By Polly Mikula
Claudio Fort, president and CEO of Rutland Regional Medical Center and Dr. Melbourne Boynton, Chief Medical Officer, discussed how the hospital is impacted as the state gradually eases the regulations that have helped to reduce the spread of Covid-19 during an interview Thursday, May 14, shown on PEGTV.
At its peak, less than 10% of RRMC patients have been Covid-positive, Fort said, “so the hospital in general has been quite safe all the way through.”
At one point, RRMC had five Covid-positive patient in the hospital, now it has just one in the ICU on a respirator. Statewide there are only three people currently hospitalized with Covid-19.
Recently, one patient at RRMC, Paul Goulet, recovered from Covid-19 after 43 days in the hospital. He tested positive on March 31 and from April 1-24 he was incubated.
“It was touch and go for a long time,” said Lisa Bissette, BSN, RN in the Intensive Care Unit in a video posted on RRMC Facebook page. But 43 days later, on May 11, he was discharged to a rehab facility.
Goulet hangs dry wall, and told the RRMC staff that he was going to do that “until they bury him.”
“He had a great attitude, he was a fighter,” said Bissette.
“He had an awesome sense of humor and we’re going to miss him, but he promised to come back and play the banjo, which I’m sure he’ll do because he’s a fighter.”
Goulet is among the 820 people, thus far, in Vermont that have recovered from Covid-19. As of Tuesday, May 19, 944 have tested positive and there have been 54 deaths.
“The low volume of cases was not predetermined and it’s not just because we’re tucked up in Vermont,” said Fort pointing to the state’s border with New York (the epicenter of the outbreak in the U.S.) and Massachusetts as well as the busy ski season at Killington in March that brings thousands of tourist to the region. “There is a lot of cross pollination here during that time,” Fort said.
He said the state’s quick and proactive social distancing guidelines had a significant effect on slowing the viral spread. “But the threat is still out there,” Fort cautioned, imploring viewers to remain vigilant as they settle into a new normal. “At RRMC, this is new normal for a while. We’re putting together a plan for how to operate over the next 18 months.”
“In the beginning,” Boynton said, “we were not prepared for the worst case scenario, but we’re ready now.”
Even if the region experiences a future outbreak, RRMC is now ready, he said citing negative pressure rooms that help keep the virus from circulating in the air, enough personal protective equipment (PPE), screening, testing and tracing protocols in place, and communications with other hospitals for mutual aid, if needed.
“It’s unlikely at this stage that we would get to a crisis level of care,” he said.
However, the supply chain is still fragile, he said, and RRMC is not wasting any PPE. Sterilization procedures remain in place for N95 masks to reuse them, he added.
Fort said the governor’s recommendations, orders and policies are based in science with strong evidence and data. “The governor and Doctor Levine aren’t making things up,” he said.
Governor Phil Scott, Health Commissioner Mark Levine and public health experts worldwide know that wearing a face covering helps to reduce the spread of the virus in a community.
“We’ll be in this for a long time, folks, so please do the right thing and listen to medical community and protect others. We need to do this together,” he said.
“Wearing a mask or not wearing a mask is not a political statement,” Fort said. “Please don’t politicize this. There are many other ways to make your political persuasions known.”
Cloth masks decrease the wearer’s ability to shed droplets by 70%; procedure masks decrease the wearer’s ability to shed them by 99%, explained Boynton. “If 60% of us wore the cloth masks (which is about 60% as effective as procedural masks) we would bring this thing to a halt,” he said.
“Even me talking loud sends out small droplets that have potential to carry virus,” Boynton said. “Cloth masks protects me moderately but it protects you a lot,” he explained.
“I have not had the gumption to tell someone to wear a mask in, say, the grocery story,” Boynton admitted, adding that he feels it’s best to assume that some people “haven’t had the opportunity to learn the importance of masks, yet. As people learn, they’ll do it. It’s a smart thing, its an easy thing, but not everybody knows or understands that yet,” he said.
“Wearing masks and physical distancing will be here to stay,” Fort added. “This is a long term challenge… We’re not used to this, we’re used to short term gratification, but there is no quick way out of this. We’re not going to recover overnight, this is going to be a long haul.”
“In Vermont we have a better chance of doing this,” Fort continued. “We work together and are less enamored by glitz and glamour. We care about our neighbors and our communities and genuinely want to protect each other.”
Fort, however, acknowledged that compliance with public health recommendations, like wearing a mask, will not be 100%. “Assume people are acting out of a place of good intentions,” he recommended to viewers. “Assume everyone is trying to do the right thing and have patience with each other… It’s going to be a long haul.”
Boyton also acknowledged that “maybe we’re overdoing it,” when it comes to some behaviors, like sterilizing groceries. “For surfaces you can clean, please do,” he said, “But you can handle groceries and open packages, just wash hands after and don’t touch your face.”
Scientific data says that less than 6% of Covid-19 cases have been transmitted from surface to hand to face, Boynton said. “So use common sense and practice good hygiene and you’ll probably be fine.”
Not feeling well, get a test!
If you’re not feeling well for any reason, call your health care provider and discuss your symptoms, both men said multiple times.
“We’re tough people, we’re Vermonters, we typically don’t let a cold hold us back, but this is a different time,” said Fort. “Call out of work and get screened by your doctor. As tough as it is to miss a day of work, it’s important to do the right thing… Even cold-like symptoms that usually wouldn’t hold us back, could infect entire workplace and shut it down. Pay attention to early signs and be overly cautious.”
Boynton said a fever doesn’t usually show up until later, and doesn’t always show up, so all symptoms should be taken seriously.
“If you have symptoms seek care, you will be tested,” Boynton said. “Qualifications for qualifying for a tests have been reduced, those with even minor symptoms that may be associated with a cold can now get tested. We have plenty of testing capacity,” he said.
“If you test positive for Covid-19, the state will then contact trace, but folks should not be afraid of that. The state will help you be a hero to help bring an end to the spread, you will not be vilified.”
Ramping back up
“We’re starting to ramp back up,” said Fort of the operations at RRMC.
Friday, May 8, hospitals were permitted to resume elective surgical procedures.
“Right now we’re doing outpatient surgery only,” said Boynton. “Mostly athletes that have had injuries or hernias — elective things that could wait, but ones where the patient can get home the same day… Routine colonoscopy or monogram or other important screening procedures are available, too… this is not a time to put off important screening procedures,” he said.
As a result of the restriction on elective procedures, “We are backed up,” Boynton acknowledged, explaining that the hospital is re-prioritizing and reshuffling the queue pushing younger healthier patients to the back to give more urgent procedures the priority.
Patients should not be afraid of getting an infection by visiting the hospital, Fort said. “Infection control procedures is not new to us,” he said.
“Don’t put off coming to hospital for care for any reason, including if you fear that you can’t afford it,” Fort added. “If you lost insurance don’t let that prevent you from coming to get care. Our financial councils will work with you. I know it’s hard for proud Vermonters to do, but please come in it’s our mission to serve you regardless of ability to pay.”