How hospitals in every state are adapting to COVID-19

Gov. Kay Ivey relaxed the rules for health care providers, such as allowing recently retired doctors and nurses to get their licenses reinstated more quickly. This means more medical practitioners can help out.

Among the Alaska Department of Health and Social Services’ efforts to adapt to COVID-19, they’ve increased their telehealth services to allow for more flexible care and to keep people in their homes. They also loosened the rules on the technology required to provide care, so health care workers can assist via FaceTime, for instance.

The director of the Arizona Department of Health Services, Dr. Cara Christ, is trying to find a way to free up hospital beds in anticipation of the onslaught of COVID-19 patients. The state has already asked for resources to open up field hospitals, and Gov. Doug Ducey has called for a 50% increase in hospital beds by the end of April. The military has said they’re ready to convert buildings, like convention centers, into makeshift hospitals.

Arkansas Gov. Asa Hutchinson signed a bill on March 28 to create a $173 million COVID-19 fund. Hutchinson can access the fund with approval from legislative leaders.

To increase the health care workforce during the pandemic, California Gov. Gavin Newsom launched the California Health Corps. The new initiative waives some professional licensing and certification requirements during the COVID-19 emergency in order to help California respond to the outbreak.

The Colorado State Emergency Operations Center is teaming up with local public health organizations and health care facilities to increase the number of intensive care unit (ICU) beds available. They’re moving patients from ICU beds to lower-needs beds, as well as scouting out alternative care sites.

In Connecticut, Yale University and its affiliated medical treatment facilities are working together to shore up resources and equip themselves. For example, the top three floors of the Smilow Cancer Hospital were converted for COVID-19 patients, and researchers from Yale are using models to help figure out how to direct resources to the places that need them the most.

Delaware Gov. John Carney imposed new screening protocols for essential workers. Carney and Delaware Division of Public Health Director Karyl T. Rattay recommend that employees are screened each day for a fever—with a touchless thermometer if possible—and for any symptoms of coronavirus. Anyone with a body temperature of 99.5 degrees Fahrenheit and above must be sent home.

To prepare for the spike in COVID-19-related deaths, all seven Veterans Affairs hospitals in Florida bought mobile morgue trailers. These will offer space to store the deceased when traditional hospital morgues are at capacity.

Hospitals throughout the state of Georgia are expanding their critical-care services throughout in preparation for the coronavirus spike. These actions include creating space for more ICU beds and securing resources like ventilators, masks, and gowns. The state is also getting "medical pods" that can function as a regular hospital in counties that don't have hospitals or ICU beds.

Travel restrictions were imposed in Hawaii on March 31 to reduce the spread of COVID-19. A statement released by the state of Hawaii Depart of Health said that anyone traveling between the islands “must self-quarantine for 14 days.” People traveling to give medical care don’t have to quarantine but do have to wear appropriate protective gear and follow social distancing rules.

On March 27, Gov. Brad Little signed an executive order so that items like ventilators or personal protective equipment can be bought quickly and the state doesn’t have to wait on essential supplies. The order made $39.3 million available for coronavirus aid.

Illinois is working to expand bed capacity throughout the state. For example, Chicago’s McCormick Place is in the process of being turned into a 3,000-bed care center, and the previously closed Advocate Sherman Hospital in Elgin and MetroSouth Health Center in Blue Island are being reopened to care for COVID-19 patients.

Hospitals in Indiana have stopped elective surgeries and created a statewide resource pool in preparation for a rise in COVID-19 patients. Also, according to Fox 59, more than 5,000 health care providers such as medical students and retired clinicians have volunteered to help.

To preserve supplies, The University of Iowa Hospitals and Clinics stopped using gowns when treating people who didn't have COVID-19. Iowa's biggest hospital also canceled nonessential surgeries and procedures, reassigned medical staff, and amped up their telehealth services.

Stormont Vail Health, a major hospital in Topeka, Kansas, cut nonpatient care staff pay by 50% to deal with COVID-19. Other staff members’ salaries were cut by 10% to 35%. The staff who deal with patients directly will maintain their current salary.

Hospitals in Hardin County set up “cough clinics” for people who may have coronavirus symptoms to keep hospitals from becoming overwhelmed. Additionally, Kentucky Gov. Andy Beshear ordered all hospitals to put elective procedures on hold to clear room for incoming COVID-19 cases.

