Whether it’s raising kids or treating COVID, the second time is always a little bit easier, and as the so-called “second wave” begins to hit the Everett and Chelsea communities – and show up at CHA Everett Hospital – things are much more calm than in the first go-around.
“When people came in last spring, we felt frantic and brought in supplemental oxygen and begged for the oxygen levels to go up and people to be able to breath,” said Dr. Melisa Lai-Becker, chief of the Emergency Department at CHA Everett. “We didn’t know. Now we know what’s going on. We let them know we’re pretty sure they have COVID and we flip them on their belly and suddenly they’re breathing easier. We know we don’t have to pump the oxygen into them like a fire hose…Everyone is more calm about being able to talk about (treatment)…and what we’re going to be able to do. It’s so nice to have a pre-flight checklist to go over with patients now. I guess we’re just accepting how it can work without engaging in all the psychic drama that it took previously.”
That said, there are preparations underway for the increased numbers that are coming into the hospital in fits and spurts. Lai-Becker said there will be days when everyone who comes in seems to have COVID-19, and then there will be days when no one has it, followed by another day with heavy cases. It is a trend, she said, and the hospital has spent much of this month re-bolstering their protocols, hiring more staff to prepare and getting plenty of supplies in order.
“There are no major numbers or breakthroughs or setbacks,” she said. “That’s all good and no major explosions either. There is a growth of cases in the community and the positivity rates and we’re admitting more people…However, the other good thing is it’s not an exponential increase of cases either. It’s still big numbers, but at the same time it didn’t double, so that’s good…I guess it’s also just realizing that viruses like the flu love the cold, dry air.”
The differences between the first and second waves has also been dramatic in the age range and the mystery in which how the disease has been contracted, Lai-Becker said. It is a much younger group of people, and many of them have been doing all the right things for the health protocols, but somehow got sick anyway.
“I want to confirm for people that last spring our hospital was filled with a lot of different populations and Nursing Home populations,” she said. “Now, as we look at the start of winter, it seems like we have plenty of people that are 20 or 30 years old. In the spring, it felt like the 30 or 40 year olds were in the front line essential jobs – like a grocery store cashier…This time there seems to be just enough people saying they don’t know where they got it. It is a bit of a puzzle. Many say they have been doing all the right things for the last six months…It’s not like they attended a 200-person wedding.”
Right now, the hospital is in an enviable position, as they invested in several different testing platforms and ample testing supplies. When people come into the Emergency Room, there is plenty of ability to test people for the traditional flu and COVID-19. That was a testament, she said, to the Laboratory Department at CHA which was very scrappy in securing testing equipment during the surge last spring, and then continuing with that push through the summer so that any second wave wouldn’t come without supplies – including all of the PPE that was missing in the spring at times.
Adding onto that the fact that the hospital has adopted newly-informed COVID precautions that are constantly changing with new discoveries and conditions, and Lai-Becker said the hospital is very safe and fully supplied.
“I believe we hit an inflection point in the summer and still are at that point where it’s safer in the hospital than to go grocery shopping,” she said, “just because of all the precautions everyone around you is taking at the hospital.”
That, of course, is one of the key differences between then and now. The preparations are in place and the experience of the first time around was so valuable that health professionals still maintain a confidence even as cases do go up week after week. That brings about a contentious issue regarding another lockdown or shutdown, something Dr. Lai-Becker said probably isn’t necessary again. Instead of lockdowns, she said it should be more about adjusting to the circumstances as they come – being vigilant and going back to good habits when cases increase.
“Look at the fact that hospitals operate and grocery stores operate and they do it by wearing a mask in the hospital and they wash their hands thoroughly,” she said. “People are still functioning. We’re not shut down. In a hospital people will be able to maintain some perspective. It’s not a shutdown or a lockdown. It’s just adjusting to what precautions we’re taking. We’re going into winter now and viruses love cold, dry air. I don’t know why, but they do, and we should remember that.”
Testing Platforms Investment
One of the great items of readiness marked off on the CHA Everett checklist is the fact that the hospital and the network invested in testing and testing supplies – multiple different kinds and platforms so that a second wave wouldn’t cause the same disruption as the first wave when testing was in short supply.
The Laboratory and Pathology Departments both got on waiting lists for different analyzing systems and testing supplies in the surge, and then took advantage of that place in line when their number was called in the early summer. Then throughout the summer they continued to invest in testing kits to be ready for any second wave.
It has proven to be a good ally now that more people are arriving in the Emergency Room with COVID symptoms. They can be quickly tested with quick turnarounds – as opposed to the spring when testing had to be done off-site and often delayed due to supply issues.
“We’re very fortunate that our Lab and Pathology Department, they did not want to take any chances of running out of any one type of test,” she said. “We have several different platforms and a couple of different analyzers. That’s been a pretty good boon for us in our supply chain…So it’s been a lot to run all these different types of tests and to have enough agents and supplies and testing kits on hand. We’re positioned well.”
To date, since March, CHA has done 81,000 tests and around 4,250 have come back positive.
Come to the Hospital
Dr. Lai-Becker said they are also encouraging people to come to the hospital when they are experiencing non-COVID emergencies – such as chest pains or stomach pains or any other injuries.
She said there was a clear message in the spring to not come to the hospital, but that time has passed and they now want patients to come in if they feel a health issues. Ignoring the emergency visits and even check-ups and follow-up visits can complicate health problems.
She stressed that the hospital is very safe, even with the increase in cases lately.
“If you’re having chest pains, that’s a good reason to come to the hospital,” she said. “If you have belly pain, that’s a good reason to come to the hospital. We really want to encourage people to come to the hospital when they need to. It is safe.”