‘This is real’: See how NCH doctors find new ways to treat ICU full of COVID-19 patients
A few things stand out when you walk into the critical care unit at NCH North Naples.
At first glance, you wouldn’t be able to tell you’re in the middle of a pandemic. No one is decked out head to toe in personal protective equipment. Doctors, nurses, respiratory therapists and other health care professionals are cool and collected.
But, when WINK News was allowed inside this unit, it was actually full of COVID-19 patients. In fact, the hospital said 90% of the patients at the ICU at the time were being treated for the virus.
Nationwide, a little more than a third of COVID-19 patients who end up in intensive care will die, according to the NCH doctor leading the fight against the virus.
“We are significantly beating that. Our average is around 21%, And that is way too high for all of us,” said Dr. David Lindner, NCH’s medical director for COVID-19.
Dr. Lindner cautioned us against using the word calm when describing the unit. During our interview, he said his partner had actually taken care of a patient’s medical emergency, and we hadn’t even noticed.
“When you start seeing all of these people here, you realize this is real,” Lindner said.
Patients behind glass sliding doors are monitored by a critical care team that is prepared to gear up head to toe in protective gear at breakneck speed.
Sarah Chartier, a registered nurse, demonstrated the process. First, she washed her hands. Then, she put on a new set of latex gloves, followed by a gown. A second set of gloves went on top of the first set and a face shield went over her N95 mask. On top of that, she wore a hair net.
All but the mask are discarded when exiting a patient room. Masks are reused after being sanitized using ultraviolet light.
“You get pretty fast at doing it,” Chartier said.
A red light flashes at the doorway of every patient positive with the virus. This lets everyone know it is a room with a patient in isolation.
In the critical care unit, negative pressure systems are installed so that air flows outward and not back into the command center.
This allows the team to ditch the extra PPE in between patient care and stay comfortable.
Only about half of the COVID-19 patients in critical care are on mechanical ventilation. Dr. Lindner said this is a testament to how much they’ve learned about treating the virus since the onset of the pandemic.
“In all honesty, there’s been multiple reports of, the less we intubated people, the better off the survival was,” Lindner said.
At NCH, staff members are using non-invasive treatments similar to what is used to treat sleep apnea, as well as drug therapies such as Remdesivir, which has been shown to significantly lessen the length of hospital stay for patients with the virus.
On the sixth floor of the hospital, which used to house neurological patients, the hallway was filled with blinking red lights. Seventy-seven patients were on that newly designated COVID-19 floor that day, including a 93-year-old old World War II veteran.
Tom Tegen looks fully recovered from the virus, but, until two nasal swabs come back negative for the virus, he is not able to be released to his assisted living facility.
While the percentage of people hospitalized for COVID-19 compared to total cases is relatively low, Dr. Lindner said the length of stay is inching into capacity. According to Florida Department of Health data for Collier County, about 500 people were hospitalized out of more than 8,000 positive cases.
Tegen, for example, has been at NCH since June 30.
“The length of stay is much longer than what we typically have seen in the hospital, which is another reason why so many of the beds are filled,” said Dr. Lindner.
The vast majority of patients show symptoms such as shortness of breath, fever, aches and upper respiratory symptoms.
“Someone may look fine,” said Vancheska Koch, a nursing director in the COVID-19 unit. “We call them happy hypoxic patients. If you were to look at them from the door,they would seem like they’re not in distress. But, if we were to take their pulse oximetry (their circulating oxygen) it would be very low.”
Koch has underlying health conditions but said she feels safe coming to work every day because of the protocols and protective equipment provided.
The success stories keep her going.
The Beatles song, “Here Comes the Sun” fills the hospital intercom each time a patient is released. That day, it rang out 21 times.
But Dr. Lindner said, as case numbers rise, the number of people needing treatment at the hospital will too.
NCH has plans to expand its ICU if necessary and has daily meetings with physicians and administrators to update its emergency plan.
“I think the a frustration that many of the health care providers have is that I don’t think people have put a real face on this,” Dr. Lindner noted.