ACCORDING TO THE BAKER ADMINISTRATION, THE PEAK OF
COVID-19 CASES IN MASSACHUSETTS IS SUPPOSED TO BE THIS WEEK
THROUGH APRIL 20TH.
THERE HAD BEEN SOME THOUGHT THAT WESTERN MASS MIGHT LAG BEHIND
THESE DATES, BUT THE CHIEF PHYSICIAN EXECUTIVE FOR BAYSTATE
HEALTH AND INCIDENT COMMANDER FOR COVID-19 SAYS THAT SOCIAL
DISTANCING MEASURES HAVE BEEN WORKING.
DR.
ANDREW ARTENSTEIN SPOKE WITH ME EARLIER TODAY ABOUT THE PEAK
AND MANY OTHER ISSUES SURROUNDING THE NOVEL
CORONAVIRUS.
>> IN THE HOSPITAL WE HAVE ABOUT 170 THAT'S ACROSS OUR SYSTEM SO
THAT'S ALL FOUR HOSPITALS BUT ABOUT 85% OF THEM ARE AT
BAYSTATE MEDICAL CENTER AND ABOUT 30 OF THOSE ARE IN THE
CRITICAL CARE UNITS AT BAYSTATE MEDICAL CENTER AND THOSE NUMBERS
HAVE BEEN PRETTY STABLE FOR THE LAST WEEK OR SO AND WE WERE AND
REMAIN ONE OF THE BUSIEST COVID HOSPITALS IN THE STATE OF
MASSACHUSETTS BUT WE HAVE MANAGED WELL TO KEEP PATIENTS
BEING DISCHARGED AND GOING HOME, WHICH IS A WONDERFUL THING, AND
ALSO TO KEEP MOST OF -- TO KEEP THE INPUT COMING IN AS WELL.
>> HOW MANY PATIENTS HAVE YOU TREATED WITHIN YOUR SYSTEM.
>> WE TREATED 450 PATIENTS SINCE EARLY MARCH.
IT'S BEEN ABOUT 5 WEEKS NOW AND THE VAST MAJORITY OF THOSE FOLKS
HAVE EITHER NEVER NEEDED TO BE ADMITTED OR WERE ADMITTED OR
DISCHARGED HOME AND ABOUT TWO-THIRDS FALL INTO THOSE TWO
CATEGORIES WHICH IS A WONDERFUL THING FOR OUR STAFF ESPECIALLY
TO DISCHARGE PATIENTS TO HOME.
>> AND LET'S TALK A LITTLE BIT ABOUT YOUR STAFF AND THE
PERSONAL PROTECTIVE EQUIPMENT, HOW ARE YOU DOING AS FAR AS ALL
OF THE THINGS THAT YOU WOULD NEED TO TREAT PEOPLE?
>> WELL, IT'S NOT BEEN EASY AS YOU KNOW THE NATIONAL STORY
UNFOLDS AS WELL.
WE'VE GONE TO GREAT LENGTHS TO PROTECT THE HEALTH AND SAFETY OF
OUR 12,500 CAREGIVERS AND THOSE WHO SUPPORT THE CAREGIVERS.
THAT'S THE NUMBER 1 OBLIGATION FOR US AS LEADERS IN ADDITION TO
CARING FOR THE PATIENTS THAT WE DO.
WE HAVE MANAGED AND WE'RE NOW IN REASONABLE SHAPE.
WE DON'T HAVE A SURPLUS BUT WE THINK WE HAVE ENOUGH AT LEAST
FOR THE TIME BEING.
WE'RE WORKING HEAVILY RIGHT NOW ON GOWNS BELIEVE IT OR NOT.
THOSE DISPOSABLE OR LAUNDABLE GOWNS ARE VERY, VERY SCARCE
THESE DAYS AND WE ARE CONTINUING TO SOURCE THOSE UNCOVERING EVERY
ROCK TO TRY AND FIND THIS MATERIAL FOR OUR HEALTH GIVERS.