In response to the sudden spike in COVID-19 cases, Louisiana Gov. John Bel Edwards doubled the number of hospital beds in the New Orleans Convention Center. The center will now be used as a coronavirus recovery center and will have 2,000 beds.

Rural Maine hospitals are coming up with creative alternatives to deal with supply shortages. Houlton Regional Hospital is sewing their own gowns and sourcing face shields from a local auto supply shop.

Maryland is planning to repurpose vehicle inspection sites to become drive-through testing sites to help keep people out of the hospitals. DMV hospitals are also setting up tents to treat patients, and there are talks to reopen shuttered hospitals such as Providence Hospital, which would help address bed shortage concerns.

Hundreds of Harvard Medical School students have volunteered to help at Massachusetts General Hospital and other major hospitals in the Boston area. The COVID-19 virus medical student response team split up into four committees focused on everything from educating the public to supporting vulnerable populations.

As hospitals prepare for the worst-case scenario, one Michigan hospital system detailed who would get priority over life-saving resources. The letter, which stated that “patients who have the best chance of getting better” are to be prioritized, is part of Henry Ford Health System’s larger emergency response plan.

Minnesota hospitals are working together to make sure patients go to centers with free beds and they’re going to divy up supplies as needed. Leaders at Hennepin County Medical Center in Minneapolis are thinking ahead on what to do if all the ventilators are in use. Dr. John Hick, a physician at the hospital, told Star Tribune they could use the ventilator equipment from ambulances or adapt anesthesia devices.

University of Mississippi Medical Center made its own COVID-19 test to ramp up diagnostics in the state. They’ve also stockpiled protective equipment, reduced the number of people coming into the hospital for nonessential procedures, and rolled out a smartphone app that lets health care workers remotely treat COVID-19 patients if they do not need hospitalization.  

Hospitals in Kansas City are trying to make their existing supplies last longer. Dr. Dana Hawkinson, a University of Kansas Health System infectious disease specialist, told reporters at a press briefing that they're looking into how they can reuse the N-95 face masks, which purify air particles, while they wait for supplies to arrive.

To keep as many beds open as possible Montana has canceled all elective procedures. Many hospitals are also working to create extra beds by converting other hospital rooms, moving patients, and fast-tracking expansion projects including Bozeman Health.

The Nebraska Medical Center, which successfully dealt with Ebola cases in 2014, has been preparing for months. They’ve put off elective procedures, moved patients to different parts of the campus, and retrained staff on how to care for COVID-19 patients. They’re also finding clever ways to make supplies last longer, such as using ultraviolet light to decontaminate N95 masks and make them reusable.

Hospitals in Nevada, such as Sunrise Hospital and Medical Center in Las Vegas and The VA Southern Nevada Health Care System, are screening all patients before they come into the hospital to lower the risk of transmission. Nevada Gov. Steve Sisolak is also allowing retired doctors and nurses to go back to work and any health care workers from out of state to help.

In three New Hampshire hospitals, staff must wear a mask at all times if they work in patient care areas. The decision by the Hospital Corporation of America was made based on new evidence that suggests the coronavirus can be spread even if the person is not showing symptoms.

New Jersey is working quickly to increase hospital capacity to deal with the onslaught of COVID-19 patients. There are plans for field hospitals to be erected within the coming week and more later this month, as well as plans to reopen hospitals to help accommodate the demand for beds. To cover staffing needs the state has said they may recruit nursing students in their final semester and new rules passed mean that ventilators can be used on multiple patients at a time.

Doctors at the University of New Mexico Hospital began their first clinical drug trial for a possible coronavirus treatment. They are testing the drugs hydroxychloroquine, for patients who have respiratory issues, and remdesivir, for patients who present with pneumonia symptoms. They’re looking to see if the treatments might help prevent the virus from spreading in the body.

To help combat the COVID-19 pandemic Gov. Andrew Cuomo set up a new hospital network to join up New York’s health care system resources. The online portal links hospitals and health care facilities all over the state and sends workers and volunteers to the hospitals that need it the most.

North Carolina hospitals put a call out for doctors and nurses to help with the coronavirus surge. Many are asking for recently retired medical professionals to come back. Also the University of North Carolina Chapel Hill is dropping tuition fees for volunteers to get quick training and for nurses to refresh their licenses via an online course.

