A large, white tent has been erected in the emergency department parking lot at Adventist Health Lodi Memorial Hospital, soon to be ready for screening and testing those in the community who think they might have contracted COVID-19.
Right now, the tent is able to house four triage stations, complete with registration computers, screening equipment, chairs and gurneys, if needed.
It will also house a generator to run heaters and outdoor lighting systems so staff can administer help during the nighttime hours, as well as air filters to circulate fresh oxygen and keep it clean.
Soon, the pop-up triage will be flanked by the smaller tents that have been in place near the emergency department delivery bays for the last week.
Those tents contain X-ray machines and other equipment Lodi Memorial staff might need to determine if residents have contracted the virus or not.
Goldie Smith, the hospital’s emergency department director, said the tents are not meant to create panic in the community, but to ensure the hospital is prepared for anything.
“The big tent came up (Wednesday), because we’re anticipating more patients coming in, and we want to be sure we have the space to keep everybody safe and everybody separated,” Smith said Thursday.
“When patients come in, we make sure anyone with respiratory symptoms, coughing, shortness of breath ... we try to separate them form the rest of the other patients,” she said. “And then from there we determine what is the proper approach or treatment for these patients. We’re just trying make sure we’re not spreading the virus, so we’re being extra cautious.”
Not everyone will be able to access the tent or get screened and tested, she said. Much like rules enacted by San Joaquin County Public Health Services and San Joaquin General Hospital, only those showing symptoms will be attended to, Smith said.
“This is still just for emergency room patients,” she said. “So if it is just for testing alone, we do ask you to coordinate with public health and your primary care physician. But if you’re sick, you feel ill and think you need to see a doctor, we’re here and can do that for you.”
Smith said the screening and testing process is instantaneous, as there is a nurse at the “front door” of their tent around the clock. As soon as someone enters, they will be asked if they are having respiratory problems if they have a cough or fever.
Typically, those showing symptoms of coronavirus will be given a face mask to wear, and nurses will use a testing kit to take a swab from the patient’s mouth. If they appear to be very sick, then they will be admitted to the hospital.
“If they’re needing care, they’ll be treated here,” emergency department educator Megan Bayrouty said. After that, the disposition of the patient is either going back home, which is then having them stay in contact with public health and self-quarantining. If they’re needing to be admitted, then they’ll be admitted into the hospital.”
After screening or testing every patient, Bayrouty said every nurse or staffer must remove the gowns, gloves, masks or face shields they wear, and replace them with new ones to ensure the virus is not spread to other patients.
In addition, alcohol sanitizers will be placed everywhere in all three tents, she said.
While county public health has said it can test as many as 60 people a day, Smith said that amount of testing Lodi Memorial can provide varies from day to day, depending on how many testing units are delivered when they are ordered.
She did say there are enough kits to care for the Lodi community, and there has never been a day the hospital has been without the kits.
Test result turnaround also varies, Smith said, as laboratories all over the county are overwhelmed. She said some days results are known within two days, but as of Thursday, turnaround seemed to be five days.
“But now, we just heard today, that there is criteria where they can prioritize certain tests, like for health care providers, or for folks who live in a shelter, because we don’t want to infect the community,” she said. “So there is a way we can prioritize testing for certain prioritizing.”
Shannon Esperson is an RN at Lodi Memorial, and was one of many nurses and staffers assigned for the day to the Possible COVID Exposure Team, which was assessing patients before they enter the hospital, in an effort to prevent exposure to patients already being treated inside.
“If they present with any possible symptoms or have had any type of exposure, we direct them to our outside tent where we are maintaining six feet of space, and we have designated team members for designated providers,” she said.
Esperson said the message to many who have come to be screened or tested is to stay home and self-isolate, However, in the event that someone can’t because they don’t have a home, the team is providing community resource information so they can find a place to keep their distance from other people.
In addition, the team is providing appropriate medication and supplies when sending patients home to recover, and they are advising people to conduct follow-up appointments with their doctors via Skype.
She said the last few days have been some of the busiest she and her co-workers have experienced, and many are working overtime to ensure the community remains healthy.
“It’s really great because we have nurses here from urgent care helping us,” she said. “One of our operating room nurses who used to work in the emergency room is here, and outpatient elective surgeries are being canceled right now, because we’re not doing any elective things that aren’t necessary. The team that is always a team, is coming together even more.”
Along with canceling non-essential procedures, Smith said administration is having those who are able to work from home do so.
The hospital is in constant contact with its incident command center, which provides updates from county public health, a count of how many test kits are in stock, how many personal protective equipment items are on hand, and how what personnel is available, she said.
We just want to make sure that when we’re needed by the community that we’re ready,” she said. “We’re trying to get ahead of it. And if it comes out we don’t need any of it, so much the better.”