"This isn't going anywhere if you go everywhere"

I started writing this the evening April 3, exactly one month since we opened the hospital Command Center. As I started to type this, the Johns Hopkins coronavirus resource center says worldwide we are just under 1.1 million cases of whom over 226,000 have recovered, and nearly 59,000 people have died. Of that, the US has almost 280,000 cases and 7,141 deaths. Oregon is at 899 patients and 22 deaths. By the time I finished writing this early on April 5, there are over 1.2 million cases (9% increase), including over 312,000 cases in the US (11% increase) and Oregon has 999 patients (11% increase) and 26 deaths (18% increase).

This post is getting very long so I think I’ll make it two posts: this one for “the environment” and another one for “me”.

Day to day life in Oregon still includes the shelter in place requirement (though exercise, grocery shopping and working at “essential” jobs are permitted). Schools are out, probably for the school year, and teachers are learning to do on-line teaching. This wouldn’t be news anywhere else, but Oregonians now pump their own gas. Grocery stores are still often out of toilet paper, hand sanitizer, antiseptic cleaners, flour and yeast, and it’s nearly impossible to have groceries delivered or even place an order for pick-up. There is lots of talk about masking in public, though at least with the expectation that medical quality masks should be reserved for health care workers.

It looks like Oregon has indeed flattened the curve. So much so that Governor Kate Brown “reallocated” the 140 ventilators she’d requested from the federal government to New York – a proud moment for Oregon both from the “we’re all in this together” / generous perspective and from the perspective that it’s likely the state has sufficiently flattened the curve that we would not need those vents. I’m awaiting the updated data from my favorite site, https://covid19.healthdata.org/, to see what the curve looks like.

A few of the things that Providence Health and Services, the organization I work for, is doing have been shared publicly in media, social media or other communications and therefore can be shared here:

•         “This isn’t going anywhere if you go everywhere. Stay home. Stay safe” is the theme of a media campaign.
•         Providence was the first health system to offer covid testing (I think my own covid test was performed by “us” on the day that service opened).
•        The eight Providence Oregon hospitals have provided care for over 25% of the state’s hospitalized covid patients, the plurality of them at the hospital where I work which is in the county with the highest number of covid diagnoses.
•         Providence is the first health system in Oregon to reuse facemasks – we use them and as long as they are not soiled or ripped they can be sent to a facility in Central Oregon to be refurbished for a total of three uses; employees are being encouraged to refrain from face makeup and lipstick in order for the refurbishing to occur.
•         Our visitor policy has undergone many changes, and while very different from the usual “anyone is welcome”, it is about the most permissive in the area: video visits are encouraged though non-covid patients (including moms giving birth) may have one designated visitor for their entire hospital stay who must be in good health and at least age 16 and covid patients generally may not have any visitors though there are exceptions such as a goodbye at end of life.
•         Everyone entering any Providence building has their temperature taken and is asked about symptoms.
•         The organization continues, with gratitude, to accept PPE from the community.
•         The scope of things that have changed and/or teams are working on is staggering – in addition to the things mentioned above, all elective surgeries are cancelled (and even things like cancer surgery and appendectomies are extremely limited as medical interventions are tried first), changes in sick time policies, ongoing PPE training (because things change every couple of days), changing units to cohort patients with covid and patients awaiting results of their covid tests, surge planning in case the number of hospitalized patients starts to look like Italy or New York, and a whole bunch of other things I either didn’t think to share or cannot share.

Before I got sick, I was part of the team that did some preliminary work for the temperature-taking. There are lots of entrances to the hospital building, we were encouraged to select two(!) to keep open and close the others. This building is hardly tiny – it’s over a 1km walk (about 2/3 of a mile) around the building, something that’s nice to do on pleasant days – so two entrances wasn’t quite doable and we settled on four. Aside from coming to grips with such a massive shift, there were numerous details to work through including supplies, staffing, scripting, hours of operation, signage, communication to staff, communication to patients and visitors, deciding when to make it happen, etc.

The support healthcare is receiving from the community is heartwarming. Many people are going outside at 7pm to cheer and make noise to support first responders and health care workers. The Washington County sheriffs did a lights and siren salute/drive-by at the hospital on Monday which I’m told touched people so much it brought them to tears (see #Providenceheroes). Many teams have received thank you meals from the community; the command center which is next to my office received a nice table with snacks and beverages from the local professional soccer organization (Portland Timbers and Thorns, whose home matches are at Providence Park).

It’s also amazing to see how many local businesses are retooling to make PPE. Necessity truly is the mother of invention. I realize that altruism is an element of why many are doing this, and I also realize that it’s a good business decision. It’s good for the companies to be able to generate some money (though some are donating the PPE or only charging for the raw materials) and some positive press as well as have “work” for their employees. Nonetheless, it’s remarkable to see it happen!

In a future post I will talk about some of the amazing collaboration I’m seeing during this pandemic, but this post is getting quite long and it’s rather late so I will just sign off here.