Penn Highlands Says Its Rural Central Pa. Hospitals Can Deal With Potential Surges Of COVID-19
Urban areas in Pennsylvania have been hardest hit by the coronavirus so far, but rural areas are not immune.
WPSU’s Min Xian talked with Shaun Sheehan of Penn Highlands Healthcare, which has rural hospitals in DuBois, Brookville, Clearfield, Huntingdon and in Elk County. He’s the head of the hospitals’ COVID-19 task force and says they’re doing their best to prepare for a potential surge of cases.
Min Xian: Dr. Shaun Sheehan, thank you for joining me.
Shaun Sheehan: I'm glad to be here.
Min Xian: Since the coronavirus outbreak, Penn Highlands Healthcare has verbally screened patients and provided testing for those whose condition qualified. With all five hospitals in rural Pennsylvania, can you talk about the demand for testing and what factors are the most significant in deciding who needs testing?
Shaun Sheehan: Well, first, I want to talk about our limitations. So, we are able to really run as many tests as we have test kits for. We go through periods where we're able to get some of those test kits replaced and other periods where we may go a week without getting any, and could even go possibly longer.
We first started our testing just following the CDC guidelines, which initially started out with a history of travel or known contact with COVID-19 patients and associated symptoms of shortness of breath and cough, fever - the things that we've all heard about. As we have tried to expand our testing, it's become mandatory to test all healthcare workers that are having symptoms. So that's number one on the list. Number two are any of our public service agencies, like EMS and fire and police. And most recently we've expanded our testing criteria to include people with risk factors, which include individuals with chronic respiratory diseases, age over 65, anyone on active chemotherapy with symptoms.
I can tell you that we have somewhere around 900 individuals [who] were tested through our healthcare system. we do get a few test kits here and there. They come in small batches to us. There's somewhere right around 2000 available to us currently. And the turnaround time has been much improved to about three days on average. But despite the urgency to get testing kits available to the widespread public, that has just not been our experience at this point.
Min Xian: Are there any Penn Highlands hospitals treating COVID-19 patients?
Shaun Sheehan: Not currently. The difficulty is since there's no point of care testing available, meaning that we could have a result back in even just a few hours, anybody that could possibly have COVID-19 is being tested and placed in this special unit until their tests come back negative. And as of right now, we do not have any positives.
Min Xian: And can you talk about Penn Highlands capacity to treat COVID-19 patients in terms of supplies and also personnel, including the numbers of available beds, ventilators and medical staff?
Shaun Sheehan: Sure. We're probably about four weeks into having our incident command structure open and operating. And I think that we are very well prepared, should we see a surge of patients. So, of course, our main hospital is in Dubois and has the most number of medical staff and options to treat patients. But we have also set up areas in our smaller spoke hospitals that have all the correct isolation, personal protective areas to put patients into. So the idea is that those with mild or even some with moderate symptoms can stay at the spoke hospitals and be treated.
System wide, we have about 90 ventilators available to us. That would be including anesthesia machines that would be converted into ventilators. We converted one of our floors into a COVID-19 unit. And the significance of that is that all the rooms are put into negative pressure, [and] the same staff work in those units. So there's not a potential cross contamination. Plus we could expand our other current critical care areas to provide that type of care if need be. So I think that we have a pretty good capacity across the healthcare system.
Min Xian: And on that topic, Pennsylvania Governor Tom Wolf signed an order on April 8th, allowing some medical supplies like personal protective equipment to be redistributed among hospitals and medical facilities. Has Penn Highlands received any supplies or had them taken away?
Shaun Sheehan: No, we have not. We, of course, are complying with that order. We feel that our supplies are adequate, and it certainly would change our operation should we be required to give up our PPE that we have in the warehouse. Because a lot of our decisions were based on the availability of that personal protective equipment. And if those supplies of those items would change, we would have to completely reevaluate some of the things that we've already put into place.
Min Xian: And rural hospitals have long faced challenges like serving an older population with limited transportation options and also with limited medical staff. So how might COVID-19 have put additional stress on those existing issues? And what kind of help do you need the most?
Shaun Sheehan: Well, the biggest stress that we're seeing and this is the case for all rural hospitals, healthcare systems, is that we're having significant financial stress related to our outpatient business being cut from as much as 60% of what we have seen historically. And so I think that that is going to be the biggest impact we see coming out of this. Of course, there are some assistance programs available, but, whether that will be adequate, I think is probably not the case at this point.
Min Xian: Is there worry, or how much do you worry about a surge of cases in rural areas? And what kind of plans does the task force have in place to deal with a potential surge?
Shaun Sheehan: A surge is everybody's fear. I think that we're certainly ready to handle that. I think the next biggest concern would be the health care workers becoming ill as a result. But, if we do see a surge, we can rapidly expand our capacity, all the infrastructure and policies and everything needed to stand up. Additional capacity is ready; it's just not activated at this point. So I think we're in a good spot as far as that goes.
Min Xian: Dr. Shaun Sheehan, thank you so much for talking with me and I hope you're safe and healthy.
Shaun Sheehan: This was nice to speak with you as well. Please stay in touch.
Min Xian: Dr. Shaun Sheehan is the medical director for emergency services at Penn Highlands Healthcare. He’s also the head of the hospitals’ COVID-19 task force.
I’m Min Xian, WPSU.