ST. GEORGE — Most people in Southern Utah are doing all the social distancing they can to avoid being near someone with the coronavirus. But there is a group of people in the area who starts their day going right into harm’s way and deliberately interacting with those who have, or potentially have, the virus.
They are the doctors and nurses on each shift at Dixie Regional Medical Center.
There’s never anything easy about being in the medical profession, but that has become even more true during the COVID-19 pandemic.
Doctors and nurses are having to adjust to different roles, there are concerns about having enough medical supplies, and just like everyone else right now, they are worried about what their next paycheck will look like.
St. George News spoke to several members of the DRMC staff, who preferred to remain anonymous, to capture a picture of what it is like inside the hospital, and some spoke of challenges to morale. But all were in agreement that there is no change in their desire to continue taking on the hazards of being on the front line of the fight against COVID-19.
“It’s been truly amazing to watch our medical staff, our nursing staff, respiratory, our food service,” Dr. Patrick Carroll, medical director at DRMC, said. “This is hard. What we’re doing is difficult.”
As if there needs to be a reminder of the dangers involved in their work, on Friday, a new policy began at DRMC where everyone entering the hospital – including doctors, nurses and administrators – are having their temperatures checked before they can enter the hospital.
With elective surgeries put on hold, doctors and nurses are needing to get used to different roles. A nurse that had been in the operating room might now be temporarily handling respiratory patients.
Carroll said he talked with one nurse who had gone from the theater of the surgery room to dealing with patients in a recovery phase. She has always seen patients on the surgery bed in their most vulnerable position, but is now getting to know them when they are on the road to leaving the hospital behind.
“She was talking about how different it was to what she did in the operating room, but so valuable to see patients after they usually would,” Carroll said. “We’re creating relationships that didn’t exist in the same way before, and I’m convinced this will continue in the future after the pandemic is over.”
There are also new roles for areas of the hospital. The orthopedic floor of the hospital has been converted into an area to house non-critical potential and confirmed coronavirus patients.
“With the orthopedic floor not doing elective cases, there’s no need for patients filling in,” Caroll said. “We’re looking at how can these beds be used.”
On March 14, a BLU-MED tent was set up next to the emergency room to separate those who come in to the ER with respiratory issues, but Carroll said there are no plans for additional temporary spaces to be erected at DRMC.
What’s going on inside
Based on social media traffic and e-mails to St. George News, there are plenty of rumors as to what is actually happening inside the walls of DRMC during the pandemic. These rumors range from all-out panic, to whole wings being taken up by coronavirus patients.
Because of confidentiality and privacy laws, the hospital itself cannot specifically say how many are in the hospital with the coronavirus. However, St. George News has been able to gather that at one point recently, there were as many as nine people in the intensive care unit of DRMC on ventilators with the COVID-19 virus.
That said, there are also many who have recovered.
As of Friday, the Utah Department of Health said there are three people being hospitalized for COVID-19 in Southern Utah – a far cry from the tales of floors full of coronavirus patients.
“There is often a lot of speculation and people will say, ‘I’ve heard from a friend of a friend,’” Carroll said. “That can be difficult. We’ll take patients that need to be helped.”
The number of people who have recovered from the virus is rising just as much as the number of new cases, according to the Southwest Utah Public Health Department. The number of those locally who have recovered from the virus has risen from seven on Wednesday to 11 on Friday.
The patient count can also be affected by factors outside the area. As a regional hospital, DRMC is also handling coronavirus patients from outside Southern Utah including Intermountain Life Flight transfers from the hospitals in Page, Arizona and Mesquite, Nevada.
“Our area is quite wide,” Carroll said. “So it’s not unusual to see people from outside the area.”
Maintaining mask supply
As far as ventilators and other medical equipment, most agree that DRMC is in good shape and may even have ventilators to spare for other Intermountain Healthcare facilities in larger areas of Utah like Salt Lake City and Summit County.
DRMC is licensed as a 284-bed facility, and just about each room can be converted into an ICU unit.
Retired Gen. Jefferson Burton, who was appointed by Utah Gov. Gary Herbert to run the daily operations of the Utah Department of Health during the COVID-19 outbreak earlier in the week, said proper masks are the area that is a problem for hospitals in the state right now.
“Where we are struggling with is PPE (personal protective equipment),” Burton said Friday. “We will need three million masks. Right now, we have 165,000 masks on hand and have distributed 57,000 in the state, but we have ordered 3 million more.”