To prepare for the rising number of COVID-19 patients, North Dakota activated a Workforce Coordination Center to help increase the emergency workforce needed. It’s looking to recruit individuals with experience in everything from health care to critical manufacturing. Many of the jobs would be for the planned field hospitals.

Gov. Mike DeWine split Ohio up into three hospital zones—Cleveland, Columbus, and Cincinnati/Dayton—to prepare for the spike in COVID-19 patients. The divide is to deal with capacity and patient care; if one is full they can direct patients elsewhere.

Oklahoma City hospitals built temporary shelters to check patients before they’re allowed into the hospital. The state also lifted restrictions on the COVID-19 test so they can get a better picture of how many people are affected and how the virus is spreading.

Researchers from Oregon Health and Sciences University and other hospitals are collaborating with Oregon Hospital Association to predict how COVID-19 will impact individual hospitals. On March 26, Oregon health officials put a statewide action plan in place that addresses necessary steps to expand the health care system’s capacity and keep up its capability to treat coronavirus patients.

Construction crews are working feverishly to finish building a hospital in Philadelphia ahead of schedule so there are more beds for COVID-19 patients. The construction of Pavilion, the new hospital on the campus of the Hospital of the University of Pennsylvania, would add an additional 120 patient rooms.

Dr. Nicole Alexander-Scott, director of the state Health Department is letting nursing students who have finished one semester of school to get a 90-day certified nursing assistant license. The move is to help bolster the health care workforce.

The Medical University of South Carolina, the largest hospital in the state, is implementing strict return to work policies to help limit the spread of the coronavirus. Hospital officials told The State that employees can't go to work if they have any respiratory symptoms of the virus. They also aren't allowed back if they haven't gotten tested after a high-risk exposure in or outside of work.

South Dakota Gov. Kristi Noem asked hospitals to reschedule elective surgeries to reduce the spread of the virus and free up resources. Secretary of Health Kim Malsam-Rysdon also told the Associated Press that the state is using the $4.5 million it got from the federal government to help hospitals prepare for the surge of patients.

The state is increasing spending on personal protective equipment (PPE), among other measures to prepare for the peak of COVID-19 cases. The state will spend $14 million on 18 million additions pieces of PPE for patients and health care workers, Gov. Bill Lee told reporters.

Texas hospitals are planning for the surge in many ways, such as adapting hospital beds for different uses and hosting emergency blood drives. To support Texans experiencing anxiety and stress due to the COVID-19 pandemic, Texas Health and Human Services launched a 24/7 statewide mental health support line.

Utah is trying to boost testing capabilities as quickly as possible. Additionally, to help conserve resources clinics and hospitals are limiting all other nonessential procedures.

University of Vermont Health Network downsized nonessential staff and reallocated others to prepare for the increase in COVID-19 patients. The group of hospitals also stopped elective procedures and increased their telehealth capabilities to limit exposure.

Virginia hospitals called on the Department of Defence and the Department of Veterans Affairs to open space at military and veterans establishments for COVID-19 patients. As of April 1, three military hospital sites are planned for coronavirus patients.

Soldiers set up a military field hospital in less than 48 hours in the CenturyLink Field Event Center in Seattle. The military field hospital has 250 beds and will handle any patients who don’t have coronavirus that overflow from hospitals. According to KUOW reporter Megan Farmer, the field hospital also has: “an emergency room area, x-ray capabilities, a patient administration division, a lab area, microbiology, blood banking, operating room suites, as well as minimal care, intermediate care, and intensive care units.”

To help reduce the spread of COVID-19, West Virginia hospitals are using video calls for patients with minor medical issues. Joe Letnaunchyn, president and CEO of the West Virginia Hospital Association, told The Parkersburg News and Sentinel the state is trying to find sites for temporary hospitals.

To alleviate the strain on hospitals, the state opened voluntary isolation centers for people with coronavirus symptoms in Madison and Milwaukee. Before patients can stay there they need to be referred by a doctor or health care professional.

Cheyenne Regional Medical Center, one of Wyoming's largest hospitals, imposed a no visitor policy to help lessen the spread of the virus. There are some exceptions to the policy; CRMC is allowing a certain number of visitors in a day for maternity and neonatal intensive care unit patients, as well as pediatric patients and end-of-life patients, and those with specific disabilties.