Front Lines: Pandemic an ‘unprecedented time’

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The COVID-19 pandemic sweeping its way around the world has put a lot of stress on the nation’s healthcare system, not only in large urban areas, but also at many small rural hospitals, where beds are scarce and resources may be harder to come by. Perry County Memorial Hospital is no exception. Dr. Matthew Gaeta, the chief medical officer at PCMH, said this pandemic is like nothing he’s seen before. “This is an unprecedented time,” Gaeta said. He said PCMH’s doctors and nurses are following enhanced protocols to prevent or at least lessen the chance of exposure during their daily duties, but even so, it’s a stressful time. “It makes us all nervous about the degree of illness that has entered our community,” Gaeta said. “We see the stories about the virus and how it’s affecting larger cities on the coast. Personally, I am so proud of our entire hospital staff’s response. Everyone in the hospital and clinics has been tirelessly preparing.” PCMH — which can stretch its 25-bed capacity to roughly 30 given the lifting of licensure regulations during this national emergency — was initially cooperating with other rural and tertiary hospitals in a strategy to maintain the rural hospitals as “clean” facilities to be able to off-load the metropolitan facilities of non-infected patients, therefore expanding the metro hospital’s capacity to care for COVID patients. That regional strategy changed at the direction of the metro hospitals. Now rural facilities will be maintaining the Person Under Investigation (PUI) and COVID positive patients until a time the patient needs more advanced medical support. Such support is similar to what is provided in intensive care unit settings and ventilator care rehabilitation hospitals. On Monday, April 6, PCMH opened an isolated unit that has the capacity to care for 8 patients who are PUI or COVID positive. The unit is isolated from the hospital with negative pound-per-square-inch ventilation, and each room is further isolated from the unit’s common spaces with negative psi ventilation which exits the room exhaust to the exterior. All PUI and COVID-19 positive patients at PCMH will be cared for in this special unit with the goal of keeping the medical surgical floor of the hospital as an environment reserved for non-infected patients and those not under investigation. This strategy is expected to remain effective up until the time the hospital’s units exceed capacity or metropolitan facilities stop accepting PCMH referrals. Additionally, the hospital continues running a testing clinic for the virus based on referrals from primary care physicians. “We are trying to keep as many people away from the hospital as we can,” Gaeta said. “We want to limit those groups, but we are starting to see more people coming into the hospital and treating them. People are so in tune with their body right now that anything that feels different is on the forefront of our mind.” As of Tuesday, April 7, there were more than 3,000 positive cases of COVID-19 in Missouri, with the United States reporting more positive cases than any other country, nearly twice as many as Spain, which is reporting the second most confirmed cases. Also on Tuesday, the Perry County Health Department reported 31 local cases since March 21, along with eight recoveries. Gaeta said the pandemic has brought with it many changes to everything from the way people interact to the way they shop, and added that it’s important to pay attention to the recommendations regarding self-distancing and staying at home unless it’s absolutely necessary to go out. “I really haven’t gone too many places in the past couple of weeks,” he said, “but when I’m driving home, I still notice that there are too many cars in parking lots. It’s so important for everyone to stay home right now, and only make quick trips for essentials.” Perhaps most telling are the changes in how people seek medical care, including telehealth screenings, in which patients speak with physicians online or over the phone before making an in-person appointment. Gaeta expects some of those changes might stick around after the pandemic has subsided. “I think in the future that telemedicine and things of that nature will be a lot more common,” Gaeta said. “There will be things that we learn from this epidemic that will become part of our mainstream medical management.” In the meantime, Gaeta urges residents to continue practicing good hand-washing techniques and social distancing. “This is a real illness that is dangerous to a large portion of our community,” Gaeta said. “We know the virus is in Perry County, its highly contagious and it can make you extremely sick!” Until the pandemic finally wanes and restrictions are lifted, Gaeta said he and his family are staying home, even if it isn’t very exciting. “My boys and I are heartbroken because there is no Cardinals baseball,” Gaeta said. “But instead, we have nightly wiffle ball games in the front yard, and that’s been a lot of fun.”