The outward signs of a pandemic, especially the masked-up workers, were in every corner of the hospital.
And then there was the unseen, pent-up emotions from those on the front lines battling COVID-19.
In a tour of Northeast Georgia Medical Center Gainesville last week, Elizabeth Larkins, nursing director for critical care, saluted staff.
“They are the ones who are with (patients) when they die, giving them that love up to the very last minute,” she said, surrounded by staff in personal protective equipment. “We’re getting through this together.”
The hospital opened its doors to The Times and other media on Friday, May 15 — the day of Gov. Brian Kemp’s visit to a COVID-19 medical unit being built on the grounds — giving journalists a behind-the-scenes look at operations, including the lab, emergency room and floors where patients are being treated.
Optimism bubbled among workers at the hospital that the pandemic was beginning to loosen its grip, but staff, many wearing full protective equipment, were still in battle mode.
“Fortunately, we’ve been able to stay ahead of the curve, with the resources we’ve gotten from the state and local businesses, sharing PPE and other things,” said Dr. J. Clifton Hastings, chief of medical staff. “We are now seeing a slight decrease in the curve, so that’s very encouraging.”
Numbers from the Georgia Department of Public Health showed that as of Tuesday, May 19, Hall had 2,191 confirmed coronavirus cases and 40 deaths.
Also, NGHS is treating 99 patients with confirmed cases — a steep drop from the peak of 159 on April 29.
Hastings said the pandemic has forced adjustments at the hospital.
“We are learning a lot. A lot of the things we took for granted have changed and we have to do things in a different way,” he said. “So, we’re living and learning. That’s what you have to do in any business, but certainly (it’s true with) health care with all the unknowns we’re facing, at this point.”
Much of the change has been physical in nature, with the addition of mobile units and the construction of the medical unit, which is scheduled to open May 26.
The mobile units have been used for those presenting with respiratory conditions in order to prevent exposure of other patients and staff.
“We wanted to get them up early so we could start putting patients through it before we reached any potential surge or maximum capacity, so we could work out our processes,” said Dr. Corey Duncan, medical director for NGMC Gainesville’s emergency department.
“We wanted to make sure what we were doing was streamlined and providing the best care with the resources we had.”
The unit yet to open will be used to treat noncritical COVID-19 patients.
“It also gives us more beds and staffing should we have to get creative, should the numbers start to rise again,” Carol Burrell, CEO of the Northeast Georgia Health System, has said.
Also, potential COVID-19 patients are seen in a special, negative-pressure room in the emergency department. Like other treatment areas in the hospital, the door is branded with a bright red “Restricted Area No Access” sign.
“We see patients with respiratory symptoms,” said Leah Wallace, nurse manager for emergency services. “In this area, we have brought additional supplies and equipment so that nursing staff can stay in this area and not have to come in and out.”
The hospital has testing done at an Alpharetta lab, but last month, the hospital was able to more quickly test people showing more serious signs of the coronavirus.
“We’re a trauma center, so there are some who can’t wait the 24 or 48 hours it takes to send (specimens) to Alpharetta,” said Jo Brewer, executive director of laboratory services.
Results come back in as soon as 45 minutes, she said.
But supplies of the test, made by California company Cepheid and cleared by the Food and Drug Administration in March, are limited.
“We only have enough to do about 50 (tests) a day,” Brewer said. “They’re still ramping up production.”
Another 15-minute test has emerged on the market, but researchers have reported that its results miss up to half the infections caught by the Cepheid test, which Brewer described as “a good one.”
Supplies, such as masks and other protective equipment, are stored in a room at the hospital where Vanessa Cortez works as a “strider,” or someone who helps deliver supplies throughout the hospital.
“Volume has gone up, but our inventory control specialists have been on point with the changing amount of donations we have received and the supplies we have to order,” she said. “It’s really heartening to see the community donating and telling us we’re their heroes.”
When the work becomes too draining, hospital staff can draw support from NGMC’s spiritual care team.
“Just like the rest of the hospital, we have had to be flexible in doing the work we do,” said Trey Morrison, pastoral education manager, in a garden area just outside the hospital chapel.
The hospital has an internal phone number family members and staff can call “to talk to somebody who is trained to (give) emotional and spiritual support,” he said.
Chaplain interns also serve both COVID-19 patients and family, who can’t see each other because of the disease.
“It’s been an interesting learning process,” Morrison said. “The students are having some great conversations with people.”
“As far as our team of chaplains in the hospital,” he added, “one of the unique challenges we’ve had is to provide support for people at the end of life. We’ve set up a family support team where we use iPads (tablets) and Zoom (teleconferencing) … so they can see their loved one. If we have to do any rituals of closing or support, then we do that there.”
One thing the hospital has done to boost morale is “Code Believe,” or playing the Journey song “Don’t Stop Believin’” over the public address system whenever someone with COVID-19 has been discharged.
“It’s a positive for me … because we are on the front lines and it’s scary at times,” registered nurse Missy Scott said in the critical care unit. “Hearing that (patients) are being discharged is encouraging for us.”