Points in Time

Tomorrow, May 3, is the 2-month anniversary of the day we opened the hospital’s command center. 

It's very nice to see that the number of COVID patients has dropped from 30+ a few weeks ago to under 5 this past week; the turnaround time for COVID tests used to be a few days and is now a few hours so the number of persons under investigation (PUIs) is also very low. Thanks to community donations and the teams that secure our supplies, we always had enough PPE and other supplies to provide care for patients and protection for employees. Our care teams didn’t have to make any horrendously anguishing decisions about which patients would receive a ventilator, critical care bed, admission, or medications. We were one of the hospitals that participated in a phase 3 remdesivir study.  

Last week I spent Monday and Tuesday days assigned to the command center. I spent most of that time, plus time later in the week, figuring out the optimal staffing for the temperature-monitoring stations. I think I shared earlier that we had 4 entrances open – to my surprise, and the surprise of our CEO, I learned that we actually had 6 entrances and also provided a temperature-monitoring station in a non-contiguous building on the campus. I walked a few thousand steps, mostly outside because it was beautiful weather, on Monday touring all 7 sites and talking with the staff to see how busy they were, how many people they thought they needed at what times of day, etc. After lots of discussions, we have a new plan starting Monday, closing one entrance and modifying the staffing at most of the others. It's kind of fun sometimes nice to pop in to address an issue, explore and understand it, make recommendations, get approval, make sure everyone who needs to know the plan and their role knows it, and then step away. 

As of today, Oregon has confirmed 2,635 COVID cases, including 109 deaths among the 4.3 million residents. The US as a whole is over 1.1 million cases and over 67,000 deaths among 330 million residents. So while Oregon is 1.3% of the US population, we have only 0.24% of the COVID cases, and 0.16% of the deaths; Oregon’s COVID mortality rate is 4.1% compared to the US mortality rate of 6.1% – for the non-statisticians in the crowd that suggests that not only are Oregonians less likely to have confirmed COVID, they are less likely to die of it if they do have it. Some of this is that Oregon is geographically large and doesn’t have much high-density housing; some is that Oregonians have done a good job flattening the curve.

Indeed, the curve has been sufficiently flattened that Governor Kate Brown is allowing hospitals to perform elective surgeries up to 50% of pre-COVID volumes as of May 1. As she said, “‘non-urgent’ does not mean ‘minor’” – there’s a whole process to prioritize patients based both on their condition and the timing of their originally-scheduled procedure.  Patients will be tested for COVID prior to surgery, hospitals need to have sufficient PPE on-hand, and hospitals have to maintain 20% capacity available should there be an increase in COVID patients – the last of which will be a challenge for a hospital that has “lived” at well over 90% capacity for the past several years. Waiting rooms are being redesigned to maintain social distancing. I’m looking forward to the day when the hospital corridors don’t feel like a ghost town. It will still seem strange to wear masks in the hallways.  

Officially, other elements of the Stay Home, Save Lives order are not changing – social distancing, teleworking when possible, schools closed for the academic year, restaurants closed (take-out and delivery are permitted), and drive for “only essential” trips – for at least a couple of weeks, until we know whether there is a spike in COVID cases, hospitalizations or deaths. Traffic is definitely increasing, hopefully people are continuing to do social distancing when they are visiting with friends and family; the two such in-person visits I’ve had so far have followed social distancing protocols.

Tomorrow is also a much happier anniversary. It’s the 20^th anniversary of the first geocache, which Dave Ulmer placed near Portland (technically near the small town of Estacada) on May 3, 2000 after selective availability was removed. I’m looking forward to commemorating the occasion with some geocaching friends via Zoom. I hope others for whom this is a date worth celebrating have equally appropriate plans.