A different—and far bleaker—view, forwarded to NC Scout by our old chum Historian.
I work at a hospital. Not as a doctor, to the well-concealed disappointment of my late mother (and the well-concealed satisfaction of my late father, who loathed doctors,) nor a nurse or a medical technician; my job is to ensure that the facility itself is capable of supporting the demands of those who use it. I’m a construction project manager for a mid-sized non-profit hospital in one of the mid-Atlantic united States, and I’m good at what I do.
Generally, this hospital is well run, well organized, and well staffed with high quality people, ranking among the top US hospitals, part of a larger system also well ranked. If friends or family were to need care, I’d take them to my hospital, which I consider one of the two best in the system and the area, one reason I accepted an offer to work there.
For the uninitiated, this is a non-trivial modification. A negative pressure room or isolation room, has to exhaust ALL of the air coming out of the room directly to the outside. Standards are for 12 air changes per hour, and the room must meet certain negative pressure standards. That means that the entire volume of the room gets replaced every 5 minutes. Our facility policy is to filter all of that exhaust to ensure that we are not placing passers-by at risk of infection, further complicating matters. Normal air conditioning, even in many areas of a hospital, recycles most of the air to reduce energy costs, so when you throw that air away, as you must do for an isolation room, you significantly increase the load on the air conditioning system. It is a BIG change.
I’ll spare you, gentle Reader, the details, but in 3 days last week we went from about 10% isolation rooms in our hospital to 15%, i.e., a 50% increase in isolation rooms by dint of much effort by a number of contractors, vendors, and hospital staff. Those rooms were virtually empty last week, and hospital volumes were WAY down. It was rather eerie. After that success, I was directed to convert another 12% of our rooms to negative pressure, and we are working that now.
This is now much more difficult as seriously ill patients are starting to swamp the hospital, and the rooms which were empty a week ago are all now filled or rapidly filling with patients on O2 or intubated, most of whom had been seen a week or two ago, evaluated as not seriously ill, and sent home with instructions to come back if they started to feel worse, not better. Well, they DID get worse, and they are coming back. In significant numbers, and this is just the beginning.
Like I said, this is pretty grim stuff for sure. But there’s a glimmer of hope as well, a demonstration of fearlessness, compassion, and humanity that provides some affirmation to lay upon the scales as a counterweight to horror and hopelessness.