>> CAN YOU TALK A LITTLE BIT ABOUT HOW IT WORKS IF A PATIENT
IS BROUGHT IN WHO IS SUSPECTED TO HAVE COVID-19, HOW ARE THEY
SENT TO A DIFFERENT PERHAPS PART OF THE HOSPITAL INSTEAD OF THE
EMERGENCY ROOM.
>> THE EMERGENCY ROOM IS THE POINT OF FIRST CONTACT FOR MOST
ILL INDIVIDUALS AT OUR HOSPITALS.
THEY GET TRIAGED APPROPRIATELY IN THE EMERGENCY DEPARTMENT AND
OUR EMERGENCY DEPARTMENT IS CRACKER JACK TO BEGIN WITH
BECAUSE IT'S SUCH A BUSY PLACE TO BEGIN WITH AND THEY GET
APPROPRIATELY MANAGED THERE AND ISOLATED, APPROPRIATE PERSONAL
PROTECTIVE EQUIPMENT IS WORN BY ALL STAFF AT ALL TIMES THERE
WHEN THEY'RE CARING FOR PATIENTS BECAUSE THERE'S A WIDE SPECTRUM
OF SYMPTOMS AND WE NEED TO BE SURE THAT THEY'RE TAKING
PRECAUTIONS WITH ALMOST ANYONE WHO PRESENTS WITH SYMPTOMS THAT
ARE IN ANY WAY CONSISTENT WITH THIS INFECTION.
THEN WE'RE ABLE TO MAKE A DIAGNOSIS NOW IN A MUCH SHORTER
TIME PERIOD THAN WE WERE COUPLE WEEKS AGO.
TESTING HAS EXPANDED.
WE HAVE IN-HOUSE TESTING WITH A TURNAROUND TIME NOW OF HOURS
INSTEAD OF DAYS SO WE CAN QUICKLY DISPOSITION PATIENTS
QUICKLY.
IF THEY NEED TO BE ADMITTED AND MAKE A DIAGNOSIS WHETHER THEY
HAVE THE INFECTION AND WE PUT THEM IN THE APPROPRIATE
ISOLATION TYPE OF ROOM WHERE THEY HAVE APPROPRIATE AIR FLOW
AND APPROPRIATE SUPPLIES AND EQUIPMENT AND WE'RE COHORTING A
LOT OF THOSE PATIENTS WHICH MEANS WE HAVE PATIENTS WITH THIS
INFECTION IN SEVERAL AREAS OF THE HOSPITALS BUT THEY'RE IN
SEPARATE AREAS FROM HOSPITALS THAT DON'T HAVE THIS INFECTION.
>> HOW MANY BEDS AVAILABLE DO YOU HAVE AT THE HOSPITAL?
>> I'M VERY PROUD OF OUR TEAM MEMBERS HERE AND WE HAVE GREAT
REASON TO BE PROUD BECAUSE WE HAVE CREATED A SURGE CAPACITY
MEANING STAFF APPROPRIATE -- APPROPRIATELY STAFFED BEDS BOTH
ACUTE CARE AND CRITICAL CONDITION BEDS TO THE TUNE OF
TWO-THIRDS THE NORMAL AMOUNT SO WE HAVE ROUGHLY ELEMENT 300
ACUTE BEDS WE HAVE AND ABOUT THREE TIMES OF OUR NORMAL NUMBER
OF CRITICAL CARE BEDS AND WE HAVE CROSS-TRAINED
MULTIDISCIPLINARY STAFF AND NURSING STAFF TO CARE FOR
CRITICALLY CARE PEOPLE.
>> YOU MENTIONED A SMALL PERCENTAGE OF PATIENTS ARE IN
CRITICAL CARE, TALK A LITTLE BIT ABOUT HOW SOME PEOPLE MIGHT
PRESENT WITH ALMOST NO SYMPTOMS AND OTHER PEOPLE WILL REALLY
STRUGGLE?
>> WELL, IT'S A GOOD QUESTION.
