Collaborations that save lives aren’t usually built on skepticism and secrecy, but that was the situation when Memorial Healthcare System and the Hollywood (Fla.) Fire Rescue Department took on the challenge of safeguarding the health of some of South Florida’s most vulnerable citizens during COVID-19.
It was no small task, since our hospital district has nearly 60 privately owned and unaffiliated nursing homes filled with elderly and medically compromised patients. While it would have been easier to have not pursued this level of proactive outreach, that wasn’t an option, especially after what we had already experienced nearly three years ago.
Those who weren’t living in the Bahamas, Puerto Rico or the Southeast U.S. in September 2017 may not remember Hurricane Irma, but, for us, it’s a storm we’ll never forget. In the wake of the onetime Category 5 storm—and when its widespread impact on South Florida was not completely known—teams we led first entered the Rehabilitation Center at Hollywood Hills after several residents arrived in our emergency departments with heatstroke.
The nursing home had lost power when the hurricane struck and had been without air conditioning for close to three days when we became aware of the situation.
Through round-the-clock efforts from those within Memorial Healthcare System, we were able to save more than 100 individuals overcome by the heat. Unfortunately, 12 people ultimately died. It was a tragic situation that underscored how quickly vulnerable populations can succumb in times of crisis.
A different kind of deadly storm
It was impossible not to think of those horrible days when reports first began to surface from China about what would become a worldwide pandemic. Since the virus was preying on those with comorbidities, our fear was COVID-19 would disproportionately affect the elderly and, given the close living quarters of many skilled-nursing facilities, decimate the resident population. Add in nursing homes’ lack of knowledge and resources about testing and contact tracing—and the reluctance by some to publicly acknowledge positive test results—and you’ve got a recipe for disaster within our service area.
While we certainly knew what needed to be done, having already instituted strict COVID-specific guidelines to keep residents and staff safe at our own skilled-nursing facility, scaling it to protect a much larger audience would require bigger-picture thinking.
We began by forming a coalition with our city’s Fire Rescue Department, knowing its strike force unit could provide staffing to assist with outreach to at-risk facilities. We were also able to break down barriers by educating and providing resources, such as personal protective equipment and setting up triage units where needed.
Our plan included widespread employee testing by Memorial Regional Hospital clinical teams, and for anyone testing positive, isolation or hospital transfers. That was followed by contact tracing to determine which residents might have come in contact with the infected staff member, enabling us to reduce transmission by suggesting quarantine for those exposed to carriers.
While we weren’t allowed to test residents in the private facilities, we did put systems in place to identify any residents with the coronavirus at our EDs and reported those cases to nursing home administrators and the health department.
So far, we’ve been successful preventing widespread infection, overseeing containment in places that wouldn’t otherwise have the knowledge and resources to manage critical conditions. We’ve also established open lines of communication and trust, two things that didn’t exist before the outreach began.
While understanding the virus remains a significant and ongoing threat, we’ll take some comfort in the meantime knowing members of our community are a lot less vulnerable.