Bob Garrett makes it clear: He doesn’t foresee a scenario — no matter how big the second wave of COVID-19 gets — where some hospitals in the Hackensack Meridian Health system would be used treat COVID patients and others would treat only non-COVID patients.
“I would hate to have people have to travel further if they have a true emergency — a heart attack or a stroke or an acute diabetic episode — because we have designated the nearest hospital to them is only a COVID hospital,” he told ROI-NJ.
“We’ve come so far to enhance and increase access to care in our state, I would hate for it to go backward, and I think we can truly manage COVID and non-COVID patients within the same hospital if we very strict safety and isolation protocols we now have.”
But don’t be mistaken: Hospitals are changing.
Garrett, the CEO of HMH — one of the two large systems in the state — said hospitals in the new post-COVID-19 normal will be impacted by the lifestyle changes that COVID has forced upon all of us.
If people have learned they can work — and go to school — from home, why shouldn’t they be able to get more of their medical care there, too? This is more than just more telehealth, which everyone acknowledges is here to stay. This a change in the fundamental way hospitals are used.
“I think the hospital of the future is going to be different,” he said. “I think one of the things the pandemic has highlighted is that people are now looking for alternative sites to be treated. So, I think ambulatory care sites are going to continue to increase. People want to be treated more at home, as they’re staying home.
“In this state, I think there will be more and more people that may be working out of their homes on a permanent basis. So, I think there’ll be an expectation that they can receive health care in their home.”
That’s why HMH — while it planned an impressive 2.0 plan during the first wave of COVID — is starting to plan for life after COVID, Garrett said.
“I think hospitals will become more ICU-focused, more for intensity of care,” he said. “Certainly, I think everybody’s infectious disease standards will stay extremely high. And I don’t think that’s unreasonable to think that we’re going to have additional outbreaks of viruses, whether they be global pandemics or not.
“We’re going through a lot of planning now to think about reinventing ourselves, if you will — whether you call it 3.0 or the Hospital of the Future. We have a recovery and transformation steering committee, we have a board a board oversight committee, they’re just thinking about those types of things: What our health care systems are going to look like in a post-COVID era.”
Of course, that is for the future.
Now, Garrett is more concerned about a present that is starting to get worse. He calls August and September the calm before the storm. The question now: Is October the start of another big storm, or a slight uptick?
HMH, which had 53 patients among all 17 of its hospitals and 11 long-term care facilities at the beginning of the month, had 189 as of Monday.
It’s a long way from April 13, when the system had more than 3,000 hospitalized, but it’s still a concern.
“I do feel that we’ve done everything we could, as a state and as a health care system,” he said. “But, having said that, are we going to go through a rough time before it gets better? I absolutely think so.”
This leads back to the original question: Can hospitals handle both COVID and non-COVID patients — and do it in a way that patients are comfortable coming in?
Garrett said they can. And that the state needs them to be able to do so.
“We need to exist in this 2.0 environment, where it’s not just about taking care of COVID patients,” he said. “People have cancer, people have diabetes, they have heart attacks and strokes, they are involved in motor vehicle accidents — they need to be treated medically.”
Garrett said hospitals can do that so much better than they could in the spring.
“There’s no question,” he said. “We have better therapeutics and a better understanding of COVID treatment, keeping oxygenation levels high, using steroids earlier.”
He notes the clinical trials — some of which are being coordinated with the HMH’s Center for Discovery and Innovation — as a reason for hope. He notes how Remdesivir is helping reduce the length of hospital stays in many.
“I think all of this gives us an opportunity to take care of COVID patients in a more effective manner, but also to keep the hospitals open to take care of other patients who really need the care during the same period of time.”