When COVID-19 broke out, hospitals became overwhelmed with patients and with determining how to give them the best care while mitigating the spread of the virus. This was only exacerbated by state and federal guidelines that put further limits on hospitals.
Solano County was in a unique situation, as its hospitals had to react about a month before the virus was officially declared by the World Health Organization as a pandemic. At NorthBay Healthcare, that response came in February when Travis Air Force Base was designated by the U.S. Department of Defense as a quarantine location for American travelers and embassy workers returning from China. During this time, NorthBay was chosen as a “destination hospital” for those being quarantined, NorthBay spokesman Steve Huddleston wrote in an email.
“During this time, NorthBay’s team worked closely with representatives from the Centers for Disease Control and Prevention, the California Department of Public Health and Solano Public Health, developing safety protocols that are now used all over the world,” he said.
Christopher Walker, physician-in-chief for Kaiser Permanente Napa/Solano, also said the potential dangers of COVID became apparent in the area very early on. In addition to the evacuees at Travis — which also eventually included those aboard the Diamond Princess and Grand Princess cruise ships where major outbreaks occurred — Vacaville was home of the country’s first case of person-to-person transmission, and the patient was transferred to the University of California, Davis, Medical Center in Sacramento.
“Very early on, probably before the rest of the country really started to think about it, we knew that this was something different that was going on (compared to past outbreaks),” Walker said. “It actually ended up being fortunate for us because we started to integrate a lot of the preparations and the plans early.”
At NorthBay, Huddleston said the pandemic “forced us to re-engineer many of the ways we delivered care to patients, many of whom could not come to their physicians’ offices and some who feared leaving their homes during the months under stay-at-home orders.”
One of the biggest changes for NorthBay was the opening of its second urgent care center just outside the Solano Town Center in March. Both this new urgent care center and the existing one in the Nut Tree Plaza became testing hubs for outpatients, Huddleston said, allowing NorthBay to share its findings with local convalescent hospitals and skilled nursing centers and teach them to test employees and residents.
NorthBay also increased its telehealth program, which was being piloted prior to COVID, but which Huddleston said exploded afterward, with more than 70 providers being trained and equipped in just one week. Physicians also posted video messages to provide information, the “Doc Talk Live” lectures were converted into Facebook Live chats and nurses began making house calls to senior patients and delivered necessities ranging from medicine to oxygen tanks to toilet paper back when the latter item was at its highest point of scarcity.
Other changes included drive-thru testing at the Coumadin Clinic, a curbside vaccination clinic during flu season and providing a drive-thru COVID test at the Ambulatory Surgery Center to clear patients for elective surgery.
Ilia Silas, a nurse in Kaiser’s Emergency Department, said several CDC guidelines were implemented to protect staff and patients, including barring visitors, frequent hand-washing, wearing face coverings and limiting the number of staffers in certain areas. Kaiser also set up drive-up pharmacies and tents for vaccinations.
Walker also said there was a shift to telehealth and video health, although in-person care is now available again for those who prefer that option. He said staff was continuing to adhere to guidelines.
“We now have safe entrances with temperature checks (and) safety checks,” he said. “We do pre-calls with our patients to make sure that they’re feeling good and are going to the right place.”
All agreed that the most difficult period was in December when the state experienced a surge in cases and a decrease in intensive care unit bed availability.
“Some days were busier than others, making sure that we communicated our bed situation coordinated with making sure we kept the pulse on the whole community knowing what was available where and staying on top of it to make sure we don’t go into a crisis situation,” Silas said. “I think it was handled very well, being that we had a command center to manage that to make sure there was a proper through-put and patients were on the floors that they needed to be in.”
Walker said Kaiser received a lot of patients in the aftermath of the holidays.
“That’s where we saw the hospital patients go way up, and the staff was pretty impacted because of the amount of care we were delivering and just the intensity of the care,” he said.
However, Walker said the curve has decreased.
“We’re feeling much better,” he said.
Huddleston said the ICU reached capacity during this period, so beds were installed and overflow patients were cared for on the second floor of the Fairfield campus’ newest wing, which was completed in Oct. 2019. He said there was also a critical shortage of ICU nurses, causing the unit at the Vacaville campus to be closed.
“There simply wasn’t enough staff for two units, so the decision was made to isolate and care for all COVID-19 ICU patients in the Fairfield hospital,” he said.
Finally, a new “surge unit” consisting of 10 overflow beds was created to provide availability for patients when regular beds were filled, Huddleston said.
Another critical month for NorthBay was August, when the region was impacted by wildfires, Huddleston said. It was during this time he said the Fairfield hospital began accepting evacuees from Sonoma County hospitals, including nine patients from St. Helena Hospital.
“Our year was filled with stories of courage and commitment; an understanding of the big picture and an appreciation for details; hard work, lots of research and always a dedication to our patients,” B. Konard Jones, NorthBay’s president and CEO, said in a statement. “No one is sorry to see the end of 2020. But some of its stories and lessons should not be forgotten.”
With two different vaccines making the rounds in Solano, Silas said they represented “a ray of hope” and “a light at the end of the tunnel.” With more businesses opening up under the red tier, she recommends continuing to follow the guidelines by social distancing and wearing masks.
“That keeps one more bed open for us to provide emergency medical care to the community,” she said. “When your turn is up, please strongly consider getting your vaccine, but also know that it’s safe for you to come to our emergency room.”
Huddleston said vaccinations have gone well, with more than 15,000 doses administered to residents, firefighters, emergency medical technicians and teachers as of the second week of March.
Silas said the work of health care professionals has been “amazing.”
“It has grounded a lot of us back into why we came into this field,” she said.”When most people turn away from situations like this, we come running. We answer the call. I feel that we’ve been the bridge for a lot of patients, being that family members haven’t been able to visit. We’ve been able to comfort them, talk to their family members, give them updates.”
Sometimes, Silas said health care workers have even been “the last hand that somebody’s held” or enabled patients to deliver their final words to family members through video technology.
“I believe it’s been truly amazing how our health care professionals have stepped up during this time,” she said.
Walker echoed these sentiments.
“I feel really proud to be amongst and one of those people who call health care their mission,” he said.
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March 18, 2021 at 09:07AM
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Coronavirus: Hospitals implement changes, step up to provide care - Vacaville Reporter
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