‘ So ill, so quickly’
Despite a “mind- boggling” start, hospitals have come a long way since the pandemic’s peak.
Tiffany Urban describes the early days of the COVID- 19 pandemic as “rather mindboggling.”
Urban, patient care manager at Norwalk Hospital’s critical care area, said when those first, rapidly- declining patients started coming into the hospital, it was startling.
“We saw things we had never seen before,” she said. “The patients who came in got so ill, so quickly.”
Urban said treating these patients as quickly and effectively as possible was an everescalating challenge. But time and again, she saw nurses, doctors and staff rising to the occasion. She saw people pulling together to find the necessary equipment, such as ventilators and personal protective gear, to take care of everyone.
She saw nurses come up with creative ideas, such as lengthening IV lines so that they could adjust and administer medication without entering a patient’s room.
Urban saw medicine in the hospital setting as she knew it change dramatically in a short period of time. And now that Connecticut seems to have moved past the peak of new cases ( for now), she said staff still haven’t taken their guards down.
“We’re looking at the things we’ve learned,” she said. “We are still talking about what would happen if there were a second wave. Do we have all the things we need?”
Throughout the region, staff and officials at area hospitals said there’s a stark contrast in mood between the start of the pandemic and now, when hospitals are caring for far fewer COVID- 19 patients and things seem to be approaching some sort of normality. Yet many are still bracing for the next step, should it arrive.
“The tension we might have felt at the beginning is no longer there, and it’s nice to see,” said Dr. Maher Madhoun, hospitalist director and infectious disease doctor at Stamford Health.
But, he said, in the early days of the pandemic, Stamford was a COVID- 19 hotspot. And, though he said he felt the hospital staff did all they could to prepare for the onslaught of patients, caring for so many critically ill people took its toll.
“I would say people were overworked,” Madhoun said. “Taking care of COVID patients could be labor intensive. They were very sick. A lot of them could barely breathe.”
Not only did the hospital staff have to adjust quickly, but the hospital itself had to shift rapidly to meet the demands. “We went from one ICU to four ICU basically in the span of a month,” Madhoun said, noting that, before the pandemic, the hospital’s single intensive care unit was typically only at half capacity at any given time.
“We really dramatically increased critical care services here,” he said.
Bridgeport Hospital personnel also had to react quickly, said Dr. Rock Ferrigno, that hospital’s associate chief medical officer and chief of emergency department. He said the hospital’s response kicked into high gear one Friday night in March in the early days of the pandemic, when officials learned that a nurse employed by the hospital had tested positive for COVID- 19.
Though it’s believed that the nurse didn’t contract the illness at the hospital, Ferrigno said, staff immediately set up a command center to deal with the illness. Though the hospital had been planning for some time for COVID- 19 to affect the hospital, until that point it was mostly academic.
“There’s that saying ‘ You can have the best plan until you take the first punch to the face,’ ” Ferrigno said.
One of the main obstacles health professionals faced in the beginning was the uncertainty surrounding CO
VID- 19, he said. It was initially unclear. “One day it was ‘ Wear a regular mask,’ ” Ferrigno said. “Then it was ‘ Wear an N95 mask.’ Then it was ‘ You don’t need a mask.’ ”
It was nearly impossible to manage the hospital’s staff and the rising pandemic without a clear protocol. “We were constantly searching for the latest information,” Ferrigno said.
But, as the pandemic progressed, hospital staff adapted, he said. They watched what other hospitals were doing. They developed protocols on how to treat patients and protect themselves and non- COVID patients. This included setting up a triage tent outside the hospital to help treat non- COVID patients.
“The whole thing grew out of itself,” Ferrigno said. “We were honing our processes.”
One leader who was in a unique position when the pandemic began was Jeff Flaks, president and chief executive officer of Hartford Healthcare. Though Flaks had worked with Hartford HealthCare for more than a decade, he’d only been president for a bit more than a year when the pandemic hit.
The crisis also took place mere months after the chain acquired St. Vincent’s Medical Center in Bridgeport. The hospital is in Fairfield County, which was harder hit by the pandemic, and Flaks said other hospitals within Hartford HealthCare soon found themselves funneling resources out to St. Vincent’s.
“We had the capacity to move staff members into St. Vincent’s and strengthen and fortify their capabilities,” Flaks said.
Like other hospital officials, he said the outbreak was like nothing he had ever seen before, but he was proud at the way workers rose to the occasion. “While almost everybody else in the community was quarantined, our workers were running into this,” he said.
Now that the pandemic has lessened, he and others at area hospitals are taking a breath — but they’re not relaxing. They’re busy thinking about what might happen next.
Ferrigno, for one, is confident that Bridgeport Hospital can adapt and evolve to meet the demands of a possible second wave the way it did with the first. He said one of the advantages that came out of the height of the pandemic was the rise of telemedicine services.
Hospitals also developed a strong sense of collaboration, Ferrigno said — even those that aren’t in same system. For instance, he said, Bridgeport developed a strong partnership with Stamford Hospital, allowing them to share resources.
Because of the pandemic, Ferrigno said, healthcare at the hospitals changed, and that will help prepare them for what’s next.
“We had preparation,” he said. “We had execution and now we have a period of recovery and, really, a transformation.”