As COVID-19 cases have surged in recent weeks across New Hampshire, Monadnock Community Hospital CEO Cyndee McGuire said they are keeping a close eye on the numbers.
On Sunday, the New Hampshire Department of Health and Human Services announced 92 new coronavirus cases in New Hampshire bringing the total of active COVID-19 cases to 1,032, including 23 current hospitalizations.
Positive COVID-19 cases in the region are up slightly, with 1-4 current cases in Peterborough, Jaffrey, Rindge and Wilton as of Sunday and six active cases in New Ipswich. McGuire said the best thing MCH can do is be ready in the event that those numbers spike more dramatically.
“We’ve certainly seen that over the last two or three weeks,” McGuire said of the increasing numbers in the state. “But our community has really not seen that.”
Dr. Luc Shippee, medical director of Monadnock Health Partners, said they are monitoring potential scenarios that would cause for the need to change how things operate at the hospital.
“We’ve developed a number of triggers internally that tells us we need to adjust,” Shippee said. Some of those triggers include staff illness and how many calls they receive for symptoms.
While Hillsborough County as a whole are high, Shippee said the area is “probably more like Cheshire County” in respect to the numbers. He said it’s not all that surprising that the numbers have increased, as the weather starts to cool forcing people inside and students going back to school.
“I think we were anticipating this,” he said. “It’s easier when you can anticipate that jump and we were always expecting to see numbers rise.”
When COVID-19 first made headlines in the U.S. in March, Monadnock Community Hospital was forced to “shut down operations across the board,” McGuire said, except for emergency situations and those needing hospitalization. The goal is to avoid that even in the case of a spike in numbers locally
“We’ve taken a lot of steps in the last six or seven months to ensure we don’t have to do that again,” McGuire said. But anything could change “if we see a significant influx of people needing to be admitted,” although it has been months since a COVID-19 patient has needed hospitalization at MCH. Now they have a partnership with Catholic Medical Center and Dartmouth Hitchcock to transfer any patients who test positive for the virus and need to be admitted.
McGuire said that if things change rapidly, like where those hospitals cannot take coronavirus patients, the hospital has the capacity of 40 beds.
“We’ve got our setup and are prepared to double down if the numbers rise,” Shippee said.
Currently 30 to 40 percent of all visits are conducted using telehealth and other visits for things like lab work, x-rays and other necessary visits are scheduled in a way that keeps patients away from each other.
“We want to be able to maintain all those services,” Shippee said.
The respiratory clinic has been seeing patients that exhibit coronavirus symptoms in a separate location, McGuire said.
The only thing that hasn’t returned is the use of the Bond Wellness Center, which McGuire said “we’re looking at ways we can offer some services to those people.”
Shutting down operations was a huge financial hit to MCH, which resulted in a loss of less than $1 million for the fiscal year ending in September, said Laura Gingras, Vice President of Community Relations and Philanthropy at MCH. That was significantly lower than what has been anticipated since services were shut down, offest partially by a $3.7 million grant from the state of New Hampshire’s COVID-19 Emergency Healthcare System Relief Fund received in September.
McGuire said the hospital is conducting outdoor testing every day and are seeing anywhere from 30 to 50 tests per day and “honestly, it’s been pretty consistent,” she said.
“The biggest change seen is a more solid supply chain,” Shippee said. “And so far it’s looking like the supply is meeting the demand.”
All the tests, McGuire said, are physician ordered for those exhibiting symptoms since MCH is not a designated testing site. She added they have not had “any challenges with the availability of what they call test kits,” which are the PCR, nasal swab tests. The collected samples are sent to Catholic Medical Center for processing. McGuire said that for all patients requiring hospitalization, MCH conducts rapid testing with results available in a few hours. General surgery patients are tested five days prior and asked to self isolate while awaiting results.
MCH is also offering drive through flu clinics on Fridays through Nov. 27, where people can set up an appointment by contacting their primary care physician.
Testing is also available for employees who show symptoms or have concerns, but there’s no recommendation to conduct testing. They also monitor employee illness rate.
When four members of the Peterborough Rescue tested positive for COVID-19 earlier this month, McGuire said they offered testing for members of the Emergency Department “just out of an abundance of caution.”
On the personal protective equipment front, McGuire said they monitor supplies daily and outside of certain sizes of N95 masks, the availability has been enough to maintain a supply.
McGuire said she attributes the relatively low numbers in the region to the community’s response to the guidelines of wearing a mask, practicing social distancing and avoiding gathering indoors. She understands that there is precaution fatigue, but reiterated the need for everyone to continue to do their part.
“That’s our message every single day,” she said. Because as of now, there’s no telling when a vaccine will be available, as it’s looking more likely that it won’t be till later in 2021.
“I think it’s just trying to remain vigilant,” Shippee said. “We as community members have to do our part.” That includes if you don’t feel well stay home, wash your hands and wear a mask.
“If not, it could change rapidly,” he said. “That’s how this thing could turn on a dime with a lack of vigilance.”
Because as Shippee puts it, “it’s still a deadly disease and my impression of the virus is that it’s kind of random.”
But unlike March when things quickly changed and everything had to shut down, Shippee said the hospital is in a much better place.
“If this thing blows up tomorrow, we’re prepared,” he said.