Hospitals are on high alert caring for people who are sick in general and are treating those who have the coronavirus.
Flagstaff Medical Center is no exception, which now has nearly three dozen patients confirmed with the virus, and about two dozen others waiting on test results.
On top of receiving patients from their own city, Flagstaff Medical Center is the only level one trauma center in northern Arizona, meaning they’re getting severe COVID-19 patients from other counties.
Currently, the hospital’s Chief Administrative Officer Josh Tinkle said they’re getting three to five coronavirus patients a day from the nearby Navajo Nation, where cases are on the rise.
“COVID-19 patients that are critically ill are difficult to manage on the ventilator, requiring a lot of our pulmonary intensive care doctors to do the management. They don’t have that out on the reservation,” Dr. Derek Feuquay, chief medical officer for Flagstaff Medical Center said.
As cases continue to arrive at the hospital, Tinkle doesn’t think they’ll run out of ventilators. However, he does have bigger concerns.
“It will be the resources and the intensivists to be able to manage the vent settings,” Tinkle said.
To prepare, hospital staff are being cross-trained.
“We’re matching up hospitalists with anesthesiologists, who manage vents more often. We manage the medical side and we’re co-managing patients together,” Dr. Feuquay said.
Already, Flagstaff Medical Center is seeing shortages of personal protective equipment. Hospital employees are using specialized equipment to spray N-95 masks with aerosolized hydrogen peroxide so they can reuse them.
“In N-95 masks we probably have another weeks’ supply,” Tinkle said.
Dr. Feuquay said most people who get COVID-19 won’t end up in the hospital, he recognizes the peak is coming. Adding those who do get sick, get worse quickly.
“We’re finding patients will go from 2 liters of oxygen to 4 liters of oxygen, which isn’t very much, especially at this altitude, then all of the sudden, they’re being intubated and they stay intubated for 10 days to two weeks,” Dr. Feuquay said.
The hospital is preparing for the peak of COVID-19 cases expected later this month. Flagstaff Medical Center has converted other areas of the hospital to accommodate ICU beds to increase their capacity.
Currently, the hospital can hold up to 265 patients, but come April 24, they’ll have increased their bed space to 396.
As of Thursday afternoon, Flagstaff Medical Center reported having 131 total patients, with 32 positive for COVID-19.
“We’re half census. The issue is really in our critical care units where we’re running over 100% capacity,” Tinkle said.