As testing ramps up, health care leaders discuss how system is coping

Leaders of hospitals that stand at the front lines of the battle against COVID-19 on Thursday discussed the challenges faced by their staffers and steps they are taking to handle the surge of cases that experts expect to be coming their way.

And at the same time, authorities discussed plans for the opening Friday of the first of two drive-thru testing facilities supported by the Federal Emergency Management Agency in New Jersey.

The pop-up, outdoors facility at Bergen Community College, and another that’s being prepared at the PNC Arts Center in Holmdel, are designed to add significantly to the number of people who get a confirmed diagnosis, and help provide a measure of clarity in a state where much remains unknown about the novel coronavirus.

In Newark, Shereef Elnahal, the president and CEO of University Hospital, provided a tour of one of the negative pressure rooms that’s critical to the treatment of those with a COVID-19 infection — one of 40 at the state’s only public, acute care hospital.

“Right now we are standing in a unit that we’re waiting to activate in case we get a surge of coronavirus patients,” said Elnahal, a former commissioner of the state Department of Health.

Air holes that perforate all the ceiling tiles play a key role in ridding room of dangerous microbes, he said.

“It takes anything that might be swimming in the air, or droplets, and instead of letting it go outside the room, it sucks it up into the ceiling and makes the environment safer for anybody,” Elnahal said.

Every negative pressure room gets an hour-long scrub down, complete with sterilization by robotized ultraviolet light.

Elnahal said University Hospital just got a $2.25 million anonymous grant that it’s using to buy 50 ventilators — which assist with breathing in lung-compromised patients — and convert more rooms for critical care.

Dwindling supplies of PPE, or personal protection equipment, have been a source of worry among medical professionals dealing with patients, including nurses and aides, at University and elsewhere across the state. Elnahal said the hospital is ordering more.

He also said University Hospital currently has enough of the scarce N-95 masks that filter virus particles. But like other hospitals, it’s reserving N95s only for health care workers attending the most critically ill coronavirus patients because supply is so tight. Staffers tending to or moving other COVID-19 patients must wear regular surgical masks.

“The CDC did say that surgical masks and lower-level masks than N95s are acceptable for folks who are not in an intensive care setting,” Elnahal said.

Appearing at Gov. Phil Murphy’s daily briefing on the coronavirus and the state’s response to it, Robert C. Garrett — CEO of Hackensack Meridian Health, a sprawling network comprising 17 hospitals, 500 patient care locations, 34,000 team members and 6,500 physicians in New Jersey — also discussed the issue of PPE availability.

“As the supply tightens, it’s going to be very important we — the hospitals in general — never run out of protective equipment,” he said. “So we have to balance that with making sure we are adhering to the CDC guidelines.

“We don’t want to put any nurses or health care workers at any risk,” he said.

Garrett said the state health care system is part of an unpredecented “global war” with the COVID-19 virus.

“We must understand that we’re in this for the long haul,” he said. “This will tax our clinical and human resources like we’ve never seen them tested before.”

Garrett said the cancellation of elective surgeries has allowed the hospital to redeploy staffers, such as operating room nurses, to the COVID-19 care areas. That’s important to help fills gaps that are occurring among the ranks of those already working there. Roughly 150 health care professionals at Hackensack Meridian are in quarantine situations at the moment, Garrett said.

Garrett noted that President Donald Trump has invoked his executive powers to ramp up manufacture of PPE. “We need this national call to action to dramatically increase the manufacturing capacity to provide the amount of PPE that is necessary to support our front line team members,” he said.

Meanwhile, outside University Hospital, workers were setting up a tent and a special Department of Health trailer to pre-screen ER patients and free up more beds inside.

“It’s all temperature-controlled, they can be made negative pressure,” said Dennis Boos, director of the center for emergency preparedness at the hospital. “It has lights, generator, backup emergency and everything else that’s required. It’s basically an emergency department, outside the emergency department.”

University will need more nurses to staff the additional rooms. At the same time, the hospital is dealing with staffers calling out, often by people who don’t have child care. So the administration is turning to temporary agencies and calling in retired nurses to fill the gap.

Similar temporary facilities have been set up at Holy Name Medical Center in Teaneck, and one was opened Thursday at Jersey’s City’s Christ Hospital.

University is also ramping up its own on-site coronavirus testing facility.

Also on testing, at the daily update in Trenton, state officials laid out how they plan to operate the FEMA drive-thru site at Bergen Community starting Friday. The Paramus facility will be open from 8 a.m. to 4 p.m., seven days a week, officials said.

Col. Patrick J. Callahan, superintendent of the New Jersey State Police, said that testing will be available only to those who are symptomatic, and not to whom officials are terming the “worried well.”

The idea is get the most out of the tests available, and to limit vehicle traffic in the area. National Guard and State Police personnel will be on hand to help keep things moving, he added.

“I do envision some long lines,” Callahan said.

“Individuals experiencing respiratory symptoms, such as cough, fever, shortness of breath, are eligible for testing,” said New Jersey Health Commissioner Judith Persichilli.

No pre-registration will be required, but people will need proof of New Jersey residency. This site will have the capacity to collect 2,500 specimens a week, with test results within two to five days. The FEMA site in Holmdel is expected to open next week.