‘This is very real’: Lowell General Hospital prepares for surge

Due to financial losses, hospital and Circle Health furlough 20% of staff

A tent setup outside of Lowell General Hospital in preparation for Covid-19 testing. Courtesy photo.
A tent setup outside of Lowell General Hospital in preparation for Covid-19 testing. Courtesy photo.

LOWELL — Despite steep financial losses amid the pandemic, Lowell General Hospital is prepared to handle a surge in coronavirus cases expected to hit the state in the next two weeks, CEO Jody White said.

The hospital has lost about 40% of its monthly revenue due to canceled elective procedures and appointments, White said. As a result, about 21% of hospital and Circle Health staff have been furloughed.

White, joined by other top LGH administrators, discussed the hospital’s preparations for the surge, and its finances, in a conference call Thursday with members of The Sun’s editorial team.

Hospitals nationwide are in a “double-edged” position, White said.

“We’ve got to stay afloat to care for all these patients, but then at the same time, we’re dealing with what results in, you know, millions and millions of dollars a month of lost revenue,” he said, in reference to elective medical procedures that have been postponed.

Massachusetts is expected to see a spike in COVID-19 patients between April 10 and 20, Gov. Charlie Baker announced Thursday.

Based on models of the virus’ spread in China and Italy, about 2,500 more individuals per day could come in contact with the virus in Massachusetts, White said.

“I am confident that we are (as) prepared as an organization can possibly be given the resources that we have available to us,” LGH and Circle Health Executive Vice President and Chief Operating Officer Amy Hoey said.

The hospital expects that it can triple its normal critical care volume, tending to upwards of 70 critical care patients, Hoey said. As of Thursday, the hospital housed 27 confirmed COVID-19 patients, and another 18 under investigation.

Fourteen hospital employees have also tested positive, although LGH did not elaborate.

“Every day that we can continue to say that we’re having a slow and steady increase of these patients in the hospital is a good day, and we continue to have a slow and steady increase of these patients in the hospital,” Hoey said.

The hospital has taken measures to expand surge capacity in critical care, traditional inpatient and emergency departments. For example, behavioral health arrivals at the hospital’s two emergency departments have been consolidated to the Saints Campus, which has allowed for the creation of respiratory evaluation units.

Those who test positive for the virus are separated within the hospital, and an “all-mask policy” has been implemented, Hoey said. All staff are required to wear masks except in office spaces, and patients who arrive at the hospital are masked upon entry.

“Many of our physicians stepped up to be cross-trained and cross-credentialed in the areas of critical care and emergency medicine, and offer what support is appropriate to their scope based on their specialty,” Hoey added.

The hospital’s biggest need will be critical care beds and ventilators, according to White. The facility has also kept a “constant line of sight” on available personal protective equipment, Hoey said.

“We feel that we are stable right now in terms of being able to activate our personal protective equipment policies and practices given our current inventory levels,” Hoey said. But even after the surge, hospital staff will be caring for COVID-19 patients for a “very long duration,” she added.

“There’s all sorts of indications that supply chains are opening up,” Hoey said. “But we don’t count on anything until it’s on our loading dock,” she added later.

As of now, workers are only using hospital-issued masks. As for ventilators, Hoey said the hospital is in good supply.

“We… could never have enough these days given what we know about this virus and the way it affects patients, but we feel very confident again in our surge capacity,” she said.

White said there has been conversation about opening a field hospital in the Merrimack Valley similar to the one established at the DCU Center in Worcester to handle overflow COVID-19 patients.

“We are actively looking across the Merrimack Valley to see if there would be a space available to us,” he said. White, chairman of the board of the Massachusetts Hospital Association, is in regular contact with other health care providers, City Manager Eileen Donoghue, and UMass Lowell Chancellor Jacqueline Moloney.

Outflow facilities would be used to house patients who no longer require critical care, but cannot yet return to nursing facilities, group homes, or other congregate living spaces, Hoey said.

“One of the challenges of activating a pandemic plan is it’s difficult to disposition patients out of the organization when they no longer require a hospital level of care,” she said.

LGH is currently conducting drive-thru COVID-19 testing at its main campus. To be tested, patients must have a referral from a primary care physician, or in the case of first responders, an occupational health department. “We’re in the middle of a worldwide crisis with this pandemic, and it’s affecting the economies across the U.S., across the world, and health care is not exempt,” White said.

Indeed, several Boston medical facilities have announced similar measures.

On Thursday, LGH and Circle Health announced that just over 21% of staff will be furloughed for 90 days. This includes 684 employees who will work reduced hours, and 163 who will lose all hours.

“We’re not laying people off. These are folks that are staying on our books, they’re getting their benefits, they’re employees of the hospital. We are just reducing their hours to balance what is a huge reduction in work,” White said.

Furloughed employees will continue to receive their salaries for a full two weeks. The entire executive staff will receive reduced salaries for the next 90 days.

“It in no way… makes up for the decrease in business that we’re seeing, and we are going to rely on the federal government to step in, and the state to step in across all the hospitals in the commonwealth,” White said.

“Listen to all of the guidance about staying home and social distancing — this is very real,” Hoey said. “The best thing that people can do to support their hospitals and to support each other is to follow those social distancing guidelines.”