used to filter and compress air to the proper density for a patient’s needs.
If anyone in the community has an oxygen concentrator available for a loan, they can take it to Christian Community Church during the day. The city of Homer is still the main hub for accepting donations otherwise, said hospital Public Information Officer Derotha Ferraro.
“It’s one sort of critical need we have right now,” Boling said.
John Bishop, service branch director of the site leadership team, explained that patients will still be screened regularly through the hospital when they are admitted as COVID-19 patients. If they are determined to have a mild case, they will be sent home. If their case is determined to be moderate, they will be taken to one specific entrance at the church, through which they will be processed and assigned a bed.
Patients designated as urgent will be treated at South Peninsula Hospital, and patients designated as severe can be treated at the hospital or flown to designated COVID-19 hospitals in Anchorage.
In addition to the 30 beds at the hospital designated for COVID-19 patients and the room for 40 beds at the church, Boling said the option exists to expand capacity even more within the church if needed.
If absolutely necessary, the hospital could expand up into the chapel of the church for more patient beds. Right now, the patient area will be carefully sealed off from parts of the church that are not being used. The same goes for the areas where food and laundry service will be brought in and out, Bishop explained along with Brie Lawrence, a registered nurse and the nursing leader of the team. The nurses’ station will be sealed off as well, and there will be an intermediate changing area between the side where COVID-19 patients are being treated and the side where medical professionals are entering the building.
Lawrence noted that all carpet will be covered in plastic and all rooms not being used will be sealed off to protect the storage and materials in the church.
“Hopefully when we leave, they didn’t know we were here,” she said. “That’s the plan, you know. And so we’re trying to be cognizant of that.”
The logistics unit of the hospital is managing construction of the alternate care site, with help from contractors including Spit Spots and Woodworth Electric.
“A lot of this stuff, right now the way it’s being built is so that when we tear this down — say that there was ever another need for this to arise again — we can build it right back up,” Bishop said.
Boling said that once the alternate care site begins getting COVID-19 patients, the hospital is going to be able to staff it appropriately based on the physicians and nurses it already has.
“We’re looking at the whole community working on that — the medical community,” he said. “We’ve asked some physicians for example who don’t typically do this type of work to step in… SVT (Health & Wellness) for example has offered their … providers and that’s going to be really helpful for us as we go along.”
Bishop said linens in each bed will be changed if obviously needed, but otherwise each patient will have the same linens throughout their stay to conserve resources. Bishop said the average COVID-19 patient will likely only be at the alternate care site for a few days.
The site will have monitoring capabilities and some X-ray capabilities, but anything greater can be taken care of up at the hospital.
Nurses who tend to patients will also be the cleaners and do other duties they wouldn’t normally. Lawrence has experience with all-hands-on deck nursing, having volunteered as a nurse in Haiti after the 2010 earthquake. She also volunteered at a pet rescue after Hurricane Katrina.
“So I did see kind of what it’s like to be in an environment that has basically nothing, and you work with what you have,” she said.
Before coming to South Peninsula Hospital as a patient financial analyst, Bishop got experience as a hospital foreman with the U.S. Navy for five years.
“That’s where a lot of my experience with this comes from, is I was on what’s called a … chemical, biological, radiological, nuclear and high explosive incident team” Bishop said. “So if there was an attack or a disaster, we would set up a hospital out in the field with hazmat suits so that we kept ourselves safe and could react in a response like that.”
Bishop and Lawrence said they’ve enjoyed getting to work together to anticipate the needs and functions of the alternate care site, both from a staff perspective and from the perspective of the hospital finances.
Work has also been ongoing at the hospital itself in order to expand the care capacity for future COVID-19 patients. People who need treatment for the disease often need to be in what’s called an isolation room or a negative pressure room. This is a room where the air ventilation is not connected to adjoining rooms or to other parts of the hospital.
Before now, South Peninsula Hospital had two negative pressure rooms in its acute care unit and one in the emergency room department. By modifying three additional rooms in the acute care unit and one room in the surgery department, the hospital has brought that number up to seven, Ferraro said in an email. The negative pressure room in the surgery department will be reserved for patients who need it for other medical reasons.
Glenn Radeke, facilities director for the hospital, is also the section chief for logistics. Through Ferraro, he said his team converted regular rooms into negative pressure rooms by having side panel windows removed by Lakeshore Glass, and replacing them with a custom plywood insert with a hole used to connect a duct from a filter fan inside the rooms to the outside of the rooms.
The fans, left to sit on the windows, will run at all hours of the day and come with filters that Radeke said will last through the coronavirus situation. The air inside the rooms will get pulled out through the fan and expelled outside. This reduces the risk to other rooms and other areas of the hospital.
Staff has saved the glass window panes that were removed, and will put them back when the rooms are no longer needed as negative pressure rooms.
Additionally, the Homer Chamber of Commerce and Visitor Center has volunteered its building as an alternate testing site. Drive-though testing is already occurring in front of the hospital, but Ferraro said when South Peninsula Hospital exceeds 20 tests in one day, that’s when the alternate testing site will be begin to be used as well.