'Light at end' of Covid tunnel, Carney leaders say

Photos courtesy Steward Health Care

Nearly ten months after Dorchester’s Carney Hospital was designated as the nation’s first Covid specialty hospital, the facility appears to have surmounted the hump of the crisis. Fewer than 20 Covid patients remain in the hospital’s ICU unit, according to hospital officials last week, and at this point, the Carney is serving more non-Covid patients than those with the coronavirus.

The hospital’s future role in administering vaccines to the general public is “yet to be determined,” according to hospital leaders who spoke to the Reporter this week last week. More than 1,500 healthcare workers, emergency responders, and other Covid-treating staff, including the vast majority of workers on site, have been vaccinated on the Carney campus to date.

Part of Carney’s role now is raising awareness and easing anxieties in communities of color about getting the vaccine. It’s what hospital president Tom Sands calls “leadership by example.

“I recognize that, rightfully so, people have been hesitant based on past things, be it the Tuskegee Experiment that we all know about where appropriate care that could have been provided was denied, or a number of other instances. So that’s where that hesitancy comes from, in addition to cultural differences...Having someone who respects the culture and communicates in a manner that people can relate to are things we are good at and that we focus in on.”

“It requires significant logistical and supply chain coordination to get this done in a timely manner, so it’s a monumental challenge that requires support and a ‘can-do-it’ spirit on the federal state and local level,” said Sands. “The plan is coming together, people are getting vaccinated, we just need to figure out a way to get more shots in arms faster.”

After scrambling to increase capacity and pivot its infrastructure nearly a year ago, Carney is now well equipped to juggle both Covid and non-Covid patients, explained Sands, even as the number of coronavirus-specific patients and staff continues to decrease. 

“Going through two waves of Covid in less than 12 months has been something we never want to go through again, but if we have to, we will be ready,” said Sands. “We’re now looking forward to how we will continue to serve the community in an effective manner as we get past Covid. We’re still in a pandemic; however we can see some light at the end of the tunnel.”

Two distinct waves

Carney experienced two intense phases of battling the virus. The first crested last spring— “We were pretty much all Covid, all the time,” said Sands. “In the summer the numbers went down but then they began to ramp back up again in October, so we found ourselves once again, almost like Groundhog Day, bringing in over 70 of what we call ‘travelers’ and contract workers to help us open up beds,” he said.

The hospital nearly doubled the number of intensive care beds on hand and doubled the number of medical and surgical beds. Along the way, on-the-fly improvisations like creating new tiered units of care and other adjustments were keys to success, Sands explained.

“One lesson learned was, in addition to ICU beds and regular medical beds, we created what was called a ‘step-down’ unit where a patient didn’t necessarily need an ICU level of care, but needed something a little bit better than the regular floor care. So we were able to create that space to support the patients,” he said.

“In terms of where we are and how we’ve made the turn, we still have Covid patients but less than 20 positive patients in the hospital,” Sands said. “The 70 travelers we brought in are now down to less than 20, and the number continues to go down. The demand for Covid services continues to go down as well, which is a good thing.

“So, lots of lessons learned, but some great success and results, and now we’re making the pivot to begin to make sure the community knows we’re safe and ready to serve the community.”

Dr. Robert Lowenstein, an emergency medical specialist at Carney, said that the emergency department patient volume is not quite back to pre-Covid numbers, but has steadily increased following a “remarkable reduction” in volume during the first wave of the pandemic last spring. He emphasized that people in need of care shouldn’t think twice about heading to Carney or putting off the visit for fear of catching the virus. 

“It’s really important for the residents of Dorchester to know we are open and ready to take care of them, and that we employ the safety protocols necessary to make distinctions between Covid and non-Covid patients,” said Lowenstein. “For example, ambulances will call in advance and say, ‘We have a respiratory Covid patient coming in.’ We’ve streamlined that process so they know exactly what room to go to. They bypass waiting rooms and so forth so as not to expose others who are non-Covid.”

A testament to how safe the facility is, Sands and Lowenstein noted, is the fact that last year, for the second year in a row, Carney Hospital was identified as a “Grade A Leapfrog Facility” by Leapfrog, a nonprofit watchdog organization that evaluates hospitals based on safety and quality of care.

“That should give [residents] an extra level of confidence that when I go to Carney, I’m going to a high-quality, safe facility for care,” said Sands.