Faces of the Frontline

As COVID-19 penetrates the Eastern Shore, we take you inside Atlantic General Hospital as it prepares to combat the pandemic’s surge

Written by Jonathan Westman
Photography by Grant L. Gursky

Long before “coronavirus” and “COVID-19” staked their claims as the world’s most trending and reviled terms, Atlantic General Hospital was strategically preparing for the potential of a pandemic to reach its doors. Over the past decade, AGH has participated in statewide emerging-infectious-disease drills focused on various planning and execution scenarios in the event a healthcare crisis occurred on the Eastern Shore.

When it became evident this winter that such an event was developing, AGH president and CEO Michael Franklin began meeting daily with his executive team to monitor the virus’s spread across the Eastern Hemisphere.

“It was becoming clear in late January and early February that we needed to be ready to consider every option in our emergency operations plan,” Franklin said. “In early March, when things became very serious in Maryland, we set up our incident command center; in doing so, we were able to rely upon our earlier planning to really speed up the process of what we were going
to do.”

Those actions were swift and decisive. In just three weeks, some of the significant capacity expansion changes included the following:

• Its Medical Infusion Center was converted into a respiratory care unit for its Emergency Department and equipped with telehealth technology, so providers could assess patients from another room, reducing exposure while maximizing the use of personal protective equipment (PPE) (masks, gowns, goggles, etc.).

• The south wing of its inpatient care area was converted into a COVID-19 unit, with negative-air-pressure systems installed in each of the rooms, to keep pathogens contained. The entire facility’s airflow was also modified to prevent the recirculation of air throughout the hospital.

• An additional 17 ICU rooms were created through the conversion of its post-anesthesia care unit (PACU) and other operational areas. AGH now has a total of 25 ICU rooms.

• AGH partnered with the Berlin Nursing and Rehabilitation Center to open a 16-bed, AGH-staffed, alternative care site in the lower level of its facility, on the AGH campus.

• All outpatient surgeries that weren’t emergent were postponed. Aside from reducing the potential spread of infection, this also provided space for a second intensive care/ventilator unit during a COVID-19 surge.

• Atlantic ImmediCare on 10th Street in Ocean City was converted to a COVID-19 referral-based community-testing center.

• Its outpatient laboratory was repurposed as ER-overflow space.

• AGH began offering video-doctor telemedicine visits to patients at home through its Follow-My-Health patient portal.

“All healthcare workers are getting a lot of support from their communities, as they should, but our plant-operations team members, who work behind the scenes, are the unsung heroes,” Franklin said. “I think our entire performance has been really outstanding.”

Franklin, who has altered the entrance and exit patterns of his own home to reduce risk of infection of his 87-year-old mother-in-law, expects the peak surge of COVID-19 to occur in Worcester County sometime in May. When it arrives, the Maryland State Department of Health projects the need for 320 hospital beds across the Eastern Shore for severely ill patients in respiratory distress, with Atlantic General predicted to need 83 beds to meet the demands of the anticipated surge, in addition to its traditional patient volume needs.

AGH’s healthcare network extends across state lines regionally, to serve residents of Delaware and Virginia. In fact, about one-third of its annual primary care visits are with patients who reside in Delaware. As of April 19, 886 cases of COVID-19 had been confirmed in Sussex County, and Franklin said that AGH was actively treating some of those individuals.

Training to do so has been ongoing across multiple medical disciplines for months, according to Matt Morris, the hospital’s vice president of patient care services. This initiative has brought together experts from various fields to create critical care teams for those who test positive for COVID-19 and the expected increase of patient volume throughout the hospital. Community physicians, who traditionally work in outpatient and office settings, have also volunteered to obtain emergency privileges, to help with staffing at the hospital.

They will all require the use of scarce personal protective equipment, and the community has been instrumental in providing critical resources for its employees. Restaurants have donated food to feed its staff, and businesses such as Hardwire (face shields), Royal Plus (ventilation systems), Sherwin Williams (face masks), Seacrets and Dogfish Head (hand sanitizer) and Plak That (intubation boxes), among many others, have made vital contributions to the effort.

“When something like this happens, it’s so rewarding how quickly our community responds to help,” said Toni Keiser, vice president, public relations. “We’re contacted daily by people who want to help our caregivers. We’ve received an incredible outpouring of support, and it reminds us all what a tremendous community we live in.”

Currently, all COVID-19 testing through its Emergency Room, 10th Street ImmediCare facility and the Worcester County Health Department is sent out for processing. The results are fast, according to Kim Justice, the hospital’s vice president of planning and operations, but she’s hopeful that in-house testing kits will become available by May. Justice stressed that if someone thinks they’re sick or has been in contact with someone who has the virus, they’re instructed first to isolate and then contact their primary care provider for instruction. If they don’t have a primary care provider, she advises them to call their local county health department to be prescreened.

Atlantic General Hospital has established a COVID-19 relief fund for those who wish to provide direct financial assistance, in-kind donations or general messages of support. Please visit AtlanticGeneral.org for more information.