April 15, 2020 COVID Update
We hope this finds you well, safe and healthy.
It has been just over a month since Maine identified its first COVID positive patient on March 12. Just a few days later, on March 17, LifeFlight transported its first two presumed COVID positive patients. Caring for and safely transporting COVID-19 patients is now a daily occurrence while we continue to care for all of the other critical emergencies we manage every day with our EMS and hospital partners, including an abundance of premature newborns over the last month.
Like you, we all continue to adjust to this new and strange normal. Social distancing, even at work, staying at home, working remotely, using Zoom for meetings and connections with friends and family—it is all rather disconcerting and disquieting.
Here at LifeFlight each shift also starts with a health check station where we record a temperature, get a health screening, and don a surgical mask for the day. When we head out on a mission we add a surgical head covering, ‘bunny suit’ coveralls, goggles, face shield, double gloves, foot coverings, and an N95 mask or a PAPR (positive air pressure respirator) which are in even shorter supply than the other personal protective equipment (PPE) in the news. Constant checks and rechecks are necessary to prevent inadvertent exposures.
In our role caring for critically ill patients, we have spent a lot of time with our crews simulating high-risk aerosolization procedures such as intubation (placing breathing tubes) and transitioning and moving patients on our ventilators. Every step of loading and care needs to be broken down, thought about, tested, tried, refined and tried again. Think NASA astronauts practicing in a giant pool in Houston which holds a full-scale replica of the space station. This practice is especially important as we work to understand how to best manage these complex and highly infectious disease patients in a complicated aviation environment.
This repeated simulation and practice not only protects our clinicians and patients, it is also helpful as we share our hard-earned knowledge with our colleagues — nurses, respiratory therapists, physicians and physician extenders — in our community hospitals and major medical centers. This is a total team effort in keeping all of our clinicians and patients safe.
In the space between transports, our crews and clinical leaders are working with colleagues across the country and world in the single largest peer-to-peer learning and research initiative ever undertaken. We talk weekly with hundreds of clinicians and specialist physicians in our largest centers — meeting electronically for clinical rounds and learning in real time how to manage this complex disease. We then synthesize this learning into new standard operating procedures, clinical guidelines, protocols and checklists, updated weekly, to share with our staff and post on our website to help guide and support our colleagues in Maine’s community hospitals and EMS services.
It is all a huge challenge. Hospitalizations lag new cases by 10-20 days so flattening the curve protects our healthcare system from being overrun in the weeks ahead. Hopefully, we will successfully manage our way through this first wave.
A great visual of how social distancing works was produced by the health folks in Ohio (it’s only 30 seconds and worth it to watch until the end).
We are cautiously optimistic, but we need your continued help. We are all in this together. The challenge in flattening the curve is to also understand this only slows the rate of infection. It does not stop it. We will be seeing COVID-19 patients for at least the next year, and likely 18 months, until the combination of vaccines and acquired immunity takes hold throughout the population. This is a long game and we will continue to experience an increased and strained workload. The situation in Maine and across the country, while hopeful, is fragile.
On an encouraging note, we believe we are beginning to see the curve flatten with the number of new cases in Maine stabilizing at a lower daily rate, although our long term care facilities are at particular risk with spreading infections. Early business curtailment and stay at home orders have helped Maine, albeit with huge economic pain and disruption. It is incredibly important that we continue the very difficult task of preventing the rapid spread of disease. We cannot return to life previous until we are all sure this is behind us. Please stay safe and healthy.
Our huge thanks for helping LifeFlight be there when needed.
Best from all of us.
On behalf of the LifeFlight team,
Thomas Judge, Paramedic
Norm Dinerman, MD, FACEP