“A longshot,” said Dr. Francis Riedo, Medical Director of Infectious Disease at EvergreenHealth in Kirkland, Wash., of his team’s discovery that would put their hospital at the spearpoint of the nation’s first major identified outbreak of the new coronavirus.
The staff had been watching as tragedy unfolded in Wuhan, China, as the virus, SARS-CoV-2, swept through, devastating a society and prompting the Chinese government to lock down the city.
An Evergreen nurse regularly checked the Centers for Disease Control and Prevention (CDC) website, waiting. When the CDC changed its testing criteria on Feb. 27 to allow for the testing of severe pneumonia — even without travel to China — they sent two samples in immediately.
They picked two people — critical patients they thought fit the profile for the disease, known as COVID-19.
A day later, Riedo got a phone call at 7:40 p.m. Both patients were positive.
“I think we all knew our lives had changed,” said Dr. Jeff Tomlin, the hospital’s chief executive officer.
Over the next 12 days, the staffers refashioned their hospital to treat the patients suddenly at the epicenter of a growing outbreak, and would see 15 die. Most of the afflicted were associated with assisted-living facility Life Care Center of Kirkland.
“We have not forgotten them,” said Dr. Riedo, urging the community to support families grieving.
As the novel coronavirus continues to infect people across the U.S., the hospital’s response offers lessons for other communities bracing for an outbreak that could threaten to overwhelm the nation’s health care system.
The hospital set up a drive-through testing center for its employees, converted part of its eighth floor into a ward for COVID-19 patients and outlasted a shortage of medical supplies that neared critical.
Some 65 patients at the hospital have tested positive for the virus. Not a single staffer has contracted the disease at the hospital, the doctors said. There’s no evidence of spread between patients. And at least 13 patients have been discharged from Evergreen after suffering from COVID-19.
“It is an important message: Some people are getting better. We have sick people in the intensive unit, but there are people getting better,” Tomlin said.
Also promising: On Monday, an Evergreen patient was enrolled in a trial of the drug, remdesivir, which is being tested by the National Institute of health, Riedo said.
The state Department of Health has confirmed 267 cases of novel coronavirus in Washington, including 24 deaths, as of Tuesday afternoon. The cases now span at least 10 counties.
Walking through the door of the emergency department at Evergreen, a hint of a breeze almost tugs you into the room.
Negative pressure isolation rooms draw air flow into patients’ rooms, preventing spread of pathogens outside.
Inside the emergency department, nurses and technicians carefully don their Powered Air Purifying Respirators, or PAPRs, adjusting the battery packs on their hips, which send filtered air up into their hoods.
What has it been like in here? Or on the eighth floor?
“Intense,” Tomlin said.
“The biggest response Evergreen has ever had,” said Barb Jensen, a nurse who manages the trauma services team.
Added Chief Nursing Officer Mary Shepler: “This is our why.”
Since late February, 188 Evergreen patients have been tested for COVID-19, with 65 positive for the disease and 47 cases still pending.
Each year, Evergreen sends 20 staffers to the Center for Domestic Preparedness in Anniston, Alabama, for incident management training.
Jensen, who manages the trauma services team, insists on it.
“She’s been a prophet: Be ready,” Tomlin said.
Now the hospital is learning the little things that make all the difference in crisis.
The hospital had stocked up on personal protective equipment as China battled the virus, knowing from staffers’ time in Alabama that it would take at least three or four days until the state or federal government could coordinate relief.
Since the outbreak was discovered, they’ve burned through personal protective equipment rapidly, Tomlin said.
Visors have worn out sooner than expected because cleaning supplies were fogging health care workers’ views.
And the drive-through sampling station for staffers has proven essential.
When the outbreak was discovered, several staffers needed testing for COVID-19. When test results came back negative, these workers could return to work and relieve tired colleagues.
Tomlin said he’s been careful about managing the workers. Many have offered to come in for extra shifts.
“The first few days are adrenaline. By the time you get to day six or seven — it’s hard work,” Tomlin said.
The trauma training, the doctors said, was essential to a coordinated response.
“There is a certain confidence right now in how we’re approaching this,” said Dr. Ettore Palazzo, the hospital’s chief medical officer.
Palazzo said the experience had been humbling, a sentiment many of his colleagues shared.
Tomlin thought back to late February. No one hesitated, he said.
“Everyone thought about their own mortality, and they put the gear on and went in,” Tomlin said. “That’s why it’s humbling to me.”
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(Seattle Times reporter Christine Clarridge contributed to this report.)
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