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With the surge in COVID-19 cases in Warren County, Warren General Hospital has seen an increase in cases coming through its doors.
The Pennsylvania Department of Health reported Friday that there were 22 COVID patients in the hospital.
"From a capacity perspective, the hospital has been responding fairly well to the influx of COVID patients," Chief Nursing Officer Joe Akif said. "The nursing team has done a nice job of getting up to speed in the needs and care of these patients."
"Several nursing units have had staff reassign and assist the Medical/Surgical team with this patient population," Akif said. "The nursing team has identified additional equipment necessary to care for the needs of this group."
"The Hospital has also modified the building to provide more negative air pressure that assists with removing virus from the air in the treatment areas," he said.
Another dramatic increase in cases and the number of cases in the hospital could become problematic.
"To this point we have managed the influx well," Akif said. "There is really a slim margin to expand. If there is a surge, the hospital will be challenged to keep pace. All staff have been stretched, but still are providing kind, compassionate care."
"We appreciate our patients and families understanding that there may be delays in the placement on a nursing floor or transfer to another facility," he said. "As the entire healthcare system grapples with this pandemic, there will be challenges that may create delays from normal experiences. This may be experienced in an extended time in the Emergency Room as the team coordinates care with the appropriate next care environment."
Friday's data also showed four of the WGH COVID patients were on ventilators. The department said there were a total of 12 ventilators and five of them in use.
COVID-19 was first identified as a respiratory disease and, since the start of the pandemic, the importance of available ventilators has been a talking point.
"Ventilators on the dashboard is a little misleading," Akif said. "In general layman's terms, a ventilator is broken into two classifications, a BiPap machine - this is a machine that assists with breathing via positive air pressure - and a ventilator - essentially breathes for you when you are unable to do so on your own."
"The BiPap machine is non-invasive," he said. "On the dashboard, both machines are categorized as ventilators."
"In addition, the dashboard reports the total number of these machines in use at the hospital," he said. "The number you see is not just for COVID patients. There are other patients in the hospital that do not have COVID that use one of these types of machines.
"At this moment, there are currently five patients on BiPap that are being treated for COVID," he said on Thursday. "This number can change at any time. The number on the dashboard is a snapshot of use at the time of reporting."
The hospital continues to give COVID tests to patients who are symptomatic and have orders from primary care physicians.
Like the department's data, a test represents a snapshot in time.
"We have been trying to reinforce for the public that because you test negative, this means at the time of the testing you are not infectious," Akif said.
It doesn't necessarily mean that the patient is not infectious by the time they get their results. Test results have been taking up to a week to return since the onset of the surge.
"You can test negative today and become positive the next day," he said. "This is why it is so important to understanding the need for quarantining and isolating."
The same time lag applies to state-mandated testing required of people who are coming into the state after being outside it for at least 24 hours, Akif said.
"Also with travel, the state requirement of 72 hours does not align with the five- to seven-day incubation period of the virus. You may have a false sense of security. There remains the need to be vigilant."
Unlike nursing homes and other long-term care facilities, the hospital is not required to test its personnel.
"With regards to testing, this is state mandated for the nursing homes," Akif said. "There is no such requirement at this time for other healthcare providers."
"Employees at the hospital are tested if they are potentially exposed or become symptomatic of COVID," he said. "At this time, I am unaware of any employee that has tested positive for COVID that was exposed at the hospital by a patient that they were caring for."
The department listed three COVID-related deaths in the county in its latest reporting. One of those was from July.
Akif said COVID-related deaths do not always follow a long descent in health.
"With regards to deaths, we have seen it as very sudden," he said. "Apparently mild one minute and then suddenly a death."
COVID is no longer just a respiratory illness. "There seems to be a major impact on the cardiac (heart) system," Akif said. "The literature is seeing these trends not only in death, but on somewhat healthy individuals."
"We will not know the true cardiac impact on people for probably five to 10 years from now, after there has been an opportunity to research the impact of the virus," he said. "We have to remember. This virus has only really been in our population for 9 months."