At Holy Name Medical Center in Teaneck — smack dab in the middle of the New Jersey county with the most confirmed cases of COVID-19 — dire necessity has become the mother of invention, as staffers scramble to fill looming gaps in critical supplies amid the outbreak.
On Tuesday, Debbie Ross, a nursing informatics specialist, was cutting a garbage bag potentially to serve as a clinical gown because supplies of the real thing are running low. She’s leading a brigade of staffers volunteering to explore ways to make do with what’s available.
“I’m not sure what it’s going to do,” she said as she stuck her head through a hole and put the bag on. “But let’s see how big it goes. Yeah, I guess this is big enough.”
Dr. Adam Jarrett, chief medical officer at Holy Name, said the medical center in hard-hit Bergen County has tested more than 800 people, and admitted 80. Twenty-five are now in the facility’s Intensive Care Unit.
Garbage bags as protective gowns, if necessary
“A week out from now, if the volume continues, there are going to be problems, which is why we are creating contingencies with such things as homemade gowns,” Jarrett said. “It’s not something I want to do, but it would work. These gowns would absolutely do the job if we had to use them.”
Jarrett said, before taking that step, the hospital would launder gowns. Shortages also persist in the supplies of other so-called PPE, the personal protective equipment used by the frontline health care workers who are treating those infected with the novel coronavirus.
The hospital has warned specifically about its stock of N95 respirators, the specialized masks designed to keep staffers from inhaling viruses and other microbes borne by their patients.
Now, it’s preparing to re-use them, after sterilizing them with UV light.
“We are doing that for every N95 mask that has been used,” he said. “We are keeping those masks aside. We are not putting them back into circulation. But if the situation changes and we have to put them back into circulation, then we will do that.”
On the specialized machines that help patients with pulmonary issues like pneumonia to breathe, Jarrett said the hospital is currently coping.
“Right now for ventilators, we’re OK,” he said. “We’re OK for the next couple days.”
Adding treatment beds
Meanwhile, a construction crew is converting a hospital storage facility into a 50-bed temporary care unit. They’re aiming to finish it this week. But then comes the issue of staffing.
“We are staying ahead of it,” he said. “But if in a week from now are opening up that 50-bed unit that I talked about, then I am very concerned that we will not be able to staff it in a safe way.”
Jarrett said that each day, he goes through a process.
“When I go home every night, I say to myself, ‘Have we compromised care today?’ ‘Have the people at Holy Name been able to keep up?’” he said. “So far the answer is yes. We have not had to compromise care, but I am very concerned that if the volume continues, that at some point Holy Name and other hospitals will be compromising the quality of care that they provide. It’s because we just don’t have enough staff.”
On the PPE front, there was a glimmer of good news Tuesday out of Gov. Phil Murphy’s daily update on the outbreak and the state’s response to it.
“We will soon receive a shipment of sorely needed personal protective equipment, or PPE, from the national stockpile, for our frontline medical personnel — an additional 200,000-plus N95 masks, and more than 84,000 respirators, among other gear,” he said.
Murphy also said that PSE&G, the utility, had committed to donating 50,000 N95 masks.
Murphy said, however, that more equipment was needed.
At Holy Name, Jarrett praised the facility’s nurses and medical staff. He said the hospital is offering them counseling.
On Monday, the chief of the infectious disease department at Holy Name had been quoted likening the scene at the hospital amid its battle with coronavirus infections as a war zone.
“I’d rather not use that term,” Jarrett said. “But I certainly understand why my staff — both physicians and nurses who are on the front line — feel that way. Again, I feel like we have not had to compromise care at this point. And so, if it’s a war, right now we’re winning it.”
Jarrett talked about a small, but very meaningful victory: A recovering patient has been removed from a ventilator. He also said that wider use of social distancing could lead to many more victories.
Late Sunday night, Holy Name reached out on Twitter and other social platforms looking for donations to help buy supplies.