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One year later, what NGHS professionals have learned after COVID 'war zone'
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Northeast Georgia Medical Center Registered Nurses Cheyenne White and Kim Metzdorf check on a COVID patient Friday, March 12, 2021, in the COVID critical care unit of the Gainesville hospital. - photo by Scott Rogers

Walking through the COVID-19 critical care unit, Cheryl Bittel thought back to what the last year has been like. The word that kept coming up: a war zone.

“We went through a war zone chaos, just supplies everywhere, to being so much better,” said Bittel, a clinical nurse specialist and interim nurse manager, about the ways they’ve adapted through lessons learned.

When you step off of the elevator into Northeast Georgia Medical Center’s COVID-19 critical care unit, one of the first signs you might see informs you to grab an orange mask at the charge nurse desk if you are transporting a COVID-positive patient.

As you round the corner, the medical staff is weaving through the hallway where the doors are adorned with yellow hangers holding gloves.

A bulletin board of cards drawn by children encourage the staff with phrases such as “Thank you,” “You’re awesome,” and “You can do it.”

Two seemingly conflicting virtues — consistency and adaptability — were some of the key attributes for the staff, Bittel said.

“That’s been the most important thing to me is having consistent people who want to take care of these patients and who appreciate the good work that they’re actually doing here,” she said.

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Northeast Georgia Medical Center Registered Nurses Cheyenne White, right, and Kim Metzdorf check a COVID patient's continuous renal replacement therapy machine Friday, March 12, 2021, in the COVID critical care unit of the Gainesville hospital. - photo by Scott Rogers

The Times toured part of the COVID unit Friday, March 12 with NGHS officials.

Saying the pandemic is not yet over, chief of medical staff Dr. Deepak Aggarwal said there is still more to learn this year about COVID-19 variants and whether there will be “flu-like adaptations and activity in the fall and winter.”

“At NGHS, our people were amazingly flexible as they adapted spaces, processes and mindsets to provide high-quality care backed by the latest research and knowledge from our peers on the frontlines,” Aggarwal said in a statement. “Moving forward, we’ll continue to place an emphasis on that ability to adapt and overcome – as well as the importance of being in a positive position clinically, financially and culturally – to weather unexpected crises. That will play out in several ways, from how we monitor our (personal protective equipment) supply chain to how we build/renovate facilities to be flexible.”

Aggarwal said the pandemic “challenged” them to serve patients through telehealth which they can now use “to provide care to so many more patients especially in underserved areas.”

“I hope it will also have a lasting impact on people not taking their health for granted,” he said. “The pandemic highlighted why it’s so important to have a healthy immune system, stay mentally and physically fit and strive to find balance in life. That’s something we can all be reminded of from time to time.”

Northeast Georgia Physicians Group and The Heart Center now have video visits, and more virtual health options will likely be expanded in the future, according to NGHS officials.

NGHS reported 55 confirmed COVID positive patients across the health system Friday, March 12, with another 35 patients awaiting test results. Most of those patients receiving care — 32 — are at the Gainesville hospital.

Seeing only two digits for NGHS’ COVID data is a far cry from the peak for NGHS on Jan. 8, when there were 355 patients receiving care and there was a rolling seven-day average of 35.79% of people testing positive.

NGHS spokesman Sean Couch said the severity of cases has “proportionately declined” as the number of hospitalized patients has declined.

“The percent of the COVID-19 cases requiring (intensive care unit) care has remained more or less stable over the past few weeks,” Couch said.

Dr. John Delzell, the NGHS incident commander, said the command schedule has gone from being open 24/7 to an hourly meeting a week but said they will ‘stand at the ready” if and when it is needed.

But when will it be “normal” again?

“We continue to look to the 5% testing positivity rate that the World Health Organization considers to be a good target before completely reopening communities,” Delzell said in a statement. “Our rate hasn’t been below 5% since we started tracking it in April, though we were very close in May. We’re getting very close again now, but there are some indications that the rate is plateauing – so we’ll keep a close eye on it.”

On Friday, the positivity rate at the health system, which serves Hall and surrounding counties, was 6.57% and has hovered between 6-8% for the entirety of March. The rate measured by the Department of Public Health has dropped below 5% for Hall County alone, though it was 5.1% on March 13.

But getting below the 5% rate is not the only thing to consider, Delzell said.

“We’ll need to continue monitoring the case rates, which have also dropped considerably, as well as vaccination rates and data about the new strains,” he said. “We’re taking all of those factors into account as our clinical teams make decisions about when to update visitation guidelines and policies.”