Officials at East Alabama Medical Center are urging residents to stay vigilant over the coming weeks as cases of Covid-19 are expected to continue to rise in the Lee County community.
Dr. Steven Presley, a hospitalist at EAMC, echoed the plea recently given by Dr. Michael Roberts, chief of staff at the hospital.
"He made a comment that said 'Don't let up,' and I think that's so important for our community to continue to social distance, to obey the governor's order, to be very careful, only go to the grocery store and places when needed, and when they go be diligent with their hands and mask hygiene and social distancing," said Presley.
As of Thursday morning, Lee County has 285 confirmed cases of Covid-19 and 12 reported deaths. The numbers statewide also continue to climb, with Alabama reporting close to 4,249 confirmed cases and 126 reported deaths.
And a surge in the number of Covid-19 cases across the state is expected in the coming weeks, according to State Health Officer Dr. Scott Harris. EAMC has surge contingency plans in place, said Presley.
"We are hoping that our hospital probably was in front of the surge in the state, and we believe that we may precede the state in reaching our peak and then beginning hopefully for our numbers to move down some," he said. "We think that Montgomery and Mobile and some of those other places will lag behind us in that, so we're hoping that we don't have to reinstitute further surge plans other than what we've already done."
The Auburn City Council declared a state of local emergency a month ago on March 17, followed shortly thereafter by a statewide public health order by Gov. Kay Ivey that placed wide restrictions on businesses and closed public beaches. Ivey later issued a Stay at Home order on April 3.
EAMC started pre-planning for the potential of a Covid-19 outbreak in the Auburn community around the beginning of February, said Presley. EAMC had its first confirmed admission for a patient with Covid-19 on March 16.
"Really, we're looking at over four weeks now that we have been in this urgent mode of treating the Covid pandemic here at East Alabama Medical Center and have had, obviously, the expansion of our ICU," he said. " We typically have a 20-bed ICU on the second floor and a 10-bed ICU on the first floor. We expanded that to add another ICU on the second floor, so we went from two to three ICUs."
During that period, EAMC saw an increased number of patients on ventilators, although the situation seems to be improving some.
"Thankfully, we think we're seeing a decreased number of patients on the ventilator over the past two or three days, so we're encouraged that perhaps things may be improving and that we may be looking at a downward trend in the next three to five weeks," said Presley.
Over the month that EAMC has been treating patients with Covid-19, the disease's high rate of transmission and death rate have been apparent to doctors at the hospital.
"I think that one thing our entire group would definitely agree with is that the level of this virus being contagious, or infectivity, or its transmission rate, is very high. It seems much more easily transmitted even than the typical winter flu," said Presley about what doctors at EAMC have learned about Covid-19 since they started treating infected patients. "Also, the death rate of this virus is higher in those who have underlying comorbidities (simultaneous presence of two chronic diseases or conditions in a patient) in many of the illnesses that we deal with, so that has been something that has been very emotionally hard for physicians. We are dealing with more life-and-death situations with this virus than we typically deal with."
As one of EAMC's 14 hosptialists, Presley said he hasn't come into contact with many people with mild symptoms, which account for about 80 percent of cases. He has seen the 20 percent of patients who are sick enough to be hospitalized. As of Tuesday evening, 48 patients with a confirmed Covid-19 diagnosis and 11 patients with suspected Covid-19 were currently hospitalized at EAMC and 47 patients previously hospitalized with Covid-19 had been discharged. EAMC has seen more than 700 confirmed cases of Covid-19 in its immediate service area, which includes Lee, Chambers, Tallapoosa, Randolph, Russell, Macon, Clay and Bullock counties.
"If they're sick enough to be in the hospital, we're seeing that they typically need to stay in the hospital from 10 days to over three weeks, depending on if they had to go to the ICU," said Presley. "Now, one thing that has been interesting to watch is that when the patients reach a certain point in the lifespan of this viral illness, it does seem like they have a fairly quick improvement once they start improving. In other words, what I mean by that is that though it may take 10 or 12 days to improve, it seems like on that 10th or 12th day once they start improving, the improvement comes more rapidly at the end, so that's been encouraging to watch.
"For those who survive the worst, they do begin to improve fairly rapidly."
None of EAMC's hospitalists has tested positive for Covid-19, which Presley said has been a "huge blessing." The handful of EAMC staff that tested positive early in the crisis have recovered, with a few having returned to work. One element that has helped EAMC employees stay healthy is that the hospital was well-prepared with its supply of personal protective equipment, which has been supplemented by the community.
"We are providing them PPE, and I think they're probably safer at work than they are in the community," said John Atkinson, EAMC's director of public relations and marketing, who added that all employees are screened for Covid-19 symptoms every day before work. "I'm thinking that if they do end up contracting it, they're probably getting it at the store, on the grocery cart, that kind of thing, more so than at work."
The most difficult PPE items to replenish have been isolation gowns and N-95 masks, said Atkinson. EAMC got some help on Tuesday morning, when Golden State Foods donated 1,000 isolation gowns to the hospital, he added.
"I was asked the other day, can you use the N-95s from Home Depot or Lowe's, and the answer is no," said Atkinson. "These are more medical N-95 masks. That's one thing that we're looking for.
"I can't say enough thanks to the people in the community who have made the cloth masks. I thought, 'Surely, we'll never get to that point,' but we're there much quicker than I thought, so it's really come in handy."
Those seeking to inquire about EAMC's supply needs can call 334-528-2255 or 528-6191.
The outreach and support of the Auburn community has been uplifting and very much appreciated by EAMC staff, said Presley. One of the most helpful things has been EAMC's partnerships with the chambers of commerce in Auburn and Opelika, which are helping provide meals to feed key EAMC employees. Atkinson said he wanted to give special recognition to the Auburn Chamber for starting that effort. Those wishing to work with the Auburn Chamber of Commerce to that end can call 334-501-3288.
"Since we are having to dress out and be limited in terms of our flow into distant areas of the hospital, it's not as easy for us to get food and that type thing," said Presley. "It's been a real huge blessing the community has provided meals to our ICU staff and to our physician staff some days and to our nursing staff on many shifts, and that's been a huge help and an encouragement, and it's something that we've really appreciated."
Presley also commended the teamwork of EAMC's employees during the crisis, including the administration and environmental services group.
"It has been very super-encouraging to see the teamwork among the different specialties, particularly, for me, the ER, our pulmonologist Dr. (Meshia) Wallace, our anesthesiologist team — we have all worked very closely together," he said. "And then I've been really encouraged to see our nurses rise to the occasion. We've had nurses who may normally work in different units be trained up to work in areas where they may not typically, and they've very flexible and very accommodating. All of the techs on the floors have been extremely helpful."