Critical care unit prepared for COVID-19 surge
WHS Washington Hospital has reached an agreement to merge with University of Pittsburgh Medical Center.
Courtesy of Washington Health System
Dr. Nadine Dandachi is medical director of WHS Pulmonary and Critical Care Medicine.
As COVID-19 case numbers skyrocket across the country, Western Pennsylvania is also seeing a rise in hospitalizations because of the virus.
One of the people on the front lines battling the COVID-19 pandemic at Washington Health Systems is Dr. Nadine Dandachi, medical director of WHS Pulmonary and Critical Care Medicine.
Dandachi joined WHS five years ago in her current role. She said critical care units are definitely seeing COVID-19 cases.
“Along with the increased testing positivity rate in our community (meaning increase in cases), we are encountering increases in our hospitalizations for acute COVID-19 infections as well as for post-COVID infection complications like pulmonary embolism,” she said.
Numbers continue to grow and have jumped dramatically in the past month.
“The hospitalized number of patients per day quadrupled within the last month compared to March-September 2020,” Dandachi said, “but remains in the range that we are able to handle within our health system.”
Battling two viruses
Flu season is now underway and, so far, the number of cases across Pennsylvania has remained low.
Locally, hospitals are not seeing an increase in flu cases yet and Dandachi said this may be because of a rise in flu vaccinations along with community behavioral change brought on by the pandemic. She said many people have decreased indoor gatherings, increased sanitizing and handwashing, mask wearing and social distancing.
Some countries in the southern hemisphere reported lower numbers of flu during their winter, but there’s little data so far as to what happens if someone contracts flu and COVID-19 at the same time.
“The only data that we have about co-infection with COVID-19 and influenza comes from Wuhan, China,” Dandachi said. “But we still don’t know the frequency of the co-infection, the severity of the illness and the risk factors for such co-infection.”
She said the best defense is to be proactive when it comes to flu.
“We are increasing efforts in educating patients about the importance of flu vaccinations,” Dandachi said. “Now more than ever, I feel that this is one of the most important steps to protect the community as a whole and the vulnerable population from co-infection in the midst of the COVID-19 pandemic.”
Dandachi said preliminary studies show patients with both infections fare worse but that data is still not very clear. As far as treatment is concerned, it’s also unclear if steroids that are being used to treat COVID-19 will have any effect on the influenza virus.
If patient counts surge because of COVID-19 and/or influenza in the coming months, Dandachi said WHS is ready.
“We have prepared for a surge for COVID-19 and increased our critical care beds and equipment capacity,” she said. “We also devised a plan for physicians and staff availability to be able to effectively and safely treat significantly increased numbers of patients with respiratory illnesses and respiratory failure and these will be used when we encounter both viruses.”
Taking care of themselves
Healthcare workers are accustomed to dealing with stressful work situations and to be on high alert for a prolonged period of time.
“COVID-19 has been a challenging situation for everyone and pretty difficult on healthcare workers and first responders who have to cope with high stress work situations,” Dandachi said. “That includes increased work hours, physical strain of PPE use, constant awareness and vigilance and increased risk of exposure, the social stigma and others’ fear of contact.”
And those are just the stressors that staff deal with while they are on the job.
Away from work, there are more challenges such as isolation from friends and family and caring for their own families including tackling at-home schooling in many instances.
All of that pressure can sometimes prove to be overwhelming.
“We encourage our staff to pace themselves, work as teams, check in with each other, to take breaks and to seek out social and collegial support,” Dandachi said.
The health system also started a peer support group called ForYOU in addition to the existing Employee Assistance Program (EAP) that deals with employee engagement, coping with stress and changes and group counseling as well as other services.
Dandachi herself is in a unique situation because her husband is also a doctor.
“I am in a challenging situation,” she said. “My husband and I are both in-hospital physicians. We are also both Lebanese immigrants with no family living anywhere close and with four kids.”
The pair have known each other for 25 years and have tackled many tough situations as a team.
“He was my best friend and we have been together through so many personal hardships,” she said. “We moved together in 2004 to a country pretty far away from ours with no family or friends to follow our dream. He is my support and I am his. Our biggest drive to stay happy and healthy is our kids’ faces and smiles.”
How do they handle the stress?
Exercising together helps, she said, along with family movie and game nights, scavenger hunts in their backyard and experimenting with new recipes in the kitchen. She’s choosing to view these unprecedented times as a learning opportunity for her children.
“We see this as our opportunity to raise mentally strong children that are able to take on world challenges in the future by discussing with them what’s happening, explaining to them about the virus, the reason behind the masks and the isolation practices, what mom and dad do every day and teaching them to be responsible citizens by them helping in our home and our community,” she said.
Hope for a vaccine
The past few weeks have brought several exciting announcements about vaccine trials proving to be very effective.
While there’s plenty of hope to go around for a COVID-19 vaccine breakthrough soon, Dandachi said that won’t be a total solution.
“The availability of an effective vaccine can be a turning point in this pandemic, but we know that the virus battle is far from over,” she said. “Mass production and distribution of the vaccine remain a challenge. I am hoping for thorough protocols to be developed detailing the safety, side effects, effectiveness and composition to help prioritize the population that needs to receive it first.”
No one yet knows how long a vaccine would provide protection again the COVID-19 virus, so she warns that we must remain careful and vigilant.
“There is an inevitable ‘new normal’ that we will have to deal with for an uncertain period of time and this is unfortunately the truth that we have to face and accept,” she said. “It is worth hoping for the vaccine but we cannot bank on that alone. We need to continue to test, be able to find a reliable antibody test, develop strategies for contact tracing and for schools and businesses to open in a safe way.”