Rhode Island Prepares For Surge In Coronavirus Hospitalizations

PROVIDENCE, RI — With Rhode Island's peak in coronavirus-related hospitalizations expected in the coming weeks, the state is scrambling to ensure there are enough beds to accommodate the potential surge. As has been the case throughout the crisis, the state is "preparing for the worst, working for the best," Gov. Gina Raimondo said.

The Rhode Island Department of Health sent hospitals a set of protocols Friday in case of a worst-case scenario where hospitals are overwhelmed, Director Nicole Alexander-Scott said. These guidelines will offer a "statewide, consistent approach" to addressing issues such as a shortage of medical equipment or personal protective equipment. These protocols are unlikely to be deployed, Raimondo and Alexander-Scott said.

Although it has only been four weeks since the Army Corps of Engineers began to scout potential sites for surge hospitals in the state, they have been prepped in record time, Raimondo said. The field hospitals at the Citizen's Banks building in Cranston and the Rhode Island Convention Center are nearly operational, with 1,200 beds between them should the need arise.

The state is working toward having at least a 30-day supply of personal protective equipment for front-line health care workers. While this goal has not yet been reached, the supply chain team remains hard at work, Raimondo said, and more supplies are arriving every week. Over the past week, 2 million surgical masks, 5 million gloves and tens of thousands of face shields arrived in the state, and more are on order. In addition, health care workers will have the ability to sanitize N95 respirators for reuse starting in just a few days, Raimondo said. Masks will be able to be sanitized at least three times, Alexander-Scott said, though possibly more.

"I feel we are absolutely headed in the right direction," Raimondo said. "I feel strong and confident about what lies ahead."

The governor also said all Rhode Islanders will need to keep up social distancing until at least May 8, she said.

"If we just hang in there for these next couple of weeks until May 8, it is my hope that by that time, we will be on the other side of the curve and be on the downswing," she said. "It's not going to be like this forever. There is another side of this. Soon, we are going to get to the business of getting back to normal. ... Now it's not going to be like it was for about a year before we have a vaccine or some therapies."

Of the 13 deaths reported Friday, 10 were in congregate living settings, Alexander-Scott said. One person was in their 50s, two in their 60s, seven in their 70s, one in their 80s, one in their 90s and one over 100 years old, she said. Nine of the victims died Thursday, while the remainder died in previous days and had a lag in reporting.

"Rhode Island is facing extreme challenges in nursing homes," Alexander-Scott said, promising nursing home residents and their families that the department is doing everything it can to keep everyone safe.

The department is focusing on infection control in nursing homes, isolating residents at the first sign of illness and quarantining anyone who has been in close contact with them. Because COVID-19 can present with atypical symptoms in older people, the threshold of concern is a very low one, Alexander-Scott said.

To help maintain staffing levels at congregate care facilities, the state has approved 960 additional licenses for health care workers, Alexander-Scott said. Approval of licenses for out-of-state providers have been fast-tracked; training requirements have been waived for certified nursing assistants whose licenses have expired within two years; nursing students can get CNA licenses after completing one semester of college; and training schedules have been accelerated for those looking to become CNAs, Alexander-Scott said.

In the weeks ahead, the department hopes in implement strike teams to coordinate efforts and expedite processes in nursing homes: providing on-site testing for residents and staff, assuring that protocols are being met and personal protective equipment stocks are sufficient, assessing quarantine and isolation protocols and more. Cyclical testing is planned so staff and residents can be tested every seven to 10 days, as needed. While testing is generally most effective when reserved for those with symptoms only, this is a special circumstance as part of the aggressive approach, Alexander-Scott said.

Patch Editor Scott Souza contributed to this report.

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