If at least 70% of Shoals residents would comply with guidelines to keep the COVID-19 virus contained, the area’s public hospital and health care professionals stand a good chance they will not be overwhelmed by patients in need of critical care, says one physician on the front line of preparedness.
Dr. Mark Smith is Helen Keller Hospital’s chief of staff. He agrees with other health officials that there will be a surge in confirmed COVID-19 cases in the coming days and weeks, but says the local health care system could handle that surge if residents tighten their compliance.
Smith said Keller, the area’s public hospital, is ready to treat critical patients. He said the Shoals is just beginning to test local residents for COVID-19, therefore it is also just beginning to climb its own curve.
“We haven’t even scratched the surface. We’re not even close.
“Our job is to lower the crest of the wave,” Smith said. “We can lower the crest, but we've got to do it right now.”
He said Shoals residents “have a shot at blunting that curve tremendously.”
How? Follow the guidelines outlined by the Centers for Disease Control and the Alabama Department of Public Health, he said.
The guidelines are simple, easy to do for many, and will make the difference in keeping the virus from generating patients with acute complications who need intensive hospitalization, he said.
Referred to as non-pharmacologic intervention, or NPI, in the health profession, the guidelines include:
• Stay home. Leave your home only for essential errands.
• Shield your coughs and sneezes.
• Wash your hands for at least 20 seconds using soap and water. Why? Washing your hands for that length of time ensures that you’re breaking the outer coating of the virus, causing it to collapse. Once collapsed, it can’t bind to human cells.
If you’re not where you can use soap and water, clean your hands with hand sanitizer that has at minimum 60% alcohol. Alcohol at that strength kills the virus.
• If you must go out, keep your distance from other individuals by at least 6 feet.
Smith referred to covidactnow.org, which is a website tool created by data scientists, engineers and designers who partnered with epidemiologists, public health officials and political leaders to help understand how the COVID-19 pandemic will affect different regions.
According to the data, Alabama, which is classified as implementing “limited action,” would overload its hospitals by mid-April. The data estimates a “point of no return” for intervention to prevent hospital overload is now through March 30.
“I want that curve flattened right now,” Smith said.
He said preventing hospital overload not only saves lives, it would save hospital resources that are needed to treat other conditions and ailments that have nothing to do with the pandemic.
Those at greatest risk for complications from the virus are people with health conditions that include COPD (chronic obstructive pulmonary disease), heart disease, compromised immune systems, obesity issues, lung disease, diabetes, or elderly individuals, he said.
“Those people need to stay inside,” Smith said. “They need to limit their social contacts, unless they’re doing social distancing greater than 6 foot. You do not need grandbabies coming to see you. They can be asymptomatic carriers. Little kids, children, still get the virus. They just may not have any symptoms. Young adults get the virus and they’re carriers.
“The problem is we’re seeing 20-year-olds, 30-year-olds being put on ventilators. At first, the 20- and 30-year-olds were saying, man this isn’t going to bother us one bit. Wrong.”
Smith said he’s not suggesting a “Wuhan level of isolation in your house.” But if you’re 80 years old or older, “you need to stay in your house.”
“When you get exposed to coronavirus, it takes two days for you to be contagious, roughly. It takes five days for you to become symptomatic. Once you become symptomatic, you're highly contagious.”
Smith said one person with coronavirus can infect three people compared to one person with flu infecting just one other person.
Another difference is that with flu, symptoms appear in one to two days. A person can have coronavirus and see no symptoms for up to five days, which gives you more time to be a carrier before you realize you’re sick.
Smith said he has spent the last four weeks preparing a disaster plan for Helen Keller Hospital. It has included dividing the hospital so that when a patient is suspected to have COVID-19, they are isolated to a certain part of the hospital “so that the general hospital is not exposed,” he said.
Staff members are divided, too. There are staff members who will deal only with known COVID-19 or suspected COVID-19 patients. They will not interact with other staff of the hospital.
All individuals, including staff, are screened before entering the hospital, he said. Screening includes checking temperature, asking questions, and even giving instructions on how to exit with minimum touching of surfaces.
No visitors may come into the hospital. All entrances are monitored, and the emergency room is set up for COVID-19 tracking so that any patient who exhibits symptoms is masked and segregated.
COVID-19 screening sites are not on the hospital campus.
“Your hospital still has to run for normal patients,” Smith said. “So we’re doing everything we can to separate an infected patient from a (non-infected) patient.”
The hospital implemented its protocols two weeks ago, he said.Keller has a dedicated COVID-19 unit with 14 beds.
Smith said there are plans in place to handle overflow, should it be needed. Keller also conducts its medical staff meetings via a noon teleconference call to keep medical personnel for being in confined spaces like a conference room.
The TimesDaily also reached out to North Alabama Medical Center in Florence. The hospital released this statement:
"Our clinical teams are trained on the proper procedures and protocols to minimize the risk of spreading any infectious disease, including COVID-19. If we have any reason to believe a patient may have the coronavirus, our providers immediately implement the appropriate infection control measures in accordance with Centers for Disease Control and Prevention (CDC) guidelines. These include masking and isolating the patient, donning personal protective equipment (PPE) — inclusive of a mask, eye protection, gown and gloves — and ensuring environmental hygiene."