By Rebecca Aguilar
President Trump warned the nation at a recent White House briefing that coronavirus is about to claim more lives, “This will be the toughest week…there will be a lot of deaths, unfortunately.” While the President prepared Americans for a worst-case scenario, at Parkland Memorial Hospital in Dallas, medical teams are ready for a surge of COVID-19 patients.
According to Parkland’s President and CEO, Dr. Frederick Cerise, the surge cannot be prevented. “It’s my job to be pessimistic and to anticipate that the surge is coming. That’s what we are doing. We are planning.” Parkland is one of the largest county hospitals in the country. In preparation for a surge, staff has already converted its operating room into a 55-bed unit for coronavirus patients. They have also found hospital space where they can expand to another 42 beds if needed.
Dr. Cerise said they continue to look for areas in the hospital that can be used for more bed space. “There are a number of things we have done to create a surge capacity. We are not squeezed in the emergency room today.” The hospital has also enclosed part of the area where ambulances bring in patients. It can be turned into a 36-bed care triage area. “We have a number of things we have started, and we’ve planned on if we got into a situation like New York,” said Dr. Cerise.
Parkland medical staff ready for increase in COVID-19 patients
Parkland’s medical staff has not been overwhelmed yet with the number of patients with coronavirus, but Dr. Cerise expects a surge in three or four weeks. He thinks now is the time for his medical staff to take it easy. “We’re sort of at an inbetween phase, and we are trying to take advantage of the time to make sure that we don’t overdo it with our staff, so they are ready for the surge when it comes.”
Parkland’s administrators have made changes to ease the work demand on the medical staff like canceling elective procedures and clinic visits for people with diabetes who go to the hospital for glucose checks. Now they are having them check themselves at home and call in results. Medical personnel in units that were closed have been re-assigned to areas where they will be needed.
The hospital has 870 beds and is well known for its neonatal intensive care unit, burn center, and trauma center. Currently, those departments are operating at full capacity with specialized medical staff. “We are taking extra precautions because we obviously don’t want to have infections in those areas,” said Dr. Cerise.
Efforts made to keep Personal Protective Equipment (PPE) on supply
Recently Parkland Hospital administrators asked the public for donations for Personal Protection Equipment (PPE). Some of the donations needed include surgical masks, surgical caps, hand sanitizer, N95 Masks, shoe covers, and eye protection goggles. Dr. Cerise said the hospital has a stockpile of PPE, but it’s crucial to have continuously have supplies coming in. “We’ve had to dip into our stockpile a little bit, but we feel that a combination of a stockpile plus our restocking will help keep our people safe.”
As the COVID-19 pandemic hits its expected peak in North Texas over the next few weeks, Parkland wants to make sure it has enough PPE for the staff to keep them protected from the virus while they care for patients and also to avoid further possible spread of the virus. Right now, some doctors and nurses are asked to reuse the same face masks when possible. Dr. Cerise said the hospital is in a conservation mode. “That means that masks that are not soiled and can be reused, we are using. We are developing a process to sterilize used masks.”
The hospital is using an ultraviolet light system to sterilized any used face mask. He added that reusing masks and sterilization fall under the Center for Disease Control’s (CDC) guidelines.
The surge may not be as bad as in other parts of the country
Parkland administrators believe there is a possibility that the sudden increase in coronavirus patients may not be in the huge numbers as in other cities around the country. Dr. Cerise said he credits Dallas County Judge, Clay Jenkins for making the decision more than two weeks ago to enforce the stay-at-home policy to help slow down the spread of the deadly disease. “I think it took a lot of courage for the judge to get out early on that because it is the kind of thing that works most effectively if you do it early. But the problem is that people don’t feel there is a problem at that time.”
Judge Jenkins recently extended the stay-at-home policy for the county from the end of April to the end of May. Dr. Cerise said Jenkins’ decisions will prove to have a positive impact and hopefully fewer patients than expected. “If you look at the numbers, I think there is some cause to be more optimistic. Before we have seen this steep climb in cases, Dallas issued an order to stay home, and that should have an impact.”
Parkland’s medical staff have sense of duty despite the risk
When you work on the frontlines of a pandemic, Dr. Cerise believes there is an understanding that there are risks and uncertainty, but doctors and nurses know this is what they were called to do. “Like we’re in it together…to take care of people at a time where there is a great need in Dallas.”
Parkland has more than 12,000 employees, and of those, 4,177 are registered nurses. The hospital’s philosophy is “Care, compassion, community.”
During this coronavirus crisis, Dr. Cerise said he has seen a real sense of bonding among his medical staff. “We say thank you a lot, and remind them that people of Dallas are counting on them and recognize that we are going to do everything we can to keep them safe.”