Porter transforms for virus surge, adds acute-care beds
MIDDLEBURY — Porter Hospital has doubled, from three to six, its number of “negative-pressure” rooms in anticipation of a surge in COVID-19 patients that could come within the next two weeks, officials said on Tuesday.
Negative-pressure rooms are designed to prevent potentially contaminated air from spreading to other areas of the hospital. Lower air pressure in a patient’s room allows air to flow into the room but not escape from it.
While the local hospital’s census as of Tuesday included no coronavirus-positive patients, Porter officials are gaining experience with the malady, which has turned into a global pandemic. As of this writing, Addison County had seen 23 people test positive for the disease. Statewide, 293 people had tested positive thus far, and 13 have died.
Dr. Anna Benvenuto, Porter Medical Center’s chief medical officer, said the hospital’s affiliation with the University of Vermont Health Network will ensure greater resources should the county’s COVID-19 patient count explode. At the same time, Benvenuto and her colleagues are maximizing PMC’s capacity to care for locals. Officials are securing ventilators and other supplies to accommodate the most seriously ill.
“We are doing a lot of preparatory work, looking across the country and at other countries and at what they’ve seen, understanding we may come to a time in Vermont where our health system is overwhelmed,” Benvenuto said.
Porter faces the coronavirus crisis at a time when its census is much lower than usual, PMC spokesman Ron Hallman confirmed. Porter in recent weeks has been serving an average of nine to 12 patients per day, according to Hallman. As a critical access hospital, Porter is limited to 25 inpatients. The lower census is due to the current restrictions PMC has placed on elective and non-essential services, in anticipation of a spike in COVID-19 patients.
Tom Beauregard is a physician’s assistant at Porter Hospital. He’s worked there for 19 years, and currently serves as clinical director of PMC’s ExpressCare clinic, and leads the institution’s hospitalist program. Beauregard is part of a PMC team organizing the hospital for the coronavirus.
“Right now, a team of us has been spending a tremendous amount of time in the ‘preparation phase,’” Beauregard said. “We’ve spent time getting ready for what we refer to as, ‘The surge,’ when we expect to see an influx of patients with this disease.”
In addition to outfitting three new negative-pressure rooms, the team has been securing other helpful equipment and training staff for what could be some busy days ahead. It’s a forward-thinking posture, but it’s also turning back the clock to the days when Porter reserved space for very sick individuals.
“A number of years ago, we made the decision as an organization to take away our special-care unit, a level of nursing and care for super-sick patients,” Beauregard explained. “We have done an amazing amount of work during the past couple of weeks to bring that capacity back to Porter Hospital.”
Nurses are receiving tutorials in the gear they’ll have to wear for their protection, including gowns, face shields and varying degrees of face masks.
“COVID-19 is a respiratory disease, and it’s contagious,” he stressed. “We’re working to increase our education about our protective equipment, and how to properly put it on and take it off.”
Porter Hospital recently served two confirmed COVID-19 patients. Those patients have been discharged and no other coronavirus-confirmed individuals were being treated at the hospital as of Tuesday, officials said.
PMC last month instituted very strict visitation policies for the hospital and the adjacent Helen Porter Rehabilitation & Nursing. People must enter the hospital from the Emergency Department, where all — including PMC staff — are screened prior to admittance.
“It’s an adjustment,” Beauregard said. “But when we made the decision to route all entries through the Emergency Department, I think people started to feel a little more relaxed, that we were starting to control it.”
THOSE WITH SYMPTOMS
Porter has a drive-up COVID-19 testing service on its campus that can be used by people who first get a referral from their primary care physician. Patients undergo a nasal swab that’s sent away for testing.
The Vermont Department of Health (DOH) used to do all the testing, but that’s recently changed, according to Benvenuto. She said UVM Medical Center is now accepting all incoming swab tests for the entire state. Officials there assess the swab samples based on the accompanying patient profiles/symptoms. Some samples are then routed to the Vermont DOH, while others are relayed to testing labs at the Mayo Clinic and other medical institutions.
“We’ve seen a much faster turnaround time, because it took the work of triaging and freed up the DOH to run the tests and do the tracking that they need to do,” Benvenuto said.
What symptoms should you look for before seeking a test?
Fever — specifically a temperature of more than 100 degrees, a cough, and what some patients describe as “chest pressure” or “chest heaviness,” according to Benvenuto.
“Everyone should call their primary care provider first, and talk to them about their symptoms,” Benvenuto cautioned.
She acknowledged Vermont Health Commissioner Dr. Mark Levine has advocated for expanding testing, even to those showing mild or moderate symptoms. Benvenuto said Porter wants to follow that advice, though she noted tests are still in short supply.
“There are still testing supply shortages statewide,” she said. “There’s a goal of expanded testing and a desire to offer expanded testing, but we are not quite at the point yet of being able to test everyone.
“The situation changes every day,” she added. “The supplies go up and down. We are trying to do the most we can with what we have.”
When asked how Addison County residents could help healthcare providers in this time of crisis, Benvenuto gave a very basic answer.
“Stay home and wash your hands,” she said. “Those are the best things you can do to stay healthy.”
MASKS & RESPIRATORS
People can also help by donating and/or making masks. Most sought after are the N95 respirator masks used by Porter’s front-line workers. These masks are federally regulated and filter airborne particles. PMC has collected more than 500 of these masks from many generous community members, but more are needed. If you have any to donate, drop them off at the Round Robin Upscale Resale Thrift Shop in the Marble Works district Monday through Friday, 10 a.m.-4 p.m.
Porter is also now accepting hand-sewn masks to beef up a reserve supply. Those too should be dropped off at Round Robin. Specific instructions and links to make the masks can be found on addisonindependent.com at tinyurl.com/t9bqz2v.
Reporter John Flowers is at email@example.com.