The Hospital Evolves with the Pandemic
By Lee Dossett, MD
When I originally wrote my article in March of 2020 about how COVID 19 was impacting the hospital and my team of hospitalists at Baptist Health Lexington, I probably would not have believed that we would still be dealing with COVID some 15 months later. Being on the frontlines along with my colleagues in the ED, ICU, infectious disease, pharmacy, and hospital administration has been a lesson in leadership and crisis management. The early days of the pandemic was marked by severe uncertainty. We had to develop and institute protocols that would frequently changes as new information came in. Availability to testing early on was a major bottle neck. Treatment regimens and best practices were unknown. Outside of COVID, my team had to adapt to a new normal of a decreased hospital census as elective surgeries were stopped and patients avoided coming in for fear of getting sick.
Eventually over the spring and summer things achieved a “new normal”. COVID cases remained steady but not overwhelming and other patients started returning to the hospital. Testing options became more available, quicker, and reliable. Studies came in showing the benefit of dexamethasone for hypoxic patients along with some other beneficial treatments. However, by late fall and early winter we began to experience a sharp rise in cases that was mirrored across the nation in the 3rd surge. While our capacity and resources were stretched, I feel like we were able to take excellent care of these patients and my partners became experts in COVID care. In parallel with this, the hospitalists also took on the task of treating qualifying positive outpatients with the newly developed and approved monoclonal antibodies.
Finally, the light at the end of the tunnel came with the approval of the first vaccines in December. I felt a special privilege in receiving it within the first week it was available. I consider the vaccines a true medical miracle given how quickly they were developed, test, approved, and deployed. Our COVID numbers finally peaked in January and have trended down ever since. This corresponded with the vaccine rollout to long term care facilities and at-risk patient populations. For now, we have reached a relatively low plateau of cases and there is reason for hope, but we must still find a way to reach those who have yet to be vaccinated for whatever reason.
I am extremely proud of my hospitalist partners at my institution and across the country for stepping up and taking on the COVID challenge like few other physician groups.