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Hospitals adapt for the coronavirus

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BRATTLEBORO — Vermont hospitals are putting a priority on dealing with the coronavirus and are mandated to suspend non-essential surgeries and procedures.

"Like all hospitals, we are preparing for an increase in volume of COVID-19 patients and have taken many actions in this regard," Gina Pattison, director of development and marketing at Brattleboro Memorial Hospital, wrote in an email response to the Reformer.

On Monday night, Pattison said the hospital had enough tests to keep up with demand for now.

"However, there's not an easy answer since we don't know how many people will get sick and therefore, how many will be enough," she said.

The hospital also had enough masks at the time. Pattison said staff members are all using personal protective equipment responsibly.

"We have had an outpouring of support from the community asking if they can provide handmade masks, which we very much appreciate and will accept," she said.

Andrea Seaton, director of development and community relations at Grace Cottage Hospital, said screening is done at hospitals and samples are sent to the Vermont Department of Health laboratory in Colchester for coronavirus testing.

"We have plenty," she said of the sample kits during an interview Tuesday night.

The hospital also has "plenty" of masks but is accepting donations, Seaton said.

"We've had lots of people dropping them off," she said. "We're ensuring our medical staff has medical grade, certified masks as they're providing patient care. But we we appreciate all of this work that the community is doing."

Gov. Phil Scott updated his emergency order Friday to include the suspension of all non-essential adult elective surgery, and medical and surgical procedures until April 15. He declared a state of emergency in response to COVID-19 a week earlier.

Scott is taking steps to control outbreaks of the coronavirus and limit the spread of infection. He also wants to conserve "critical resources" including ventilators and personal protective equipment, according to the order.

When deciding whether to perform surgery, Scott is asking clinicians to consider the current and projected number of COVID-19 cases in the facility and region, the supply of personal protective equipment, ventilator availability, health and age of the patient, and urgency of the procedure.

BMH announced how it would be adapting its operations.

"The changes we have made, and will continue to make, will prepare us for the challenges ahead," Steve Gordon, president and CEO of BMH, wrote to community members last week in an email update about COVID-19.

A new outpatient testing site was set up outside. If experiencing a fever or cough, people are asked to call their primary provider to see if testing is needed. Those without a primary care provider can call the hospital's centralized scheduling department at 802-251-8777 to arrange an appointment.

Gordon said the hospital is "working on rapidly implementing teleheath capabilities" for outpatient visits.

Visitors are no longer allowed in the hospital but exceptions will be made at the discretion of the hospital. Those exceptions include one parent or guardian for a patient under the age of 18, one birthing partner for a patient in labor, one person at a time for a hospice or end-of-life patient, one clergy member for an end-of-life patient, and one caretaker for a completely dependent patient.

Starting Monday, the Richards Building entrances at the hospital will be closed to all traffic. All patients and visitors are required to enter through the main entrance, where they are greeted and screened. The emergency room entrance remains open. All other entrances are going to be locked for entry. All exit doors will remain available as part of fire code regulation.

The Lobby Cafe was closed starting Monday. The Maple View Cafeteria is only open to employees, patients and visitors.

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Volunteer services, cardiac rehabilitation services and student rotations were suspended. Construction of the Ronald Read Pavilion is postponed until June. And all outside meetings, support groups and non-essential internal meetings are canceled.

Grace Cottage Hospital in Townshend shared similar communications.

"We are working hard and diligently to stop the spread of COVID-19, while continuing to provide high-quality medical care and to protect the safety of our community, including patients, their families, and our employees," Doug DiVello, Grace Cottage Family Health & Hospital president and CEO, wrote in an email to community members Tuesday. "By helping yourself and your loved ones, you will be helping everyone. On behalf of all of us at Grace Cottage, thank you so much for your generous and overwhelming outpouring of support, which has been offered in so many different ways; it has truly been humbling for me and for everyone here. We will get through this, by working together. "

At the time of the communication, DiVello noted that the Vermont Department of Health was aware of five residents of Windham County who have tested positively. At that time, Grace Cottage had tested 63 people for COVID-19 and only one came back positive.

"This patient, who had been in a 'hot zone' out of state prior to testing here last week, was tested in our drive-up testing area and never entered our facility; the patient has been quarantined at home," DiVello wrote.

The Grace Cottage Family Health clinic was divided into two sections, according to the email. One is isolated from all other patients with an airflow system preventing the recirculation of air to the rest of the building and will be for patients with respiratory illnesses or systems, and the other is for all other patients.

Grace Cottage Hospital has "negative pressure rooms" where patients with COVID-19 can be treated in isolation from the rest of the hospital, the email states.

"Should a COVID-19 patient develop severe illness requiring critical care, we have relationships with regional hospitals to allow transfer to their Intensive Care Units," DiVello wrote.

Grace Cottage is requesting all providers assess all well visits and non-urgent appointments to determine the best way to care for patients. A system was developed for patients to have video-based meetings with their medical provider. Phone calls also are being arranged.

Visitors will not be permitted to see hospital patients until further notice. But exceptions may be made for immediate family of patients in end-of-life care.

Grace Cottage closed its hospital cafeteria until further notice. It also reduced the number of public entrances to three: the Emergency Department, Outpatient Services (lab and diagnostic imaging), and the main entrance of Grace Cottage Family Health.

"Patients with symptoms will be given a mask immediately, and staff will take appropriate actions to ensure the safety for all patients, visitors, and staff," DiVello wrote.

Grace Cottage suspended its volunteer program, all non-essential meetings and all meetings held on site by outside groups. Its Messenger Valley Pharmacy is closed to foot traffic but will be providing curbside service at the store, deliveries and mail service for prescription and over-the-counter needs.

Reach staff writer Chris Mays at cmays@reformer.com, at @CMaysBR on Twitter and 802-254-2311, ext. 273.

Related coverage:

-- Scott steps up fight as COVID-19 cases rise

-- Vermont House passes virus response legislation

-- Meredith Burt, RN: Common questions on novel coronavirus

-- A message from Windham County delegation


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