By Mary-Justine Lanyon
To say that the staff at Mountains Community Hospital has been busy would be a gross understatement.
Kim McGuire, MCH’s director of community development, reported to the Mountain Sunrise Rotary Club that the “ER and acute care departments had more than double the number of patients days in December 2020 as compared to December 2019.”
She added that many staff members have been sleeping at the hospital “to ensure patient care around the clock.
“Our nurses,” McGuire said, “are becoming true ICU nurses in a facility that doesn’t have an ICU.”
She introduced Renee Limpus, who has served as the hospital’s education coordinator “but now has stepped into the role of disaster coordinator.” Limpus and Terry Peña, MCH’s chief nursing officer and chief operating officer, have led the hospital’s COVID-19 response, McGuire added.
Limpus showed the Rotarians a photo of the MCH ER, calling their attention to the plastic dividers they have installed to isolate each patient. “They have negative pressure so they suck out any germs,” she said.
Initially, Limpus said, the majority of MCH’s COVID-19 response was through the ER. During the first eight or nine months, they were testing and caring for the patients there. “When we got a patient with COVID who was not well, we would send them down the hill to a facility that was well equipped. Then everything became full. In December, we had to start caring for them in house,” Limpus said.
To do that, changes had to be made in the med-surg department. One change has been the surgeon, Dr. Van Martin, “has had to do surgeries that we would typically send down the hill.”
To isolate the COVID patients from others, MCH has installed plastic barriers that can be lowered and zipped shut in the hall of the med-surg department. The back barrier gives MCH four rooms for COVID patients.
Close the next zipper, Limpus said, and they gain two more rooms. How they use the barriers depends on the census.
On Jan. 26, Limpus noted, they had six patients in the COVID unit. But, on Jan. 27, they only had two as the others had been treated and released.
MCH has also set up beds in a small conference room and has added a bed in the solarium, which they could expand with dividers.
“Our need for nursing staff has been tremendous,” Limpus said.
A graph she displayed showed the number of positive COVID-19 test results and number of COVID patients admitted to MCH from June 2020 into January 2021. “It’s been really busy the last two months,” Limpus said, noting that these numbers do not include normal admissions, just COVID-19 patients.
Comparing MCH’s numbers with the county, Limpus acknowledged that “we missed the first curve. There was some increase but not as dramatic (as in the county overall).” She added that the numbers are starting to decline a little bit now but the hospital is still “quite busy.”
In talking about COVID-19 vaccinations, Limpus said MCH had gotten 20 doses in the first batch. Those went to frontline doctors and nurses. “We got another 280 doses soon thereafter,” she said. “Not everyone opted to take the vaccine in the first wave so we were able to offer it to some of the community.”
She referenced the vaccine interest form posted on the MCH website (www.mchcares.com). Close to 6,000 people have signed up she said. “This is amazing news. People in the community want to help us get life back to normal.”
Limpus said that she had no idea as to when those people will be able to get vaccinated. “We have been bugging the county about when; they don’t know either. We have the intention of putting on a vaccination clinic as soon as we can. We will reach out as soon as we know.”
When asked if the second dose had to be given on the exact day after the first (21 days after the first dose for Pfizer, 28 days for Moderna), Limpus said no. “There is no change of efficacy” if you get the second dose after that minimum window. “The vaccine’s ability to work is not diminished if you are later with the second shot.”
Limpus added that the first shot gives the patient about 50 percent coverage seven to 10 days after they get it. The second shot will give 95 to 96 percent protection after that same time period.
What if you have allergies? she was asked. “We don’t give you a shot and send you on your way. Reactions typically happen within 15 minutes so we monitor everyone for 15 minutes. If you have had anaphylactic reactions to other vaccines, you might want to do it under medical care.”
There is no need to wait to get the vaccine if you have had COVID-19, Limpus said. “We ask you wait 10 days from the first signs and symptoms so you don’t share the contagion.”
As to why you would get vaccinated after having the virus, Limpus said that, while you have natural immunity when you get the virus, you have immunity to that strain. “The vaccine is specific to the spike protein. Any time there is a mutation, the body will recognize it a little more slowly. The vaccine recognizes a spike protein so it still covers it.”
Asked if the hospital staff is double-masking, Limpus said a lot of them have been. “I do that when I go out in public,” she said, noting she then has six layers of protection instead of three. Face shields, however, should not be worn in lieu of masks “but are helpful with a mask.”
And where does Limpus think we will be in a year? “We have a light at the end of the tunnel now but I don’t think much will change this year. We are looking for herd immunity before we see a change. How fast we can administer the vaccine will determine the change. We will probably all wear masks this year.”
Some changes, Limpus said, will be with us for the rest of our lives – washing our hands, the need for social distancing. “I don’t think COVID-19 will ever go away. Once we have herd immunity, we will have a COVID-19 season along with flu season.”
One Rotarian said he had been told that, even after getting the vaccine, the body can be attacked by the virus and you could be a carrier. “That’s my understanding,” Limpus said. “Because it’s such a virulent strain of virus, if someone sneezes, I can get particles in my nose. Then, if I talk or sneeze and you’re not wearing a mask and haven’t been vaccinated, I could transmit the virus to you. Even though I’m protected, you’re not.
“Even if you are vaccinated now, continue to wear your mask.”