PLATTSBURGH — Besides PPE, effective treatments for the coronavirus were among the milestones frontline workers celebrated at the University of Vermont Health Network-Champlain Valley Physicians Hospital.
“I don’t remember there being any one day like, ‘Oh my God, this is it,’” Keith Collins, MD, Infectious Disease, said.
“It was more of a thing where as time progressed, we started getting treatments that actually were effective. We started having people actually listen in the community that would start to exercise caution. I don’t remember any one thing but I think it was just as time progressed, the data got better, the science got better, we knew better how to isolate people, we knew what we did and didn’t need to do, and we started getting some effective treatments. The biggest turning point of all was getting the vaccines.”
TURNING POINTS
Erica Moore, RN, infection prevention manager at CVPH, said there were a variety of turning points.
“I think that one thing that the community and the healthcare workers and people in general is understanding that we are a vector and we, when we’re contagious and as hard as it is to say, I need to stay away from other people when I’m sick, that’s what we need to do,” she said.
“And sometimes we are not that important and we don’t need to be where we think we need to be. We don’t want to miss out on the fun. We don’t want to miss out on work. But we need to realize that when I’m sick, a small sniffle may turn into something more and we need to understand what other respiratory illnesses are out there that I could stay away from somebody who is immune-compromised. Someone who is immune-compromised doesn’t have to be elderly. It could be someone who is fighting cancer. It could be someone with cystic fibrosis. So, it’s understanding our own bodies, what respiratory illnesses are out there and making that decision on how I will prevent the spread of something and what can I do to stop the spread of something, and then using all of our respiratory hygiene in addition to what can I do maintain my own health and stop the spread.”
Collins gave shout-out to his environmental service colleagues at the hospital.
“Our environmental service folks really, really did an incredible job and remember they don’t have the same medical training as our RNs and MDs,” he said.
“They relied on us, I think, to some extent. I think there was a level of trust that I will always be grateful for. Because they still did their job. I think they had some trust in us to make sure that we would try to keep them as safe as we could because they were on the front lines like everybody else. They were really, really part of the solution here in what they did.”
Collins also praised Lisa Mark, MD, chief medical officer and vice president of Medical Affairs.
“We had a great CMO through this whole thing who was really level-headed,” he said.
“She did a great job through the entire pandemic. She just started her job at the beginning of the pandemic. I don’t think she had been working for two months when she got thrown into this. I just want to have a shout-out to Lisa. She did a great job.”
TAKEAWAYS
Besides patient intake protocols, there were aspects of the hospital’s physical plant that were changed.
“ICU was a place where we changed the HVAC – how our internal systems execute air, how the air moves through our system, our ventilation system,” Moore said.
“So, we had ORs that were set up to move air differently. Our ORs, our ICU, we set that up differently where we placed patients is different. We set it up permanently. We took it down, but we can access that in the OR at any time if we need to. Those were permanent/temporary accesses that when we need to we can still access.”
For Collins, the biggest take-away was the importance of communication with people.
“Try to convince them that the science behind what we do is important because if we don’t do that we’re going to fail,” he said.
“It’s still the biggest challenge I think right now is that science is being questioned. I don’t care what politics you have. The reason that COVID went the way it did is because of project (Operation) Warp Speed that was put on by the current Administration and they did a great job. Somehow we’ve lost track of the fact that viruses and infections don’t care what politics you have. I think the biggest challenge we have is try to bring people back to understanding that science is for a reason and medicine should follow science because without it we’re just witch doctors.”
“Take politics out like Dr. Collins said,” Moore said.
“I would say always go back to your primary doctor and talk to your doctor. Sometimes friends can influence you and you need to understand your health care. Talk to your doctor. That’s important, too. You know your health and so does your primary. When you don’t have a primary, there’s public health. There are some friends who are health care workers who can talk to you. It was a very scary time, but inevitably there were other things that will come down the pike. But we have a strong community that really does help each other. We could lean on each other.”
PRAISE FOR COLLINS
Moore shared insights during that desperate day-to-day of the pandemic that confronted Collins and Madiha Tahir, MBBS who were the two ID doctors at CVPH then.
“I think Dr. Collins is being very humble, and I want to say something about him,” Moore said.
“They do more for this community than people realize. But he is our only (infectious disease physician), full-time here at the facility. He took calls all the time, and I don’t think he slept. And, I still don’t think he sleeps. Dr. Tahir has since moved on to a different opportunity with her husband, but he takes calls all the time.
“I mean you talk about a community provider, as many community providers do when they work at a community hospital beyond ID, but we’re talking ID. He took calls all the time when he was available, and I don’t think he ever said no. I think he’s being humble, but I don’t think he took a full night’s sleep probably two or three years into COVID. Yes, he shared the burden with your intensivists, but I think he’s being very humble and we are blessed to have him in his position.”
For Collins, emergent pathogens are always on the horizon.
“Hopefully, measles will be contained,” he said.
“There’s been a recent Ebola outbreak. We’re not short of infections. The big one I actually do worry about is bird flu jumping. I think it’s a real possibility because it’s jumped to so many mammals. It does worry me, especially when it’s in swine because it’s easier for bird flu to mix, like in pigs. It’s easier for it to reinsert and potentially … It hasn’t happened but it’s worrisome. It can happen. It’s the single biggest one that I worry about right now is bird flu.”