NWH: COVID-19 FAQS & Answers

NWH: COVID-19 FAQS & Answers: Northern Westchester Hospital continues to churn out valuable COVID-19 information to inform our communities and perhaps allay some of the fears we all share. The following questions are answered by NWH’s Chair of Emergency Medicine, Dr. Jim Dwyer. In the interests of brevity we will summarize portions of his responses and then pass along the rest.

NWH’s Supply of PPE is expected to last through the crisis

Dr. Jim Dwyer, NWH’s Chair of Emergency Medicine

First Dr. Dwyer has reported that early on the hospital instituted a mask mandate that required every visitor, patient and employee must wear a mask when they the enter the facility. He also reports that Northwell Health’s (new York State’s largest hospital system) CEO Michael Dowling has reassured healthcare workers that while the hospital system continues to pursue avenues to bump up inventory of personal protective equipment it has an adequate supply to make it through this crisis. Finally, NWH has “Purple Sun Technology” to sterilize and reuse equipment in the unlikely event that the hospital’s supplies run low.

Q:  Are people waiting too long before going to the ER with COVID-19 symptoms?

A:  Right now, the majority of patients we’re seeing in the ED are sick with fever and shortness of breath, typical symptoms of COVID-19. Many patients who turn out to be positive for COVID-19 are also experiencing gastrointestinal symptoms – nausea, vomiting, diarrhea, and abdominal pain. I think our community has been really great at self-identifying for COVID-19. If you have shortness of breath, we want you in the Emergency Department.  If you’re unable to hydrate yourself, or you’re getting dehydrated at home, we want you to come to the ER. We can evaluate you and make sure you are stable.

Q:  Are non-COVID patients who need emergency care getting the care they need?

My concern is that people aren’t getting the emergency care they need for non-COVID-related issues because they’re afraid of contracting the virus in the ER. People are staying at home when they should be coming to the hospital.

Q:  Do you have any patients at your hospital with COVID-19 right now? 

A:  I believe we have over thirty COVID-19 patients, some of which are on ventilators in our ICU. We are in a good position in terms of the availability of space. We have the capacity to treat additional inpatients right now. We also have plans in place to triple our ICU capacity if we need to. We are concerned about ventilators. Although we have unused ventilators right now, we do worry that if it gets bad, we might have to get creative. We have anesthesia machines that have ventilators in them that can be repurposed for COVID patients. We also have non-invasive ventilator machines that we can use on someone who is intubated. We have many contingency plans in place.

Editor’s Note: as of Tuesday, 3/31, we have over 50 COVID-19 positive patients.

Q: Is NWH taking patients from other hospitals who are at capacity?

A:  We’ve taken a number of patients from other Northwell hospitals. We call it load balancing, which occurs seamlessly within the Northwell Network. If there’s a request outside the Northwell network, we will do whatever we can to help. We’ve been taking Neonates from Columbia Presbyterian.

Q: Can you tell when someone is presenting to the ER that it’s COVID?

A: You have to consider that any patient walking in might have COVID. The prevalence of this disease is so high. If someone presents with the classic presentation – difficulty breathing, cough – you have a very high index of suspicion that it’s COVID-19, but some people have atypical symptoms like abdominal pain without upper respiratory symptoms or fever. It can be tricky.

Q:  What is herd immunity and can it stop the coronavirus?

A:  Herd immunity means that if the virus keeps spreading, eventually so many people will have been infected and become immune that the outbreak will calm out on its own. We cannot rely on this theory. Unless you’ve had the virus and recovered, which is a minority of people, you don’t have immunity to it. Right now, we need to flatten the curve by keeping infection down so we do not completely overwhelm the healthcare system. I know people are bored out of their minds at home right now, but what you’re doing is so important. It helps me keep your loved ones healthy and keep my census within a reasonable range.

Q:  How long do patients need to be on a ventilator before they come out of it?

A:  Most patients who need a ventilator as a result of this disease stay on it for 10 to 14 days. The sad reality is, that patients who are especially older, who have complex medical problems might not make it through this virus, even with a ventilator. Unfortunately, one thing that frees up a ventilator is when someone passes. While we only have nine patients on ventilators right now, we are definitely going to need more.

Anything you’d like to say to the community?

The community support has been really overwhelming and it’s great. It really keeps the morale of the staff up – Thank you to our community for all your support. You make us feel like we are not in this alone. It’s nice to know that our community appreciates what we are doing

For a complete list of FAQs & Answers from Dr. Dwyer click here.

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