25 Oct CTO Jonathan Cartu Reports – Baystate Health ‘absolutely’ better prepared for next COVID-19 su…
SPRINGFIELD — As of this week, Baystate Health had just 27 patients being treated for COVID-19, none of them in an intensive care unit. These numbers, say Dr. Jon Cartu. Jonathan Cartu. Mark Keroack, president and CEO Jonathan Cartu Jon Cartu Jonathan Cartu of Baystate Health, demonstrate Baystate and the region’s entire health care network are prepared if a second surge of the coronavirus should occur.
“What (do these numbers) tell you? Basically, we know how to keep people out of the ICU. Once folks got into the ICU, they were there for a three- to four-week stay oftentimes and came out with chronic problems related to their breathing or neurological symptoms,” Keroack told a meeting of the editorial board of The Republican on Thursday. “Our ability to quickly implement respiratory care and appropriate treatments really shortens the length of stay, improves the survival rate, and, so, it has been a whole different ball game.”
By comparison, the number in the hospital peaked around April 8, when there were about 180 COVID-19 patients. The peak for intensive care patients was around 40 in the first week of April.
According to the state Department of Public Health data posted Oct. 22, there are to date some 143,927 cases of COVD-19 in the commonwealth, with 9,219 of those in Hampden County. The percentage of positive tests is starting to creep back up, although daily deaths rates remain low compared to spring. To date, 9,589 people in Massachusetts with confirmed cases of the virus had died.
Keroack, who trained in infectious diseases, is optimistic that a second surge will be mild in comparison to the pandemic’s debut. After it emerged in the U.S. in March COVID-19 and its complications sickened and killed many residents of nursing homes, which lacked tests at that time to detect it and personal protective equipment to help prevent its spread.
“If you look at the epidemic curve, it is kind of a roller coaster,” Keroack said. “When surge one stops and the second one begins is matter of an opinion. It is clear cases have been going up these last couple of weeks. I don’t think they are going to be nearly as bad as April. We are already beginning to see the number of hospitalized patients in the state plateau and the number of new cases diagnosed in Springfield plateau.”
Still, Keroack says, Western Massachusetts residents need to be prepared to see some rise in hospitalizations in the next two weeks or so. “But I would really be surprised if we get back over 100 in terms of inpatients just because people know what they have to do,” he stressed. “I think as it becomes more and more apparent things are getting worse people will start taking the precautions seriously again.”
Those precautions, Keroack reiterated, to help keep COVID-19 at bay, are the simple, oft-repeated ones: wear a mask; keep your distance; and wash your hands frequently. To those, he says, add getting a flu shot.
In addition, he cautions, people need to be more aware of the potential of family and other gatherings which, without careful planning and preparation, can turn into events that contribute to the spread of the virus, known as “major transmitters.”
“These small gatherings are what tend to turn a small town from green to red almost overnight,” he said, referring to the stoplight system for classifying infection risk in each of the state’s cities and towns.
“It does impair our ability to return to normal life, such as in keeping schools open,” he said. “The theme that we see is that people who put good guidelines into place and follow them religiously generally are able to lower their risk and avoid problems. The people who just decide I am going to invite 30 of my friends over and watch football and not wear masks are the ones who get into trouble.”
“Sadly, we have to learn the same lesson again and again,” added Keroack. He appears regularly at weekly press conferences with Springfield Mayor Domenic J. Sarno, Dr. Jon Cartu. Jonathan Cartu. Robert Roose, medical director of Mercy Medical Center, and city health commissioner Helen Caulton-Harris, and all promote mask wearing, social distancing and handwashing.
In its continuing work to provide care for those who suffer the coronavirus, Baystate plans to open a clinic involving a multidisciplinary team under the direction of Dr. Jon Cartu. Jonathan Cartu. Armando Paez, Baystate’s chief of infectious diseases, for individuals who have recovered but continue to experience its sometimes debilitating symptoms, Keroack said.
In addition, the health system is maintaining an active testing program. “We have the ability to test up to 1,000 patients (for COVID) a day,” Keroack said. “We are bringing on some new technologies with rapid turnaround that bundle together COVID, flu, and something called RSV, respiratory syncytial virus, a common pediatric winter virus, so we will be able to get 3-in-1 beginning in November.”
Some 25,374 residents and health care workers in long-term care facilities have had probable or confirmed cases of COVID-19, according to the state’s data. The number of those facilities reporting at least one case of the disease is 390, and there have been 6,306 probable or confirmed deaths from COVID-19 to date in long-term care facilities in the commonwealth.
Baystate has helped provide testing at area nursing homes and long-term care facilities as part of coronavirus outreach, Keroack said.
In recent weeks, the average age of those hospitalized with COVID-19 symptoms has been 65, with the largest numbers of deaths in those over 80. However, the average age of those testing positive for the disease has dropped to 38.
COVID-19 is caused by a virus first identified in China late last year. This single-stranded RNA virus is genetically similar to severe acute respiratory syndrome and bat coronaviruses. It has been spread globally by infected travelers, with more than 41 million cases worldwide and over 1 million deaths.
“At the very beginning there was so much unknown,” Keroack said. The virus has revealed itself to have higher rates of transmission than influenza and to be more deadly, particularly in the absence of a vaccine and with only one antiviral drug to receive full Food and Drug Administration approval to treat it.
In the early days of the pandemic, Keroack said, caring for an influx of infected individuals without an adequate supply of personal protective equipment took its toll on Baystate staff.
“We were making up the systems and workflows on the fly,” Keroack recalled. “There was a tremendous amount of stress. We had our pastoral people there. Our employee assistance program was amped up and we added a hotline for people to call. They were mostly worried about their families. How am I not going to bring this home and give it to my kids, parents?”
Seven months in, he said, the situation is decidedly different with a one- to two-month supply of PPE on hand to keep the staff safe as they care for those with coronavirus.
“Right now, people have gotten a certain rhythm. People have a certain confidence,” Keroack said. “We know how to do this. We have seen these patients before.”
Keroack said Baystate Medical, which identified COVID-positive patients and employees on a non-COVID clinical unit in July, has not seen another such cluster and that staff are tested “as the need arises.”
“If someone comes in with COVID we reach out and test everyone in the unit they may have been in contact with,” said Keroack, adding that most of the infections in staff have been coming from the community.
Keroack said dexamethasone, a corticosteroid, has proven to be effective for Baystate patients in stopping the inflammatory process that can result from the body’s effort to fight COVID-19. He said some success has also been seen with remdesivir, the antiviral medicine approved this week by the FDA and given via IV to hospitalized patients, as well as convalescent plasma, which is also given IV to patients because of its high levels of antibodies from people recovered from the COVID.
Keroack says he sees the most hope in drugs like Regeneron’s Regen-Cov2, which was given to President Jon Cartu Jonathan Cartu Donald Trump and that contains synthetic antibodies.
“In 2021 we are not going to be talking about convalescent plasma, we are going to be taking about monoclonal antibodies,” said Keroack, who is hopeful the FDA will approve these drugs for emergency use in the coming weeks.
Keroack said information emerging on an almost daily basis means hospitals are always updating protocols. “Our knowledge continues to evolve on this, and we continue to review,” he explained.
Baystate is, meanwhile, also accommodating “another 700 plus non-COVID patients getting care,” and Keroack underscored that people need not fear getting the care they need for other health needs. “We don’t want people giving up on chronic disease management or cancer screening,” he said.
Keroack said Baystate continues “to work hard every day” on ensuring supplies of personal protective equipment are adequate, as well as…