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Tufts looks to free up hospital beds by opening its dorms to patients needing less critical care

Tufts Daily reports on planning by the university to provide dorm rooms to hospital patients who don't need ICU-level care - and for medical professionals on the front lines of the Covid-19 crisis who don't want to expose their family members to the risk of infection.




Maybe a medical professional can reply.

But the Project Manager in me suggests taking a smaller hospital or converting some of these urgent care centers to non COVID 19 places. Make them known that they are for non C19 people, and do a parking lot screen before they come in side.

This way people who say.. actually are sick with non-c19 illnesses can still be seen and not fear getting it by going to the ER.

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I think that's happening to some greater or lesser degree.
Optimize the places that have some of the infrastructure for ICU and isolation that's critical for Covid 19 treatment. Alternative facilities that don't necessarily have all of the isolation, etc... pick up some of the remaining workload.
- they're going to be setting up the Javitz convention center with somewhere between several hundred and two thousand beds (numbers vary in the reports), non-covid
- the hospital ship being activated and sent to NY will also be detailed to relieving non-covid workload.
- I read an article last night of an upper-west side plastic surgeon - with all elective procedures postponed, he's offering his premises as a walk-in urgent care

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Interesting, I didn't realize the hospital ship was going to be dedicated to non C19 care, which is easy as it is a floating general hospital and trauma center. But from what I've read, the Javitz is being setup for C19 only?

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The Javitz numbers and description are erratic - I think I saw three different versions between the weekend and yesterday, so you might easily have seen something more up to date than my last read.
I don't know how Javitz would work as a COVID facility. How do you isolate patients from each other in one big space? Or several big spaces - I don't know how/if their exhibit space divides.

Could it be a large quarantine for positive-result, mild symptoms cases?
Could it be a large quarantine for post-symptomatic recovering cases?

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I've worked in healthcare a long time now, as a former hospital administrator, and now as an IT systems analyst. One of the most difficult resources to manage and conserve is personnel. This is a good idea, but personnel are already stretched thin. It's hard to staff regular hospitals, where everything is, and create new sites for non-C19 patients, w/ all the necessary resources that makes a general hospital, general, or gives a trauma center its level of certification.

It's somewhat easier to create C19-only wards in convention centers and such, as their symptoms and expected medical needs are much more predictable and less varied than dealing w/ the general population of sick/injured.

Also, ED personnel are now under the assumption that anyone that comes in potentially is spreading C19, even if asymptomatic. All ED personnel are now wearing minimum of surgical masks, even admin and clerical. Anyone coughing or sneezing is masked, if they didn't come in w/ one, and hopefully moved to negative pressure rooms immediately.

It still kind of sucks if you're a patient for anything else, though, since there is ongoing research and questions on how airborne C19 could be, just from asymptomatic patients breathing normally. But unfortunately, giving masks to every patient in the ED, when PPE is in critically short supply, is just not doable.

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Non C 19 are at home now

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Two things, people can be asymptomatic carriers of covid and then test positive which causes a lot of accidental infection of healthcare workers. So you essentially need to treat everyone like they have covid right now. Even the tests aren't reliable. If the clinical picture looks like covid and the swab is negative you treat them like covid, full PPE, etc.until you have an answer of what they had or you manage to get a covid diagnosis.

Second, if you do have covid and it progresses on the described path from requiring a little oxygen to intubation and ARDS within less than 24 hours you can't afford to be in a facility that doesn't have an attached ICU.

Intubation, the act of putting a breathing tube into someone is considered extremely high risk for infecting staff due to the high amounts of aerosols that are generated during the procedure. It requires a lot of advance planning or you're going to infect a bunch of highly trained individuals that you won't be able to replace.

So if you put people into a "non-covid" hospital you better hope you picked correctly, or you'll infect everyone there and then you have to hope no one actually deteriorates quickly because there's a real possibility you won't be able to save them.

A better use for those facilities may be to take people who are in the process of recovering and need assistance but are basically over that hump that kills them.

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Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Standards or are those standards now not required.

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In China, they had a tier of quarantine levels and used hotels or the like for them. One level was for healthcare providers so they didn't infect their families. One was for those who'd been exposed. And one was for those who were sick but didn't need hospitalization. It worked very well for helping contain the infection.

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By the way, out of the colleges that did send students home, does anybody have a sense of how many were saying "pack up and take ALL of your stuff, you might not be back this school year" and how many were saying "pack up and take anything you'll need, we're going to distance operations for at least "x" weeks"? I'd guess it might be mostly the former but there must be at least some cases of the latter.
Practical impediment to conversion if someone's stuff is still there.

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Harvard gave the students 6 days to pack up and get out for the rest of the school year on March 9th.

I don't know about the other schools.

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