Charlotte hospitals are at war against coronavirus

As the number of COVID-19 cases climb, hospitals are bracing for a surge sometime between mid-April and mid-May.

To meet expected demands, Novant Health and Atrium Health are planning to set up a field hospital on the campus of UNC Charlotte within “a matter of weeks” that will be able to accommodate up to 3,000 patients.

Known cases in Mecklenburg County: 665. In North Carolina, at least 2,585 people have tested positive. Thirty-one state residents have died of coronavirus-related complications, including six in Mecklenburg.

Hospitalizations: 261 coronavirus patients are currently hospitalized in N.C. In Mecklenburg County, one in five patients have been hospitalized at any point in time since the diagnosis. The Charlotte area has 40 percent of the state’s hospitalizations.

Data: On Wednesday, the state released new data about demographics, ventilator and PPE supply, and hospital bed counts as it relates to the coronavirus pandemic. You’ll see these numbers throughout this guide.

Testing: 40,045 tests have been completed in North Carolina by the state lab and reporting hospital and commercial labs. About 15,000 people await results.

Due to a shortage of supplies, not all who are sick are being tested at this point. North Carolina is concentrating its available supplies on those who have the greatest need like hospitalized individuals, healthcare providers, and individuals and employees in senior care facilities.

“The federal government did not provide enough supplies and tests across the country to be able to do the kind of testing we need to do,” says Governor Roy Cooper in a press conference on March 25.

This is in accordance with the Centers for Disease Control and Prevention’s recent guidance on testing priorities. Other countries like South Korea, however, have been successful at “flattening the curve” by taking a different approach: test early and often. According to the New York Times, Korea has tested far more people than any other country, and it’s paid off.

Stay at home order: All state residents are under a stay at home order except for “essential needs” like grocery shopping and picking up prescriptions — or going to work if you are considered an essential worker. (Questions? Check out this FAQ document we created for you.)

This is the latest and most drastic measure taken to control the spread of coronavirus thus far. It is modeled after a similar orders in San Francisco and Illinois.

The order is an effort to prevent our hospitals from being overwhelmed.

“The reason that this pandemic is so scary is that it absolutely has the ability to overwhelm our healthcare system in a short period of time,” says Kimmery Martin, an emergency medicine doctor-turned-novelist.

Just prior to the coronavirus pandemic, Martin spent a half-year researching viral outbreaks for an upcoming book, spending months with experts at the Centers for Disease Control and Prevention.

“You would have to decide who can get by without immediate care and who can not,” Martin says of a situation where the hospitals become overwhelmed. “And in worse case scenario, you’d have to decide who doesn’t get care.”

Preparations at Charlotte’s hospitals:

Restrictions: 

• In order to limit exposure and slow spread, Atrium, Novant, and Wake Forest Baptist announced on March 17 that non-essential surgeries, procedures, and ambulatory appointments are to be rescheduled.
• Hospitals have also restricted visitors. For example, no visitors are permitted in Novant’s acute care facilities except for one visitor for laboring mothers and for patients who are minors.

Personal protective equipment (PPE): Doctors, nurses, and other healthcare workers are on the “front lines,” Martin said. When caring for those with COVID-19 (among other infectious diseases), care workers often need PPE.

As of April 1, the state has not received a majority of the supplies its requested from the national stockpile. It still needs N95 masks, gowns, gloves, face shields, and more.

Local hospitals like Atrium and Novant have said supplies are sufficient right now, but that is likely to change. In the meantime, they’re accepting donations of gloves, masks, and other protective equipment. Some manufacturers, especially those in textiles, have already begun to switch to producing needed masks.

“We know right now that it’s the Wild West out there in trying to buy this equipment,” said Cooper on March 25.

Ventilators: COVID-19 is an acute respiratory disease, so a ventilator is sometimes necessary in serious cases to help a patient breathe. But local hospitals might not have enough if the virus continues to spread.

As of April 1, there are 2,818 ventilators in North Carolina and 691 are in use by patients (not specific to COVID-19).

Hospital beds: The state has lifted restrictions on hospitals to allow them to add and relocate beds into hallways and other spaces that meet federal safety requirements in the event of surge. Between the two largest hospital systems in Mecklenburg County — Novant and Atrium — there are 2,164 acute-care licensed beds.

In the state, there are 18,972 total inpatient hospital beds and 7,473 remain empty. There are 3,223 ICU beds and 856 remain empty.

With the field hospital, the Charlotte area could accommodate up to 3,000 more patients.

