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Date: 5/6/2020
SPRINGFIELD – Dr. Mark Kenton, chair of the Department of Emergency Medicine for Mercy Medical Center told Reminder Publishing he’s been concerned by a trend he’s observed in the Emergency Department (ED) over the past two months.
That trend was not the growth of potential COVID-19 patients visiting Mercy’s ED for testing and treatment. It’s been the lack of patients seeking help for other issues such as chest pain, abdominal pain or other life-threatening situations.
“We average 230 to 240 patients a day” in the ED, Kenton said. “At the peak of the flu we saw 280. We’ve been seeing somewhere between 110 and 120 since [COVID-19] started. Our lowest was 75 patients in one day. That’s a significant dropoff.”
Kenton noted the decrease in daily ED patients is both a good and a bad sign. “In one sense people are listening and taking advice to stay home [and] avoid going out unless absolutely necessary,” he said. However, that same trend points to another potential, equally serious health situation. “What happens if we knew there are patients out there with chest pain, or the stroke victim with symptoms for five days who waited to come in?” he shared.
He recognizes that dropoff in ED visits has everything to do with people’s anxiety surrounding COVID-19 and the potential to contract the virus in a hospital setting. “There is a fear that coming to the ED, people think they will get COVID-19,” he said. “Those chances are very minimal.”
Kenton said Mercy Medical Center recognized early on they were going to need a plan in place to evaluate and treat patients presenting with COVID-19 symptoms, and patients with other illnesses and potentially life-threatening conditions
“We ended up taking our outpatient registration area and converting it into a COVID-19 outpost. It’s completely isolated from the Emergency Department,” he said. This area has four patient rooms and a separate waiting area that medical staff can “use for patients concerned about symptoms who need swabs and testing” he said, adding most of these patients “can be discharged home.”
For another set of patients “with more moderate symptoms, who need x-rays or bloodwork” and who “may or may not be admitted,” Kenton said there is an area in the ED set up that is separate from the main treatment area. Within the main area of the ED, he said Mercy has “rooms with negative pressure, for sicker patients that may need oxygen care or intubations. These rooms are isolated, individuals are kept away from other patients.”
“We’ve done a really good job of trying to separate non-COVID-19 patients from COVID-19 patients to try and keep people safe. We really have those two populations isolated,” he said. This separation extends to the hospital itself, Kenton noted, with a designated elevator for moving COVID-19 patients who need hospitalization to specific areas of the facility, and floors within the Medical Center that are designated for patients who are hospitalized for non-COVID-19 conditions. Patients receiving treatment in the regular part of the ED may not encounter staff wearing full complement of personal protective gear, he said, but they will have face shields and other equipment to mitigate any possible COVID-19 transmission during treatment. “We don’t want to give it to anyone, or have our providers infected by someone asymptomatic,” Kenton said.
Though Kenton wants individuals experiencing symptoms of potentially serious conditions not to shy away from visiting the ED for care, he does acknowledge the threat of COVID-19 is very real in the community. “There’s no doubt of it, with over 1,000 cases in the Springfield area, but we haven't been hit like Boston was and we are nowhere near New York or Seattle,” he said. “It’s out there and everyone needs to take the social distancing precautions seriously; it’s really important to listen to authorities and Governor Baker.
“But I think because we acted early we were able to flatten down the curve in Massachusetts,” Kenton said. “We see that it is moving downward and hopefully we will see the downward trend continue in the next few weeks.”
Controlling your COVID-19 fears
As someone on the front lines of the pandemic, Kenton understands people’s fears about the COVID-19 virus. “I think we all have to work through our own anxieties.” Kenton said, explaining that he has his own concerns he’s had to overcome as he’s the father of three young boys and he and his wife both work in emergency medicine.
“When I talk about the fear of coming to the ED, the fear I feel is real, but I know the chance of catching COVID-19 is low, and I control what I can control.” he said. That includes making sure he and his staff have the protective gear they need and take the proper precautions in the work environment, and that he changes and showers after his shift, before interacting with his family. Kenton said if you are going to keep up with the news of what is happening in the pandemic fight around the country, it’s crucial to put that news into perspective, and then concentrate on the things you can do to keep yourself and your family safe.
“If I’m going to watch the news and I watch what’s happening in New York City, it’s important to remember that’s not what's happening here,” he said. “If you focus on what you can control - turn off the news, turn off Facebook for a time; we’re not seeing the good outcomes [there], we’re constantly barraged with the number of people diagnosed and dying, but a great number have no disease.
“Focus on what you can control and you will rid yourself of a lot of the fear,” he said.