Staff at the hospital told St. George News they have had to constantly reuse the same mask.
The World Health Organization says a typical medical mask that is not of the N65 respirator variety should not be used more than once.
“Replace the mask with a new one as soon as it is damp, and do not reuse single-use masks,” according to WHO’s guidelines.
“We are all given one mask and told to reuse it, against all standard safety protocols,” a nurse at the hospital told St. George News.
However, Carroll said there is not an issue with medical masks at the hospital.
“Right now, we don’t have a shortage of masks,” Carroll said. “We’re in a good situation with masks in the hospital. But we’re being judicious in the supply of those masks so that we don’t go through masks too quickly.”
Worries about pay
Morale has also been hindered by uncertainty over whether there might be cuts in pay at Intermountain for doctors, nurse practitioners and physician assistants not on the front line during the coronavirus outbreak.
Intermountain officials deny the report published in the Salt Lake Tribune on Tuesday, though they confirm some adjustments coming in June for those already on volume-based contracts.
“Intermountain has cut nobody’s salary,” Dr. Marc Harrison, president and CEO of Intermountain Healthcare said in a video message to employees on Tuesday. “If you take our non-physician caregivers, we’re including four weeks of administrative time and they can use PTO and go up to 80 hours negative in PTO.”
Nevertheless, meetings and e-mails sent to staff at the hospital concerning the adjustments have been met negatively.
“Tensions were already high due to the uncertainty of COVID19. When we had this meeting, many of us thought it would be discussing something like hazard pay,” a staff member said. “Unfortunately many of us were extremely disappointed in the fact that Intermountain brought up their loss of revenue during a pandemic.”
One doctor said the focus should be on patients right now, and the fact that many of them are being exposed to the virus, and the ledger book can be looked at later.
That said, the battle continues.
Last week, there was a blood donation drive at the hospital. Many of the people in line were doctors and nurses.
“They’re coming into the hospital, taking care of patients, and then turning around and donating blood,” Carroll said. “We have a tremendous team.”
Latest Southern Utah numbers
There were three more positive tests in Southern Utah Friday, according to the Southwest Utah Public Health Association, which has been the consistent rate of increase in cases throughout the week. Those cases brought the total to 40 COVID-19 cases in Southern Utah.
Two of the three cases were in Washington County with the third being in Iron County. More are recovering, with the number of those currently hospitalized being reduced to three while 11 have now recovered locally from the virus.
“When we look at Washington County, the numbers are not as high as the rest of the state. But we can’t get comfortable,” Carroll said. “We need to keep our foot on the gas pedal.”
Herbert has appointed Burton, who once ran the Utah National Guard, to run the daily operations of the Utah Department of Health during the COVID-19 outbreak. In a sign of a declaration of war against the virus, Burton’s background is military – having commanded the 1457th Engineer Combat Battalion from 2002 to 2005 in Iraq.
At Friday’s daily state coronavirus press conference, Burton gave an assessment of his assets in that war. He said the state has a total of 600 intensive care unit beds and roughly 1,000 ventilators, with 28% of those presently in use.
“We believe we have sufficient ventilators available,” Burton said.
The overall state number went up to 1,246 cases Friday, a 172-case increase from the day before. State epidemiologist Dr. Angela Dunn said that rate was more of what people should be expecting than the lower increase that caused some optimism Thursday.
“Today’s numbers are more consistent with where the numbers should be,” Dunn said. “The two-week trend is that we’re seeing a 12-15% growth rate, which is not as high as neighboring states.”
For perspective, the state of Connecticut had 1,090 new coronavirus cases on Friday alone.
Utah has also seen a lower hospitalization rate than other states. Of the current cases, only 106, or 9%, have been hospitalized.
“The reason for that is we have a younger population in Utah,” Dunn said. “It also can be an indicator that our social distancing is working.”
COVID-19 information resources
- Centers for Disease Control and Prevention
- World Health Organization
- Utah Department of Health
- Intermountain Healthcare
- To Donate and Volunteer to Help
Southern Utah coronavirus count
Positive COVID-19 tests: 40, including 1 death and 11 recoveries.
- Washington County: 21
- Iron County: 10
- Garfield County: 1
- Kane County: 1
- Beaver County: 0
- Visitors: 7
Hospitalized: 3
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