Triage tents: These aren’t as worrisome as they sound. Triage tents are a way to help screen sick individuals before they enter a healthcare facility to protect other patients as well as care providers. Novant and other healthcare providers use these.

Staff: Even with enough ventilators, PPE, and beds, hospitals are also preparing for a possible staff shortage. As more cases crop up, healthcare workers are at risk of contracting the virus.

How does testing work?

The availability of the coronavirus test is still limited, according to Harris. “We would like to provide widespread testing if we could,” she said Thursday. “I don’t see that happening anytime soon.”

On Thursday evening, LabCorp announced it now has the capability to perform 20,000 tests a day — a huge leap from where the North Carolina-based company stood last week. As state and local officials, as well as hospitals and labs like LabCorp, are able to test more widely, we should expect to see more cases.

Feeling sick?

• Step one: call your primary care doctor. Don’t go to the emergency room unless it’s an emergency. Your doctor will ask about your symptoms, travel history, and who you have been in contact with to see what the next steps may be.
• If you don’t have a primary care doctor, call the Mecklenburg County public health department’s hotline: 980-314-9400.
• You can also use virtual care services through your health insurance plan or through hospitals like Atrium and Novant Health.

Testing criteria: Not everyone who wants a test can get a test, Harris said. North Carolina recently loosened the criteria for those who get tested. An individual must have one of the following:

• A fever or lower respiratory symptoms (like a cough or shortness of breath) and close contact with a confirmed patient

• A fever, lower respiratory symptoms, and a negative rapid flu test

Where to go: That depends where your doctor or local public health department sends you. Atrium, Novant, Tryon Medical, and other local healthcare providers are operating screening clinics. Some have added triage tents outside of emergency departments to screen individuals for COVID-19.

One testing site is at Charlotte Motor Speedway, in partnership with Atrium. Here, patients can stay in their cars and be swabbed within a matter of minutes. The samples are then tested at Atrium’s in-house lab and results are typically available in 24 hours. Atrium says it has the capacity to test about 1,000 samples a day. Upon its March 24 opening, the speedway became the first professional sports venue in the U.S. to serve as a remote testing site during the coronavirus pandemic.

What the test is like: A patient is swabbed in the nose and/or throat. It’s not comfortable, but it’s quick. Buzzfeed News has a helpful article that explains what happens to the swab from there, and a Post and Courier photographer in South Carolina recorded the testing process.

Cost: The COVID-19 test is free, thanks to a bill passed by Congress, but you may have a copay or a bill for other tests run.

Timeline: In some cases, it will take a while to get results back — as long as three days to an entire week. We asked two people what the testing process was like: one person got results back in one day. Another person is still waiting for results five days later.

For those with coronavirus: If you test positive for COVID-19, but don’t require hospitalization (most don’t), you will be required to isolate yourself under an order by Harris. For the next couple days and weeks, you will be called by the health department to check in on your symptoms and to ask about your known contacts. You’ll remain in isolation until you have two negative tests 24 hours apart or have no fever for at least 3 days. Ultimately, listen to your doctors and the health department for instructions. Everyone is a little bit different.

Glossary

There are many terms I had never heard before I started reporting on the coronavirus pandemic, and the list grows every day. Here are some of the most common terms you need to know:

Community spread — “Community spread means there is at least one case where we don’t know how someone contracted COVID-19. They didn’t have contact with someone who has tested positive or travel to highly impacted area,” according to N.C. Department of Health and Human Services.

Coronavirus — Coronavirus is actually a large family of viruses that cause illnesses, including the common cold, MERS, and SARS. This present strain, “novel coronavirus” or COVID-19, is new to humans, meaning we needed new tests and still need a new vaccine.

Flattening the curve — What experts are most concerned about in the spread of coronavirus is exponential spread, basically when we go from 2 cases to 4 to 16 to 256 and so on. If you picture that in graph form, the cases create a steep curve. In order to prevent overwhelming our healthcare system, experts say we have to “flatten the curve” through social distancing measures. The New York Times recently released these charts that show which countries are flattening the curve.

Isolation — If a person is ill or tests positive for coronavirus, and it doesn’t require hospitalization, he or she is given an isolation order. Essentially, stay home and don’t make contact with anybody.

PPE — This stands for “personal protective equipment” like masks and gloves.

Social distancing — Maintaining a minimum distance of 6 feet away from others.

Quarantine — Quarantine is different than isolation. People who are well can be placed under quarantine if, for example, they returned from a cruise. Here’s a further explanation.

Ventilator — A machine designed to help patients breathe by mechanically moving air in and out of the lungs.

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