If there was one word that Mission Health wanted to signify the virtual community forum call it held Monday on COVID-19, it was “reassurance.”
For one hour, Mission Hospital CEO Chad Patrick and Mission Health Chief Medical Officer William Hathaway — along with two other senior hospital officials — provided an overview of the current state of affairs as they fight a worldwide pandemic in their own backyard.
The hourlong question-and-answer session marked the end of a series of community forums held across the health care system’s regional footprint, each conducted by the president of a regional hospital and Hathaway.
[The latest: North Carolina coronavirus daily updates]
Mission Health is the largest health care provider in Western North Carolina. Based in Asheville, it operates hospitals and clinics across the mountain region.
Last year, Tennessee-based for-profit corporation HCA Healthcare acquired previously nonprofit Mission Health, but not without agreeing to key stipulations from N.C. Attorney General Josh Stein.
Amid accusations that HCA has not met its obligations, Stein has asked Mission a series of questions about alleged problems. Due to the pandemic, Mission has been given additional time to respond.
Mission also faces a unionization effort by nurses at its Asheville hospitals.
Personal protective equipment
Karen Olsen, Mission Hospital’s chief nurse executive, told members of the community in and around Buncombe County that there is currently no shortage of personal protective equipment, better known as PPEs, at the Asheville hospital.
The masks, gowns, gloves and other paraphernalia that staff needs to remain safe while also keeping those around them safe are in good supply, she said.
Staff members receive considerable training in handling this equipment before engaging patients and receive just-in-time refresher training “right there on the unit to be a resource,” Olsen said.
Olsen said five PPE distribution centers are spaced throughout the Asheville hospital, and runners are available day and night to get the equipment to where it is needed quickly.
The hospital has plenty of Level 3 masks, those that get the majority of use on any given day, with 3,400 currently on hand and 1,700 on order, she said.
N95 masks, the tighter-fitting ones that filter out at least 95% of large and small airborne particles and that are a first line of defense when caring for a patient infected with COVID-19, are well-stocked. Olsen said Mission’s warehouse holds 2,400 boxes of such masks, 20 to a box, making for a total of 48,000 currently available for drawdown.
“We’re thankful that we have not had to use an abundance of this precious resource,” she said.
Patrick, the hospital CEO, said employees are monitored as they arrive for work by screeners looking for symptoms of COVID-19, inquiring whom the employee may have been in contact with, taking employees’ temperature and then sending them to a primary care or in-house provider if their temperature has reached 100.
Coronavirus testing
Since February, Mission has provided space for patients who are known to be infected with COVID-19 or who are under investigation for the disease, said Anthony Spensieri, the hospital’s chief medical officer.
As of March 29, Mission was providing inpatient treatment to two confirmed COVID-19 cases and was caring for a total of 122 patients under investigation, Mission Health said in a recent public filing.
On Monday’s call, Hathaway, Mission Health’s chief medical officer, would only say that about “a dozen or so cases of proven COVID-19” have led to hospitalization across Mission’s six-hospital system.
Spensieri said Mission uses two types of in-house testing when working with COVID-19 patients: a molecular test with a 45-minute turnaround time and batch-testing of 48 samples at a time, with a three-hour turnaround.
While the medical community, elected officials and many members of the public would like to see universal testing become available, that is not in the cards at present due to the late start in developing and deploying a sufficient quantity of test kits, panelists on the call said. More widespread community testing can occur only when reagents — the substance used in a chemical reaction to detect other substances — become more plentiful in the marketplace, Hathaway said.
In the absence of universal testing, local and state officials are to be commended for mandating social distancing, he said. “It’s made a huge difference.”
Elective surgery
In March, Mission cut back on elective surgery and other nonurgent procedures in an effort not to diminish the supply of personal protective equipment that would be needed during a surge in COVID-19 cases.
That decision, informed by guidance from the Centers for Medicare & Medicaid Services and the N.C. Department of Health and Human Services, also had the benefit of not inadvertently exposing those already in the hospital to individuals possibly having asymptomatic infections stemming from the new coronavirus, which causes COVID-19.
Panelists on Monday’s call suggested that elective surgery and nonurgent procedures could start to be reintroduced “over the next weeks” if the COVID-19 curve flattens.
“We’re not out of the woods by any stretch of the imagination,” Hathaway said.
Overcoming fear
As Mission Health continues to care for COVID-19 patients, staff members are also expressing concern about members of the public whose fear of contracting the disease may prompt them to delay necessary treatment for other health issues.
In a call to WWNC talk radio earlier Monday, Angela Solesbee, a registered nurse at Mission, asked listeners who may be displaying symptoms of a heart attack not to give in to their fears and avoid the hospital.
Those who think they may be having a heart attack should call 911 immediately and be transported to the hospital by an emergency medical service crew instead of having a family member or neighbor drive them there, she added.
Common symptoms of a heart attack include tightness of the chest or in the arm, lightheadedness, shortness of breath, unusual fatigue and nausea.
“We want these people to come in and we want to give them the care that they need,” Solesbee told her listeners.
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