Amid growing coronavirus cases, hospitals have shared goal: Prevent the spread within their walls

From an "ask and mask" policy at the door to dedicated coronavirus testing tents, health systems are working furiously to limit exposure.
Image: The University of Utah Hospital erected two triage tents on Saturday where patients who are potentially infected with the new coronavirus can be tested without exposing everyone in the emergency room to the illness.
The University of Utah Hospital put up two tents on Saturday, March 7, 2020, to test patients for the coronavirus without exposing anyone in the emergency room.University of Utah Health

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By Elizabeth Chuck

At the University of Utah Hospital in Salt Lake City, patients who are worried that they may have the coronavirus no longer enter the hospital itself. Instead, they are treated just outside in big tents, where physicians donning protective gear test them and a special air filter whisks germs away.

Two 20-foot-wide tents were put up on Saturday as a way to limit the exposure between individuals suspected of having the coronavirus and patients in other areas of the hospital. A third, smaller tent was erected on Sunday.

As of Monday afternoon, only two Utahns were confirmed to have the coronavirus, including one evacuated from the stricken Diamond Princess cruise ship — but the University of Utah Health, which includes the Salt Lake City hospital, is not taking any chances.

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"It's an all-hands-on-deck situation right now."

"We're spending almost all of our time right now at the hospital system educating our staff, educating the public. It's an all-hands-on-deck situation right now," Kathy Wilets, spokeswoman for University of Utah Health, said.

Through social media and news conferences, the health care system is urging people to call first if they believe they may have COVID-19, the illness caused by the coronavirus.

Over the phone, the patients will be directed to the tents outside of the hospital, Wilets said, or be told to drive to an urgent care center, where a doctor in personal protective equipment will walk over to their car and test them without them having to get out of the driver's seat. They will then be instructed to drive home, where they are to remain while they wait for the test results.

It's part of a greater effort by hospitals from coast to coast to contain the spread of the virus. With more than 600 cases of the coronavirus confirmed across the United States, hospitals are not only preparing for a potential influx of patients, they are also examining ways that they can avoid contributing to the growing epidemic, which has sickened more than 105,000 people worldwide.

At Northwell Health, New York's largest health care provider, there is a new procedure for how to greet patients who walk in: "Ask and mask everyone," said Dr. John D'Angelo, senior vice president of emergency medicine for the health network.

"We have really tight procedures at our front doors to screen people right away," he said.

A greeter or triage nurse will question patients upon entry about whether they have recently traveled to a location that is experiencing an outbreak or whether they had close, prolonged contact with someone who is confirmed to have the virus, D'Angelo said. If they have, or if they are displaying symptoms of the virus — coughing, fever, shortness of breath — a face mask is put on and they are brought to an isolated area of the facility.

"The risk is usually much higher with close contact for more than five or six minutes. Walking past someone quickly on your way to the back room is unlikely to spread it to anyone."

"If they're coughing and sneezing, getting a mask on them reduces the likelihood of them spreading it to others dramatically," D'Angelo said. "The risk is usually much higher with close contact for more than five or six minutes. Walking past someone quickly on your way to the back room is unlikely to spread it to anyone."

On the other side of the country, Sutter Health, which cares for about 3 million patients across Northern California, is encouraging people to use virtual tools first before entering their hospitals. They are directing patients to their online symptom checker and to their video telehealth appointments — which were averaging 16 to 20 video visits per day before the coronavirus epidemic and now get as many as 121 a day, according to Dr. Albert Chan, chief of digital patient experience at Sutter Health.

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"I think this is a great opportunity to leverage telehealth," Chan said, adding that some private insurance companies have started to cover telehealth and legislation is seeking to remove Medicare restrictions on it in response to the coronavirus concerns.

Transmission from patient to patient is not the only concern: Health care workers can get sick, too.

At the University of Utah Health system, travel restrictions for staff and limits on visitors to the hospital are going to be unveiled soon, said Wilets, the spokeswoman. Even the health system's CEO, Dr. Michael Good, has started telling everyone to "fist-bump and elbow-bump instead of shaking hands right now" to stop the spread of germs, she added.

If a widespread outbreak does happen in Utah, the hospital has another tent it is prepared to set up that will serve as an isolation unit, Wilets said. She and others reiterated that calling a provider first before showing up to be tested is the best way to help keep the illness at bay in a health care setting.

"What we really don't want is a bunch of people who think they have coronavirus showing up at our hospitals and urgent cares without the appropriate masks and so forth," Wilets said.

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