Although the health system’s volume of Covid-related emergency department visits and admissions is much lower now than during the peak of the crisis, it’s higher than at the end of summer, Katz said.
“Right now we have no capacity issues," he said. “We understand that, of course, could change going forward. And if we did have capacity issues, we would again cancel elective surgeries and other elective visits and procedures.”
Crain’s reported earlier this year that elective admissions can make up 30% or more of a hospital’s revenue, according to a recent analysis by researchers at Weill Cornell Medicine in the Journal of the American Medical Association. Although there have been billions of dollars in federal relief dedicated to helping hospitals withstand the crisis, hundreds of millions of dollars in lost revenues and supply costs could continue.
Katz said expanded testing—including rapid testing—has helped with keeping non-Covid care going.
“I can still remember when we had to call individually for every patient we needed a test for because it was being sent to the Centers for Disease Control and Prevention,” he said.
Other measures at H&H have included equipping patient rooms with cameras and microphones to enable more remote monitoring, maintaining 90-day reserves of personal protective equipment, purchasing additional ventilators and dialysis machines, establishing hot (Covid) and cold (non-Covid) areas in hospitals, and training some existing nurses for ICU work, Katz said.
At Northwell Health, Dr. Mark Jarrett, senior vice president and chief quality officer, said the recent rise in Covid-19 cases is alarming. The health system is considering limiting visitation again as a result, he said.
Right now Northwell has more than enough ICU space, Jarrett said. Early in the week, the health system had about 280 Covid-19 patients in its hospitals, compared with some 3,500 in April. But two months ago there were just 80 Covid patients.
At the same time, hospitals are in a better place to handle an increase in cases than they were in the early days of the pandemic, Jarrett said. There are better treatments now, and patients—including those in the ICU—are having better outcomes.
Monoclonal antibodies—laboratory-made proteins that mimic human antibodies in the immune system to fight off viruses—are among the new treatments for certain Covid-19 patients. Northwell today plans to open its first outpatient infusion center for treating Covid-19 patients with monoclonal antibodies at South Shore University Hospital, Jarrett said. The center is located in a medical tent erected during the height of the crisis and will be kept separate from other services because monoclonal antibodies work best early in Covid-19’s course, when people are shedding the most virus and are highly contagious.
The process is similar to administering infusions to patients for rheumatoid arthritis and ulcerative colitis. The plan is to open additional regional infusion centers, Jarrett said.
Although the impending arrival of a vaccine holds promise in the fight against the coronavirus, how New Yorkers celebrate Thanksgiving could set the tone for what a second surge will mean for hospitals.
“Our biggest concern is Thanksgiving,” Jarrett said. “We will have to wait two weeks to see the effects of it.”
