The doctor leading the coronavirus response at the largest health system in Arizona shares how it's confronting a surge in cases since the state reopened
- In recent weeks, Arizona has seen its coronavirus cases surge.
- The increasing trend is "concerning," Dr. Marjorie Bessel, the chief clinical officer at Banner Health, the largest health system in Arizona, told Business Insider.
- The health system is grappling with the rising case count and hospitalizations at a time when it still has to manage the care of non-COVID-19 patients. Bessel shared what the organization has learned about how to do that since the pandemic first hit the US in March.
On June 8, Banner Health sounded the alarm on the rising number of coronavirus cases in Arizona. The number of people on ventilators had quadrupled since the state reopened on May 15, the health system said.
Banner Health operates in eight states and is the largest health system in Arizona. It's managing nearly half the people hospitalized with confirmed or suspected coronavirus cases in the state, Dr. Marjorie Bessel, the health system's chief clinical officer and COVID-19 lead told Business Insider.
Maricopa County, which includes the Phoenix metro area and where Banner has most of its beds, has particularly been hit hard.
"We continue to see a concerning increasing trend of COVID-19 that is both at our hospital level, at the county level and in the state statistics," Bessel said.
What hospitals have learned since March
For now, Banner's hospitals still have the capacity to handle the surge in patients. She said they have sufficient protective gear for staff and ventilators, for example.
Plus, Banner is bringing on additional staff from other areas around the US to Arizona.
Early on, Banner, sent healthcare workers to locations in Colorado, which was hit harder earlier in the pandemic. Now, workers in Colorado are returning the favor in Arizona. The organization is also hiring on contracted workers, something they'd otherwise do in the course of a typical flu season.
Banner has learned from observing how places like New York cared for patients and from later research, and the health system is treating patients differently.
For instance, it's not using hydroxychloroquine and chloroquine, the antimalarial medications that gained popularity early in the pandemic, but that flopped against the coronavirus in robust trials.
And the system is now evaluating the literature on whether to include dexamethasone in its protocols for treating COVID-19 patients, after UK researchers said that they'd found some success in using the decades-old steroid in hospitalized patients.
The health system has also had to adjust to whom they give remdesivir, an experimental antiviral that's one of the leading treatment options for the novel coronavirus. That's been based largely on the limited availability of the drug Bessel said.
Keeping the caseload down as scientists learn more about the disease remains key.
"Every additional day that we buy ourselves of reduced activity gets us a day closer to either more definitive treatments, or a day closer to an effective and safe vaccine," Bessel said.
Treating COVID-19 and non-COVID-19 patients at the same time
In the early days of the pandemic, hospitals and clinics canceled many less-urgent visits and procedures to focus on caring for coronavirus patients. Now, they've started seeing more patients again, which means they have to figure out how to balance the needs of both kinds of patients.
Bessel said hospitals have learned how to handle treating both COVID-19 patients and non-COVID-19 patients, a reality that's not going to change any time soon. That includes steps like testing patients before they go into surgery to be sure they don't have the disease as well as protecting healthcare workers with masks and other protective gear to limit the spread.
Ideally, the health system won't have to cancel procedures again, but it's part of the playbook if needed.
"It's our desire to hopefully not get to that point because we understand the impact of what it's like to be a non-COVID patient needing something to be done and having it be delayed," Bessel said.
Suppressing the transmission of the virus remains key
As Arizona's case count continues to rise and the state remains open, Bessel's hope is that the general public takes appropriate precautions — especially wearing a mask.
"It's going to help us tremendously as we work our way towards a vaccine and more definitive treatments," Bessel said.
In recent weeks, the WHO has come out in support of face coverings, like masks and face shields as a way of mitigating the spread of the virus. A study published on Tuesday in the journal Health Affairs found that states that made people wear masks in public saw a decline in COVID-19 growth rates.
Suppressing transmission of the virus can be critical as well to making sure elective procedures can continue, Bessel said. It might also mean that other aspects of society like schools and businesses can remain open rather than shutting down.
"It's a fairly simple intervention and it has such a positive output on so many other things," Bessel said. "Masking can help you keep your business alive. Masking can help us keep schools open so children can remain educated. "