Memphis-area hospitals adjust to COVID-19 challenges, while more uncertainty looms

Despite the essential work their employees are doing to save lives during the COVID-19 pandemic, hospitals have not been immune to the devastating financial impacts that have ravaged the global economy. And enhanced infection control procedures at hospitals and assisted living facilities, including limiting visitors, are likely to be the new normal for the foreseeable future. 

Hospitals in the Mid-South and across Tennessee have reported large financial losses largely due to weeks of suspended elective procedures, while their fixed costs have largely remained the same. In Memphis, Methodist Le Bonheur Healthcare and Saint Francis Hospitals have furloughed employees, though some have started being recalled to work as elective procedures resume.

Even as Shelby County continues to reopen and the area tries to return to some level of pre-COVID-19 normality, uncertainty abounds. An uptick in cases remains a possibility in the near future. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said a second wave is inevitable. 

Whether that happens next week or in November, it could prompt another lockdown, again forcing hospitals — and patients — to forgo elective procedures, curtailing revenues and postponing operations that could become urgent if put off for too long.   

Public health officials, medical workers and elected officials have repeatedly talked of a “new normal,” cautioning that until a vaccine is developed, life will not go back to the way it was before cases started to be reported in the U.S. 

Testing employees, curtailing visitors

Assisted living facilities and nursing homes have reported outbreaks as COVID-19 spread in Shelby County.

At Christian Care Centers of Memphis, Executive Director and Chief Operating Officer Jason Murphy said they were particularly concerned that staff members could become infected through community transmission — possibly by visiting a grocery store or pharmacy — and be asymptomatic. 

“We concluded that while testing individuals with symptoms is helpful, it leaves too large a gap for potential unknown infection to exist. In order to enhance resident safety, though not required to do so, we elected to test 100% of the facility’s staff and residents and implement a system of periodic 100% facility-wide testing,” he said in April. 

Across the board, assisted living facilities have embarked on rigorous testing regimes, are screening and temperature checking everyone who enters the facility, including staff members and paramedics, and have barred visitors entirely. While those measures help keep residents safe, they can take an emotional toll on residents, their families and staff members. 

Workers at assisted care facilities who were already concerned about caring for vulnerable patients and worried for their own and their families’ safety have to step into the role of family members for the people they take care of, who can’t be close to their own families. That applies to hospital workers as well. 

“Our doctors and nurses and janitors are having to step in and be that support system for people who are extremely sick. I think there’s a new emotional toll on our health care workers,” said Dr. Laura Shultz, director of behavioral health-ambulatory care for Methodist Le Bonheur Healthcare.

Hospitals have also curtailed visitors, are temperature checking everyone who enters their facilities — including staff — and requiring everyone inside the hospitals to wear masks. At Methodist and Baptist hospitals, all patients undergoing elective procedures are tested for COVID-19, and procedures are postponed further in the event of positive tests. 

Dr. Steve Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-Memphis, said Baptist was also working to test all its employees.

“The health care facilities need to be the safest places there are,” he said. 

Changing the visitor and employee screening measures depends on continued COVID-19 testing. Threlkeld said the Memphis area is likely to see an increase in reported cases as reopening progresses, but if there is a decrease in cases, the measures could be loosened.

“I think as to when that relaxes, it comes down to what the community testing tells us,” he said. “Right now I don't think people are interested in backing off the screening.”

However, what he hopes won’t change when a COVID-19 vaccine arrives and the virus presents less of a threat to the community as a whole is a focus on hand hygiene and other simple infection control practices that can help prevent the spread of other viruses, including seasonal influenza.

Corinne Kennedy is a reporter for The Commercial Appeal. She can be reached via email at Corinne.Kennedy@CommercialAppeal.com or on Twitter @CorinneSKennedy

Tips: How to stay safe at the doctor's office

• Call ahead and ask for guidance about protocols.
• Wear a mask.
• Ask which door is best to enter.
• Ask if you can check in or fill out forms online.
• Remain distant from others in the waiting room, or wait in the car and ask them to call you to come in.
• Use a tissue or gloves to open doors.
• Bring your own pen to fill out forms.

SOURCE: Dr. Peter Alperin, via USA TODAY