‘Strained at every level.’ COVID-19 pressures already burdened Chicago hospitals

Roseland Community Hospital has operated at about 90% of capacity each day since nearby MetroSouth Medical Center closed last year.

And that’s before the coronavirus outbreak hit.

So Roseland, a so-called safety net hospital that serves predominantly low-income families on the city’s far South Side, is now bracing for a wave of patients to come through its doors.

“I think even a single hospitalized COVID-19 patient causes an overburden for us because it brings staffing issues and concern of the virus transferring to other people,” said Dr. Terrill Applewhite, chairman of the Roseland’s COVID-19 task force. “Even though we are facing this crisis, we are still dealing with everyday ailments.”

In that sense, Roseland is not alone. And it’s not just bed space about which hospitals are concerned.

Hospitals across the state and country are being burdened with setting up drive-thru testing sites — tents outside their buildings to keep people potentially stricken with the virus away from the general patient population.

And then there are worries about whether there will be enough ventilators for potential severely ill patients, as well as masks and other personal protective equipment for staff.

Five of Roseland’s eight ventilators — three of which the hospital just received — were in use late last week.

None was being used by COVID-19 patients. That could change rapidly.

‘Preparing for a pandemic’

Danny Chun, a spokesman for the Illinois Health and Hospital Association, said there are supply issues throughout the health care system. So much so the advocacy group has pleaded with construction companies, dentist’s offices, universities and others to donate supplies of N95 respirator masks to hospitals.

“The health care delivery system is being strained at every level,” Chun said. “Hospitals are already taking care of patients and using the limited supplies they had, but now they are left preparing for a pandemic.”

Chun said there needs to be more of an effort to protect hospital workers from the virus by getting them the correct protective gear, and there needs to be more emphasis on preparing rural hospitals that are already operating on thin margins.

“As the number of COVID-19 patients needing hospitalization increase, the supply pressure will only ramp up over the next few weeks,” Chun said.

A outdoor triage tent at Edward Hospital’s emergency room in Naperville, Friday March 20, 2020. | Brian Ernst/Sun-Times

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COVID-19 testing area at Northwestern Hospital, Friday, March 20, 2020. | Tyler LaRiviere/Sun-Times

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A outdoor triage tent at near the emergency entrance at Swedish Covenant Hospital, March 20, 2020. | Brian Rich/Sun-Times

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Drive-up testing for COVID-19 at Advocate Lutheran General Hospital in Park Ridge, Friday morning, March 20, 2020. | Ashlee Rezin Garcia/Sun-Times

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COVID-19 testing area at University of Chicago Hospital, Friday, March 20, 2020. | Tyler LaRiviere/Sun-Times file

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COVID-19 testing area at Roseland Community Hospital, Friday, March 20, 2020. | Tyler LaRiviere/Sun-Times

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A sign indicating Edward Hospital’s emergency room parking lot is closed in Naperville, Friday March 20, 2020. | Brian Ernst/Sun-Times

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COVID-19 testing area at University of Chicago Hospital, Friday, March 20, 2020. | Tyler LaRiviere/Sun-Times

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Dr. Brian Stein, the associate chief quality officer at Rush University Medical Center, couldn’t give the exact number of ventilators the Rush network has but said it is fortunate to have more ventilators than most hospitals.

He’s not sure if the spread of the virus will overburden and cause shortages, “but at the same time, ventilator shortages are a concern for everyone.”

Rush’s network of hospitals was among the first to establish outside testing/triage centers in ambulance bays with tents.

Stein said the network has canceled all elective surgeries and only life-saving operations are taking place.

The hospital is now using empty surgical floors to treat patients and deploying surgical nurses to assist with the growing number of patients. It is working to increase the number of staff.

Ashlee Rezin Garcia/Sun-Times

At Sinai Health System, an infectious disease control team is tracking developments. A physician at Mount Sinai Hospital tested positive for COVID-19 Friday morning.

“We are looking at all options for handling a surge of patients at Mount Sinai Hospital and Holy Cross Hospital, including using mobile triage trailers outside the building to handle patients with respiratory issues,” said Dan Regan, a spokesman for Sinai Health System. “We have also put plans in place to isolate patients in re-purposed rooms in our hospitals.”

Regan said the health care system is working with other hospitals to establish an agreement to transfer patients in the event they become overburdened. Despite this, he’s optimistic Chicago’s medical system will be up to the task.

“We anticipate that most of of the people we will see with COVID-19 will not require hospitalization,” Regan said.

Still, the hospital is monitoring its supply chain and working to preserve its supply of masks and ventilators.

Tyler LaRiviere/Sun-Times file

Hunkering down

Back on the South Side at Roseland, the hospital has taken a number of measures, including re-purposing rooms, establishing an outside screening center and bulking up staff, in preparation of the virus spreading exponentially in the coming weeks.

Roseland also has “hunkered down,” closing all entrances except for two to better monitor the flow of people entering and leaving the facility.

Applewhite, the aforementioned head of the hospital’s coronavirus task force, said by Wednesday the hospital’s drive-through COVID-19 testing site will be fully operational; the hospital should be able to test people for the virus and deliver results within two-and-half hours. Current testing can take up to 10 days for results.

It has cleared out its medical-surgical overflow unit and turned it into an isolation wing for COVID-19 patients; the closed unit is separated from the rest of the hospital.

All elective surgeries have been canceled.

Applewhite said the hospital has received additional gowns, face shields, gloves and masks from the Illinois Department of Public Health. He was confident in his supply level but said that could easily change if the hospital is overwhelmed.

There are other needs, though; the hospital is having difficulties finding just one additional medical infrared thermometer.