I'M AN INFECTIOUS DISEASE PHYSICIAN BY TRAINING AND CUT MY
TEETH IN THE BIODEFENSE AND BIOTERRORISM AREA SO WE'VE SEEN
PATIENTS ACROSS THE SPECTRUM WITH VARIOUS EPIDEMIC DISEASES,
SOME OF WHOM WHO ARE COMPLETELY ASTIMPMATIC AND SOME WHO ARE
CRITICALLY ILL.
THE SAME CAN BE SAID OF THE SAME INFECTION.
WE DON'T KNOW ENOUGH ABOUT THE ASIMPLE MATTICS OR THE PEOPLE
WITH VERY FEW SYMPTOMS BECAUSE AS YOU KNOW, WE HAVE ONLY BEEN
TESTING FOR A WHILE AND THE TESTING DOES NOT INCLUDE BLOOD
TESTING.
THE THING ABOUT BLOOD TESTING WHEN WE START DOING THAT WHICH
WILL BE IN A COUPLE WEEKS FOR ANTIBODIES, IT WILL TELL US HOW
MANY PEOPLE HAVE BEEN INFECTED WITH THIS VIRUS EVEN THOUGH THEY
MAY NOT HAVE HAD SYMPTOMS.
WE DON'T KNOW THAT NOW.
WE CAN JUST GUESS AT IT BUT WHAT WE DO KNOW PEOPLE CAN PRESENT
WITH VERY MILD SYMPTOMS AND THEY CAN PRESENT WITH VERY SEVERE
SYMPTOMS.
SOME PEOPLE GO FROM ONE END TO THE OTHER OVER THE COURSE OF
DAYS SO THEY CAN COME IN WITH JUST A FEW SYMPTOMS AND GET SICK
QUICKLY.
>> SO THOSE PEOPLE WHO WOULD BE CRITICAL MIGHT NEED A VENTILATOR
OR OTHER TREATMENT AS WELL, CORRECT?
>> THAT'S CORRECT.
GENERALLY THE PEOPLE IN THE CRITICAL CARE UNIT -- THE
INTERESTING THING ABOUT THIS INFECTION IS THE VAST MAJORITY
OF PATIENTS WHO GETS TO THE CRITICAL CARE UNIT LEVEL OF CARE
IT'S BECAUSE THEY CAN'T GET ENOUGH OXYGEN INTO THEIR LUNGS
AND INTO THEIR BLOOD.
THEIR LUNGS ARE JUST ALL CONGESTED WITH THE VIRAL
INFLAMMATION, THOSE PATIENTS TYPICALLY NEED MECHANICAL
VENTILATION ABOUT 70, 75% OF THEM, WHICH IS A HIGH NUMBER.
HEIGHTS A HIGH PERCENTAGE OF PEOPLE WITH THIS PARTICULAR
INFECTION THAT CAUSES VIRAL PNEUMONIA.
THAT'S A HIGH PERCENTAGE OF PEOPLE NEEDING MECHANICAL
VENTILATION WHICH IS WHY YOU'VE HEARD A LOT OF DISCUSSION OVER
THE LAST SEVERAL WEEKS ABOUT THE SCARCE SUPPLY OF VENTILATORS IN
THE UNITED STATES AND WHY PRODUCTION HAS GEARED UP BECAUSE
MOST TIMES IN CRITICAL CARE, WE CAN PREDICT THE NUMBER OF
VENTILATORS THAT WILL BE NEEDED.
THIS IS A LITTLE BEYOND THOSE PREDICTIONS.
>> AND HOW IS BAYSTATE AS FAR AS VENTILATORS?
>> WE'RE IN A REASONABLE WAY.
WE CAN MANAGE THE CAPACITY WE'VE PLANNED FOR, OBVIOUSLY, WE DON'T
HAVE A SURPLUS OF VENTILATORS, NO ONE DOES, BUT WE ARE -- WE'RE
MANAGING WELL AND WE THINK WE CAN MANAGE THE PREDICTED SURGE
BASED ON OUR OWN MODELING.
>> WHAT ABOUT SOME OF THE MEDICATIONS THAT HAVE BEEN
TALKED ABOUT AND THAT HAVE BEEN USED AS WELL, SOME WITH
CONTROVERSY, THE ANTIMALARIA DRUG IN PARTICULAR.
