Sky Ridge in a 'groove' thanks to public compliance

Second COVID-19 surge is imminent, but staff are far better prepared, chief doctor says

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Sky Ridge Medical Center staff members have a little breathing room after a month of stay-at-home orders slowed the cases of COVID-19. 

In March, Sky Ridge, along with hospitals throughout Denver and Colorado, prepared for a surge in COVID-19 cases that has yet to happen. Dr. Jason Kelly, chief medical officer at Sky Ridge, credits the state's collective initiative to heed stay-at-home orders, which Gov. Jared Polis implemented March 26.

“We're kind of getting into a groove now. When the pandemic hit, we didn't have a huge number of patients, but we really had to rewrite the policies and procedures for the whole hospital,” Kelly said. “Right now, we've gotten through all the supply chain hookups. Things are certainly a lot more regular now than they were a few weeks ago in terms of not changing on a daily basis.”

Sky Ridge is planning a system to transport non-COVID-19 patients through corridors that have had zero patients in them since mid-March and no exposure to COVID-19. Everyone who enters the hospital has his or her temperature taken. The hospital has 30 ICU beds. COVID-19 patients are either in separate sections of the ICU or on the third floor. The hospital counts its confirmed COVID-19 patients and how many occupy ICU beds twice daily.

Of Sky Ridge's staff of 1,200, fewer than 10 employees have been furloughed due to contracting the virus and no “outbreak” among staff has occurred, Kelly said.

While Sky Ridge anticipates offering elective surgeries soon, it also anticipates a second surge in COVID-19 that, while maybe not as drastic as once thought or as seen in other places, is imminent.

“It's almost certain there will be some kind of second wave,” Kelly said. “Some people have said to some degree the lockdown was a little bit too successful in Colorado. People were really good about staying at home, so when you relax that you're certainly going to get more cases.”

Staff erected an emergency medical tent near the end of March, a measure taken expecting a large second wave. The tent has not been used as of April 23. If needed, the tent would be used to screen patients who need emergency medical care for COVID symptoms.

The challenge now for Sky Ridge is to maintain its protective measures as it begins thinking about rescheduling appointments for elective surgeries. Elective surgeries are procedures that are not considered an emergency. Common elective surgeries are knee and hip replacements, cataract extractions and ligament repairs.

“We really feel like we have a solid process in place to offer these services we're offering and gradually open things up, but we're awaiting direction from the governor and what is reasonable to do,” Kelly said.

Kelly encouraged anyone who needs emergency medical attention to feel safe at Sky Ridge.

“I feel safer at a hospital,” Kelly said. “I know everyone who has walked in the door has had their temperature taken and they've been screened … out and about, that's not the case. I get it that people are worried about hospitals, but I don't think that's the reality of the situation.”

Sky Ridge doctors have provided about 10 patients with convalescent plasma transplants, an investigational procedure headed by the Mayo Clinic to inject plasma of a patient who has recovered from COVID-19 into a patient suffering from the disease. Presumably, antibodies from the recovered patient's blood would help fight the virus, which is a logical procedure, Kelly said. However, the novel coronavirus does not act like a typical virus, and results from the patients Sky Ridge has already treated will not be definitive for at least six months, he said.

While Denver has so far avoided a second surge, at least to the scale of that experienced in New York City and elsewhere, Kelly warns there still will naturally be a "surge" in COVID-19 cases once the stay-at-home order is lifted. Sky Ridge is better prepared for that surge now than a month ago, he said.

Kelly compared the process to water flowing from a dam versus a flood — a more controlled, steady stream of cases rather than all at once. A "flood" would overwhelm staff and lead to more serious cases and deaths, he said.

“The governor is on the right track as far as slowly and thoughtfully lifting the restrictions so this second wave is not a huge swell,” Kelly said. "We want to be careful we're not lulled to sleep and there's a second surge we're not prepared for.”

Kelly said at some point, years down the road, nurses will be administering shots for COVID-19 like annual flu shots. The effects of the pandemic will last months if not years, he said. The current procedures to prevent the spread of COVID-19 will be in place at Sky Ridge “for the foreseeable future,” Kelly said.

“I can't see us relaxing those requirements until cases of COVID are pretty rare and we have a vaccine,” Kelly said.

With so many unknowns with this virus, Kelly reiterated the importance of heeding the now-cliché phrase “abundance of caution.”

“I've never experienced anything like this before, and I don't think anyone practicing medicine has seen anything like this … Part of it is we don't totally know how this virus behaves and I don't think we know the mortality rate because there are a lot of people of haven't been tested and have silent versions of COVID,” Kelly said. “There are so many unknowns with this, but I think it's good we're using an abundance of caution. You feel like that's an overplayed term, but it really does apply to what we're dealing with. A year or two from now, when we have a bit more perspective, we might be able to say it was just a really bad flu season, but it's too new for us to put it in that category. It's certainly better to be on the safe side.”

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