KALAMAZOO, MI -- After preparing for a surge of COVID-19 cases that has yet to arrive, Kalamazoo’s two major hospitals are now planning for a longer-term health crisis surrounded by uncertainty but that is sure to reshape their operations.
Early predictions of the virus advised that hospitals on the west side of the state gear up for the same influx of patients that overflowed hospitals in Southeast Michigan.
Instead of a spike in West Michigan, the curve started to flatten and public health officials started using “cautiously optimistic” in describing expectations and next steps.
The ever evolving circumstances have left Kalamazoo’s two main hospitals preparing for the worst and hoping for the best as they battle what Ascension Borgess Medical Director Dr. Thomas Rohs calls a “many-headed Hydra.”
“It’s amazing what we don’t know about this virus,” Rohs said.
While questions still linger about how quickly the virus mutates, how long recovery takes or when a vaccine would be available, Ascension Borgess and Bronson Methodist hospitals have started planning to deal with COVID-19 for the foreseeable future.
“We’re going to have to run, essentially, a two-track hospital of coronavirus versus non-coronavirus patients for a long period of time,” Rohs said. “And that’s a completely different kettle of fish than what we were originally designing things to take care of.”
Related: A timeline of coronavirus in the Kalamazoo area
In the beginning of April, the two hospitals were approved for an additional 405 beds in preparation for a predicted surge of coronavirus patients that never came. Neither hospital has needed those extra beds.
As of April 29, Bronson Methodist Hospital is currently treating 21 coronavirus patients, according to its website.
Rohs estimated that, on average, Borgess has 15 patients being treated for the virus. Ascension Borgess has declined to give precise numbers detailing patient, recovery and death data, citing patient privacy.
However, within the state application for more beds, the hospitals outlined COVID-19 unit plans that were put into place.
Having a COVID-19 unit separate from the rest of the hospital is now one of the most important element in a three-prong plan to manage the virus at Bronson, said Dr. Martinson Arnan, chief clinical officer for Bronson Medical Group.
Bronson’s plan is to increase testing to better understand who has it, continue screening to limit access of possible exposures in the hospital and isolating patients who have tested positive.
“We’ve not blindly done everything based on just a model, but we’ve kept our eyes open on what is happening here and now,” Arnan said. “We’re going to keep doing that.”
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Arnan and Rohs both noted that — as the weather warms up and the stay-at-home order allows activities such as boating, gardening and golfing — another increase in COVID-19 cases is possible if social distancing measures are not followed.
In short, hospitals are left to make plans around the unpredictability of people, Arnan said. He pointed to the protests in Lansing that happened on April 15 and again April 30.
“It’s not because the math is not good enough,” Arnan said. “It’s because the conditions change that fast. Nobody would have expected a group of people to gather.”
As case numbers fluctuate in Kalamazoo County, and Michigan as a whole, hospitals are designing plans to start reopening for elective surgeries and other care.
Both Arnan and Rohs had great concerns about the backlog of patients with chronic pain and illness who have had their care postponed for many weeks.
“Our strategy is not to wait until the executive order is lifted to make care delivery safe," Arnan said. “We’re doing that right now.”
Since March 1, Bronson Healthcare has completed 7,400 video visits with patients Arnan said.
Additionally, healthcare workers are now battling the public perception and fear the virus created as well.
Bronson and Borgess encouraged patients not to wait if they are feeling signs of stroke and heart attack. Healthcare workers are reassuring the community that emergency rooms are safe and contained.
Protocols such as separate intake and care areas, waiting room distancing, staff screening, ongoing use of personal protective equipment and extensive sanitization are in place at both hospitals.
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Shutting down non-emergency services has started having lasting effects — not just on patients but on healthcare systems as a whole.
Across the board, Michigan hospitals reported financial losses in March and April, according to The Michigan Health and Hospital Association. It is estimated hospitals are losing more than $300 million a week while spending $100 million on supplies, protective equipment, staffing and other costs associated with a surge of COVID-19 patients.
Bronson announced elective surgeries were postponed on March 18. The healthcare system saw its March revenue decrease by 50% compared to last year, CEO and President Bill Manns said in an interview with MLive.
On April 21, Bronson Healthcare announced pay cuts at executive levels and furloughs for non-clinical workers.
The same day, Ascension Borgess committed to no layoffs and a pay protection programs, according to a statement.
Ascension did not clarify whether furloughs, pay cuts or other measures were implemented or will be in the future.
Still, Rohs predicts that the bottleneck of elective services and the slow reopening of hospitals will change how healthcare is run for the foreseeable future.
“I would say it’s safe to say that the entire North American healthcare system is going to look different after all this is over,” Rohs said. “There’s not only going to be a difference in diseases but the economic model that has kept everyone afloat for the past 20 years has been completely interrupted for at least a month, and will be significantly disrupted for much longer.”
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