Being prepared for COVID-19 is now ‘part of daily life’ at EvergreenHealth

As Washington state seems to have passed the first wave of COVID-19 infections and looks toward returning to some sense of normalcy, KIRO Radio’s Gee and Ursula Show spoke to two doctors who have been on the front lines of the fight against this virus.

Dr. Jeff Tomlin and Dr. Ettore Palazzo from EvergreenHealth shared some good news and talked about how their hospital was uniquely prepared to handle COVID-19.

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“We at Evergreen had been watching the unfolding events in China very closely and making sure that we were following the CDC guidelines as far as testing and who was recommended to be tested,” Palazzo said. “And on February 27 there was a change in the recommended testing guidelines that now started to allow providers to look for patients with unexplained respiratory symptoms that hadn’t necessarily traveled or had exposure to someone with COVID-19.”

With the new guidelines, they found two patients that met the criteria and decided as an exercise to prepare for the potential surge to send the two tests. To their surprise, the results came back positive.

“The first reaction is it’s hard to believe that of all the hospitals in the United States, this would be the one that would be on the cutting edge of this,” Tomlin said.

While EvergreenHealth didn’t have a “pandemic playbook” the staff was prepared to respond to emergencies. They immediately sprung into action to ensure the facility and staff was prepared.

EvergreenHealth has been sending 20 people a year to the Center for Domestic Preparedness in Alabama, which covers all hazard responses from chemical blasts to shootings to pandemics, Tomlin said. This training meant the staff at Evergreen knew how to stand up an incident command system and knew that the first response would be critical.

Luckily, Evergreen never saw the overwhelming situations seen now in New York. Tomlin and Palazzo were the ones who first communicated to the staff that there was COVID-19 within the hospital.

“The response of the staff was not panic or even fear,” Tomlin said. “It was really problem solving. They asked us really good questions.”

At the start, there was enough personal protective equipment (PPE) to get through, but the supply did become a little strained in day three of four, Tomlin said.

“But at no point I would say that we were really overwhelmed, but we were challenged,” he added. “Certainly, there was an intensity by the staff in terms of meeting this, and perhaps the greatest challenge is really the unknown enemy.”

Now, they do have a playbook prepared in case a surge happens, with protocols and procedures in place at every level. Evergreen staff have planned out where they can expand to care for these patients with airborne precautions in negative pressure rooms. The staff also gets an almost hourly assessment of how much PPE they have, if there’s a need, and where they’re going to need additional resources.

“That’s part of daily life here now,” Palazzo said. “We continue normal operations, we’re open for business. We know that elective surgeries are still off the table, just given the governor’s proclamation. But we need to take care of the patients that come to the hospital, whether it’s COVID or non-COVID.”

Early on, testing capacity was a limiting factor at Evergreen. Today, Palazzo said, capacity has improved, but there’s still a long way to go.

“We know that to start progressing through this and being able to open up services … we need to be able to test more,” Palazzo said. “We need to be able to do contact tracing and quarantine those individuals if they come positive. So the expansion of testing is a top priority.”

EvergreenHealth has seen a 75% reduction in hospital admissions for COVID-19 from March 21 to April 18. The number of cases in the ICU on ventilators has also decreased.

“It allows us more flexibility to take care of the other patients that come in,” Palazzo said. “It allows the physicians … to be able to do their work in a bit of a less stressful situation. And, of course, start thinking about a return to more normal operations when it’s safe and clear to do things like elective surgeries.”

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EvergreenHealth may be in a good spot right now, but that’s not the case statewide. However, Dr. Tomlin said Vice Admiral Raquel Bono has been holding weekly calls with all the hospitals in the state.

“The purpose of bringing the retired Navy surgeon three star admiral into the state was to make sure that should a crisis happen and the surge that was expected … that we ‘d all be prepared to work together to confront it,” he said.

“So we all submit reports now and we meet weekly,” Tomlin added. “I would say, it’s been a success story in terms of how we’ve come together through all the different health care organizations in the state to bring the forces to bear for COVID-19.”

Listen to the Gee and Ursula Show weekday mornings from 9 a.m. – 12 p.m. on KIRO Radio, 97.3 FM. Subscribe to the podcast here.