Jersey City Hospitals Adopt New Triage Protocols for Pandemic

Jersey City Medical Center has created a new protocol and an expanded locale for its emergency department in response to the coronavirus pandemic sweeping the city and the country. Earlier this month, Jersey City Mayor Steven Fulop joined Christ Hospital administrators in announcing a new screening system designed to safeguard health care staff and patients during the crisis as well.

Both hospitals have set up pre-screening tents outdoors, outside their emergency departments, a sign of just how busy the institutions have become. That is where the protocols at the two facilities diverge slightly. At the medical center, individuals who present with severe symptoms of COVID-19 “will be transported directly to the ED (emergency department) for a more comprehensive evaluation, care, and isolation. Others will be directed to a mobile satellite emergency department on site,” said Michael Loftus, MD, chief medical officer, Jersey City Medical Center- RWJBarnabas Health.

“For non-COVID-19 related urgent or emergent care, patients will be directed or shuttled to a new urgent care directly across from the hospital at Colony Plaza, 414 Grand Street,” Loftus continued. “This is not a COVID-19 testing site but will care for non-COVID emergent and urgent patients during the ongoing pandemic,” he explained.

Christ Hospital is also separating those with non-coronavirus-related emergencies from those with symptoms of COVID-19, such as fever, cough or flu-like symptoms — or any combination of thereof. But it is sending the former to its existing emergency room for appropriate treatment whereas persons who present with at least one COVID-19 symptom are themselves bifurcated: Those who hospital staff determine can safely recover at home are treated and released; those determined to need admitting are directed to beds dedicated to Covid-19 patients that are spread among three floors of the hospital, according to Dr. Tucker Woods, Christ Hospital’s chief medical officer.

Triage at Christ Hospital, photo courtesy Dr. Tucker Woods

As of last week, Christ Hospital was caring for 50 persons diagnosed as coronavirus patients, according to Woods. All are elderly, and the majority are male.

Since the hospital began admitting coronavirus patients, there have been “expirations,” Woods went on to say — though he declined to say how many. Equally vague was Woods regarding the number of infections amongst the hospital’s staff. While Woods did note that, in epidemics, it’s not unusual for personnel infection rates to approach 35 percent, in discussing Christ Hospital’s own employees having the coronavirus, the chief medical officer said simply “Not so many here.”

Woods said the hospital’s health care staff is doing the best it can to cope with limited amounts of personal protective equipment.

“We don’t have enough sanitizing wipes for disinfecting mattresses, so we’re using bleach, which is not ideal” he said. As of last week, other items needing replenishment were hospital gloves, swabs used to check for the virus and ventilators, he said.

Woods credited New Jersey Health Commissioner Judith Persichilli, R.N., with quickly arranging for a March 24 delivery of five ventilators that were urgently needed. Prior to their delivery, the facility was using 14 of its 16 units (and prior to that, before coronoavirus’s becoming a household word, Christ maintained three to six ventilators at any one point in time, according to Woods).

What’s to come?

“In early March the (ER) numbers were off the charts,” Woods said. “We were 40 percent busier than usual. Many of the admissions were for flu-like symptoms, but after the news of the pandemic hit, the numbers took a nosedive down,” he said.

Still, Woods remains cautious. “I think it hasn’t peaked yet,” he said. “I think it will get worse and eventually plateau. We’re doing the best we can to contain it.”

Woods credited the hospital’s housekeepers and health care professionals on the front line with bearing the load. He also thanked the community at large for their donations of medical supplies and food for staff.