- File Photo - Laurel Brauns
- The entrance to the emergency department at St. Charles Medical Center in Bend on a snowy afternoon this winter.
So far, St. Charles has been underwhelmed by COVID-19 cases but is ramping up for the worst-case scenario.
“So far [St. Charles Medical Center in Bend] has discharged six patients from the ICU and currently has nine COVID-positive patients who are hospitalized, and four who are in the intensive care unit," said Dr. Jeff Absalon, the chief physician executive for SCHS. More people have been coming into the hospital this year for general respiratory illnesses but testing negative for the virus, he said. He expressed some concern that new patients were delaying trips to the hospital because of fear of the illness or the belief that the hospital is overrun, but he emphasized the hospital is still open for people with health concerns other than COVID-19.
The hospital has three to four weeks of supplies of personal protective equipment based on today’s usages but could come up short in the event of a COVID-19 surge, Absalon said.
“We continue to be impacted by disruptions in production and high global demand,” Absalon said. “N95 masks [medical grade masks] and isolation masks are our most challenging items to source.”
Absalon said the hospital was grateful for all the PPE donations from the community. Since launching its 10,000-masks campaign last week for hand-sewn masks, it has received over 3,800 homemade mask donations.
- Screenshot via Central Oregon Emergency Information Network
- Presenters at "St. Charles COVID-19 Update" on Thursday. Clockwise from top left: Bend PD Officer Camille Christensen (sign language), Jeff Absalon (chief physician executive for St. Charles Health System), Julianne Repman (Bend La-Pine Schools District director of communication and safety), Michael Johnson (senior data scientist at SCHS), Joe Sluka (CEO SCHS), Jenn Welander (chief financial officer for SCHS).
Testing ramps up
St. Charles has tested nearly 1,000 people so far and confirmed 801 negative results, 33 positive cases (nine who are currently at the hospital), and it is waiting for 137 pending test results. As the Source reported last week, St. Charles has to send samples to the University of Washington and does not get results back for 48 hours. It has been difficult for the hospital to obtain testing supplies because Central Oregon has not been a high-priority region, officials there said.
Starting Friday, St. Charles will be able to do some tests on site. While it had this capacity for some time, it was waiting for re-agents (chemicals needed to mix with throat/nose samples) to arrive at the hospital. Once its own testing is up and running, the turn-around time for results will be just a few hours, Absalon said.
With the new testing capacity, St. Charles is expanding its testing criteria. So far, it has used the guidelines from the Centers of Disease Control and Prevention.
“We [now] have the opportunity to test anyone that has worsening symptoms,” Absalon said. “We encourage you to go to your doctor. This will help us identify who has it, how we isolate them, and how we can manage this disease.”
In addition to worsening symptoms, the patient must have also had a fever above 100.4 F in the last 24 hours and either a cough or chest pain.
The hospital will test for COVID-19 antibodies in the asymptomatic population in the future, but this is part of a long-term strategy and will not be available in next two weeks, Absalon said.
Preparing for a Surge
The hospital is prepared with adequate workforce and medical supplies if COVID-19 cases surge in the region. It can increase capacity and convert rooms to COVID-19 patient rooms at all four of its locations in Central Oregon (Bend, Redmond, Madras and Prineville). It is prepared to repurpose outpatient and visitor spaces and can double the inpatient beds in the hospital, Absalon said.
- Mike Johnson, the senior data scientist for SCHS
- St. Charles will need approximately 15 additional ICU beds for COVID-19 patients by April 27.
“We are very early in this battle with COVID-19,” said Mike Johnson, the senior data scientist at St. Charles. “[Some people are worried] we are lagging behind the rest of the state. Lagging is a good thing because we were able to jump on it by changing public behavior, adhering to social distancing and canceling large events, closing schools and washing hands.”
“We will not see our peak resource use in the next three weeks,” Johnson said while presenting a chart showing that Central Oregon is at a flat point in his projected local case curve. “By the end of April, the curve is on an upward trend.”
“Now is the time to double down,” Johnson said. “Early efforts return an exponential payback if you do it early enough in this curve. Although we’ve done very well, we do have room to improve; we could flatten the curve even more.”
Will St. Charles survive?
St. Charles Health System has enough cash and liquid investments on hand to run for eight months without revenue, according to Jenn Welander, St. Charles’ chief financial officer. Since March 16, the hospital system’s revenue dropped by 45%, largely as a result of delaying elective surgeries. It recently drew on its line of credit.
At the same time, the hospital’s expenses went up as it paid for COVID-19 preparedness and continued to pay employees for their scheduled shifts.
In order to conserve cash, the hospital suspended all capital projects unrelated to safety, regulations and preparation for the COVID-19 surge. All non-essential spending has stopped and contract work discontinued. The hospital suspended employee educational travel through the end of August. It is trying to get discounts and payment extensions from its vendors.
“We are continuously evaluating all available [funding] opportunities,” Welander said.
Funding opportunities include advanced payments from Medicare and a 12-month interest-free loan from Medicare, emergency funds from the Federal Emergency Management Agency and funds for worker safety through the State Accident Insurance Fund Corporation. The hospital is also trying to settle contracts with insurance companies from last year instead of waiting until the end of the standard collection period.
Welander is waiting on the details from the federal government about how to apply for the Coronavirus Aid, Relief, and Economic Security (CARES) Act, but said she expects to find out within the next few days.
The president of St. Charles, Joe Sluka, closed the meeting by encouraging people to donate to the St. Charles Hero Fund run by the St. Charles Foundation or to the Deschutes First Response Fund managed by the Deschutes County Sheriff’s Office.
Have questions about how St. Charles is handling the coronavirus crisis? Put them in the comments below! We are in frequent contact with sources at St. Charles.
In the meantime:
COVID-19 local trivia – Quiz your friends!
(Answers provided by Dr. Jeff Absalon of St. Charles Health System)
- Can St. Charles help patients from other places if that region’s hospitals become overloaded?
St. Charles is the designated regional hospital by the Oregon Health Authority for region seven in Oregon which includes Central Oregon’s four hospitals as well as Sky Lakes Medical Center in Klamath Falls, Lake District Hospital in Lakeview, Blue Mountain Hospital District in John Day and Harney District Hospital in Burns. This consortium can sent patients and resources to one another when needed.
- Are employees at St. Charles who are not working on COVID-19 laid off? Are St. Charles employees safe at work?
St. Charles has not laid off any medical workers even though elective surgeries have been canceled for the coming months. All caregivers who provide direct patient contact at the hospital must wear masks, and the hospital is working hard to conserve its supply of PPE.
- Are doctors in Central Oregon prescribing their patients the anti-malaria drug hydroxychloroquine along with the antibiotic azithromycin? President Trump has touted this as a miracle cure, but some people in Central Oregon need these drugs for other illnesses and are worried there may be a shortage.
St. Charles is using this combination for some patients at the hospital with COVID-19. The Oregon Board of Pharmacy does not allow doctors to write prescriptions for these drugs for outpatient use.
- What percentage of people with COVID-19 are carrying the illness but present no symptoms?
Twenty percent of COVID-19 carriers have no identifiable symptoms, 60% will have symptoms consistent with the flu, 20% will have significant illness and require hospitalization and 5% will end up in the ICU.
- What is the mortality rate for COVID-19?
Mortality rates range by country from 1-12%, but the global average is 3%.
See all our Coronavirus coverage at our Coronavirus HQ.