>> IT'S A GREAT QUESTION, AS IT HAPPENS IN MY PAST LIFE IN AN
THORAX RESEARCH I STUDIED THOSE BECAUSE THEY DO HAVE AN IMPACT
ON ANTHRAX AT LEAST IN THE MOUSE MODEL.
I DON'T KNOW ABOUT HUMANS BUT THOSE DRUGS WORK AT THE CELLULAR
LEVEL SO THERE MAY BE REASON TO BELIEVE AT LEAST IN A TEST TUBE
AND IN -- IN CULTURES, IN LABORATORIES THAT THEY MAY WORK
IN HUMANS.
WE JUST DON'T KNOW.
THERE ARE SOME ANECDOTAL REPORTS MEANING INDIVIDUAL CASE REPORTS
WHERE PEOPLE MAY HAVE HAD A BENEFICIAL EFFECT ESPECIALLY
OVERSEAS IN CHINA AND THERE HAVE BEEN SOME REPORTS OUT OF THE
U.S. BUT BECAUSE THE STUDIES WERE NOT DONE IN A
SCIENTIFICALLY RIGOROUS WAY THERE'S NO WAY TO BE ABSOLUTELY
CERTAIN AND THEY DO HAVE SIDE EFFECTS.
ALL DRUGS REGARDLESS OF HOW BENIGN THEY MAY BE OR WHAT YOU
HEAR ABOUT THEM CAN HAVE SIDE EFFECTS AND SOME OF THEM CAN BE
MORE DANGEROUS THAN OTHERS SO THAT'S WHY WE DON'T WANT PEOPLE
USING DRUGS WILLY-NILLY.
YOU SHOULD BE USING THEM IF THERE'S THE POSSIBILITY THAT
THEY COULD PROVIDE SOME BENEFIT.
AND THESE MAY.
THEY NEED TO BE STUDIED AND THEY ARE BEING STUDIED RIGOROUSLY BUT
IT WILL BE SEVERAL MONTHS BEFORE WE KNOW THE RESULTS OF THOSE.
BUT THAT DRUG IS HARD TO FIND.
IT'S MORE AVAILABLE NOW BUT IT'S HARD TO FIND BECAUSE IT'S NOT
PRODUCED BY MANY MANUFACTURERS.
>> SO GOVERNOR BAKER HAD MENTIONED THAT OUR SURGE IN
MASSACHUSETTS WE'RE IN THE MIDst WOULD BE APRIL 10TH THROUGH
APRIL 20TH, HOWEVER, WESTERN MASS LAGS BEHIND.
CAN YOU TALK A LITTLE BIT ABOUT THAT?
>> WELL, WE'VE LOOKED AT OUR OWN DATA BASED ON OUR OWN EXPERIENCE
AND MODELED SEVERAL FAIRLY SCIENTIFICALLY SOUND KEK MODELS
THAT YOU CAN GET OUT THERE AND YOU'VE SEEN SOME OF THEM ON
NATIONAL AND STATEWIDE MEDIA AND IT LOOKS TO US LIKE WE ARE IN A
STABLE PLATEAU PHASE HERE IN WESTERN MASS CURRENTLY.
NOW, THAT COULD CHANGE.
THERE'S NUMEROUS THINGS THAT COULD CAUSE SETBACKS BUT FOR
ABOUT A WEEK WE'VE HAD A STABLE, ALTHOUGH HIGH, NUMBER OF
HOSPITALIZED PATIENTS AND SOCIAL DISTANCING WOULD -- OR WHAT WE'D
LIKE TO CALL PHYSICAL DISTANCING WORKS.
THAT'S A WELL PROVEN PUBLIC HEALTH INTERVENTION, A PUBLIC
HEALTH TOOL THAT HAS WORKED THROUGHOUT HISTORY.
IT'S JUST HARD TO PRACTICE.
