Citizens Medical Center has converted dozens more rooms to be negative pressure rooms and received 16 health care workers from the state to cope with the recent surge in COVID-19 patients.
Officials with the county hospital detailed the major adjustments the facility has made throughout the pandemic at a hospital board meeting Wednesday.
Dr. Daniel Cano, the hospital’s chief medical officer, said Citizens saw a peak of 57 COVID-19 patients a few days ago. As of Wednesday morning, about 50 patients with the respiratory disease were in the hospital.
The most significant change at Citizens was the conversion of 78 standard hospital rooms into negative pressure rooms. In these rooms, the air inside the room is not released directly back into the hospital, and the air is cycled through HEPA filters 12 times per hour.
The hospital initially converted a 38-bed unit to be completely negative pressure in March, but has since added an additional wing to make more rooms negative pressure. Prior to the pandemic, the facility had 11 such rooms.
“When we first started the transition to negative pressure rooms, we built a 38-bed unit, and I thought, there’s no way we’re going to fill a 38-bed unit,” Cano said. “It didn’t take long. It was really over the course of about a week that we filled that unit and had a need to exceed that unit.”
Although the Centers for Disease Control and Prevention’s current recommendations say that not all COVID-19 patients need to be in a negative pressure room, Cano explained that it’s easier to have all positive patients in these rooms because it’s difficult to tell which patients will progress to need more intensive care when they first get to the hospital.
”It’s much safer and simpler to just admit them to a negative pressure environment from the start,” he said.
The virus is primarily spread by respiratory droplets that are sprayed when an infected person speaks, coughs or sneezes, according to the CDC. But a growing group of scientists are concerned about the virus’s potential to linger in the air. It’s unclear how often this happens, however, and if small viral particles that can float in the air are enough to infect someone. But the World Health Organization has updated its guidance to encourage health workers to take all precautions necessary when medical procedures are performed on COVID-19 patients, and negative pressure rooms are among the steps that can reduce the risk.
In addition to the infrastructure changes, the state has deployed 15 nurses and a respiratory therapist to temporarily work at Citizens to help with the increase in cases. The additional staff have allowed more beds in the hospital to become available. Citizens typically has enough staff for 265 beds, and the added staff is enough for 15 to 20 more beds, depending on how sick the patients are, said Citizens spokesperson Jennifer McDaniel.
And to help free up bed space, Cano said, the hospital is working more closely with its home health agency so that relatively healthy COVID patients can be sent home from the hospital with an oxygen tank, and watched for any changes. Cano said that for younger, healthier patients, this arrangement has allowed them to leave the hospital a little bit earlier but still be closely monitored for any changes.
Most people who become infected with SARS-CoV-2, the virus that causes COVID-19, will not require hospitalization. But for some patients, the virus can cause serious illness or death. Victoria and the rest of Texas are in the midst of a surge of coronavirus cases. Some data indicates that the number of new cases and hospitalizations might be leveling out, although it’s nowhere near a downturn yet. The current number of seriously ill COVID-19 patients has left hospitals in the Victoria region with few empty beds. Throughout Victoria’s trauma service area, which covers Victoria and five additional counties, 79 regular beds are free and 12 intensive care units are available, according to the Texas Department of State Health Services.
Mike Olson, the CEO of Citizens, said roughly 1 in 4 patients coming to Citizens’ emergency room had COVID-like symptoms and was seeking treatment for them.
Cano said a coalition of local physicians have developed a standard and aggressive treatment protocol for the sickest COVID patients in Citizens and DeTar Healthcare Systems hospitals.
As the pandemic continues, Cano said he’s most worried about the upcoming flu season this fall, and whether Citizens will have to handle an influx of COVID patients, flu patients, and people sick with other respiratory illnesses.
“That is what’s scares me the most, and I think most people in health care,” he said. “What happens if we have the same volume of the widespread coronavirus issue at the same time as flu and other respiratory stuff in the fall. What does that look like?”
The hospital can convert another 20 rooms to negative airflow fairly easily if needed, McDaniel said.