THE FACT THAT WE'VE BEEN ABLE TO DO IT FOR THE LAST SEVERAL WEEKS
IN THE UNITED STATES, I THINK, IS REAL TESTAMENT TO PEOPLE
TAKING THIS SERIOUSLY AND THE MORE OF THAT WE CAN DO, THE MORE
LIKELY IT IS THAT WE CAN KEEP THIS STABLE PLATEAU AS WE
CURRENTLY HAVE AND PERHAPS EVEN SEE A SLIGHT REDUCTION IN CASES
OVER THE NEXT SEVERAL WEEKS BUT THERE'S ALSO A FEW OTHER THINGS
THAT COULD CAUSE SETBACKS AND WE'RE NOW DEEPLY LOOKING AT SOME
OF THESE POCKETS OF TRANSMISSION IN NURSING HOMES AND IN
VULNERABLE COMMUNITIES.
YOU'VE HEARD A LITTLE BIT ABOUT THIS.
THIS IS A POTENTIAL BURNING EMBER THAT WE NEED TO EXTINGUISH
BECAUSE TRANSMISSION CAN OCCUR IN THOSE PLACES AND PRETTY SOON
IT CAN BREAK OUT INTO THE COMMUNITY AGAIN SO WE NEED TO
REALLY PAY ATTENTION TO THAT AND WE ARE AT BAYSTATE HEALTH.
>> SO JUST TO CLARIFY, YOU THINK WE HAVE REACHED THAT PEAK IN
WESTERN MASS?
>> WELL, I CAN TELL YOU WHAT WE'VE SEEN AND WHAT WE'VE
SEEN -- WE WATCH THIS VERY CAREFULLY.
WE ARE CURRENTLY AT A PLATEAU OR A PEAK.
IT'S LOWER THAN THE INITIAL PREDICTIONS OF SEVERAL WEEKS AGO
BECAUSE PROBABLY BECAUSE OF THE PHYSICAL DISTANCING THAT'S TAKEN
PLACE.
IT DOES APPEAR TO BE LOWER.
IT COULD BE MORE SUSTAINED BECAUSE WHEN YOU BLUNT THE CURVE
OR FLATTEN THE CURVE AS YOU'VE HEARD OUR NATIONAL AUTHORITIES
TALK ABOUT, SOMETIMES YOU PROLONG IT, BUT PROLONGING IT AT
A LOWER LEVEL IS A LOT BETTER THAN A SURGE THAT'S
UNMANAGEABLE.
>> ONE LAST QUESTION, I KNOW THAT WHEN PATIENTS ARE RELEASED
AFTER BEING TREATED FOR THE CORONAVIRUS, YOU DO SOMETHING
SPECIAL AT BAYSTATE.
CAN YOU SHARE THAT WITH US?
>> SURE, THIS WAS THE BRAINCHILD OF SEVERAL MEMBERS OF OUR TEAM
AND FROM THE GRASSROOTS THAT, YOU KNOW, PEOPLE WANTED SOME
REASON TO BE HOPEFUL.
PEOPLE WHO WORK IN THE HOSPITALS NEEDED SOMETHING TO HAVE HOPE
AND OPTIMISM AND THERE'S REASON TO BE OPTIMISTIC SO WE STARTED
PLAYING THE THEME SONG FROM ROCKY OVER THE OVERHEAD SPEAKERS
BEFORE SOMEONE WAS BEING DISCHARGED TO HOME WITH
CORONAVIRUS INFECTION AND WE ALSO SENT TEXT MESSAGES AND
EMAILS AROUND -- OR WHATEVER STAFF COULD GATHER WITH
APPROPRIATE MASKING AND SOCIAL DISTANCING AT THE FRONT LOBBY
WHERE PEOPLE ARE DISCHARGED TO GIVE A ROUND OF APPLAUSE TO THE
PATIENTS AND THE PHYSICIANS WHO TOOK CARE OF THEM.
THAT'S BEEN LAST WEEK AND IT'S GONE VIRAL AND GANG ABOUT USERS.
PEOPLE LOVES IT BECAUSE -- GANG BUSTERS.
EVEN IF YOU CAN'T BE THERE, YOU KNOW THERE'S SOMEONE LEAVING THE
HOSPITAL AND GETTING BETTER.