Home is where the heart is, but Dr. Raul Magadia’s heart is in shared custody with Anniston Regional Medical Center, where he works as chairman of infectious disease control.
Magadia’s specialty in communicable disease made him an ideal choice to manage the hospital’s response to the COVID-19 pandemic, including a position on the Calhoun County Infectious Disease Task Force, formed in March to stem the spread of the coronavirus. Now he’s in charge of the hospital’s three COVID-19 units, with capacity for just less than 60 patients, and the number of patients keeps rising, reaching 46 on Friday — one less than the day before. But for every two COVID-positive patients treated and discharged, Magadia said, another four arrive.
Asked when he last went home for the night, Magadia chuckled, but didn’t say. His wife, Joy, tells him he’s only there to eat, shower and sleep before he heads out again, he said. There’s also a 2-year-old Australian blue heeler, Diego, who jumps on Magadia when he gets home and goes running with him.
“My dog misses me,” Magadia said.
Infections have ramped up in the last two weeks, stretching hospital staff as the numbers grow. Another 62 people had tested positive for the virus in Calhoun County since the day before, according to Alabama Department of Public Health numbers released Friday morning. The county’s cumulative total since March reached 970, and 480 of those cases — about 49 percent — had been confirmed in the prior 14 days.
Patients aren’t quick to leave, which keeps the units busy. COVID-1 used to be orthopedics; that’s where the most dire, critically ill patients are treated. Of the 20 there, most are intensive care patients, and 12 are on ventilators. COVID-2 — gynecology, before the pandemic — had another 16 people. COVID-3, introduced to meet high demand last week, the former fifth-floor ward, has 10 patients.
Rey Vargas, clinical team leader for COVID-1, said staff in that unit have been working with coronavirus patients since the pandemic began. They’re used to the danger and getting by without backup. When COVID-3 was established last week, staff from other parts of the hospital were moved to the 16-bed unit. They were nervous, Vargas said.
“I told them, ‘COVID-19 is already in your community, you’re going to encounter it. You might as well be wearing PPE,’” Vargas said, referring to personal protective equipment. “From my perspective you’re at your safest when you’re over here on the COVID unit. That’s been my selling point, and knock on wood, no staff on COVID-1 to my knowledge has tested positive after working on the unit.”
Vargas said the typical hospital patient population is about 170 or 180, with COVID pushing that number up by about a third. Staff lives day-to-day — Vargas can give you a day off next week if you’ll pick up a weekend shift — and he spends his time on the unit pulling together support for his staff, like PPE and other supplies.
“I’m pretty much robbing Peter to pay Paul,” Vargas joked.
Community outreach has helped staff morale, he said; cards and food and gift cards for food have been welcome and have helped staff feel like they’re not alone, he said. Seeing viral numbers come down from more people wearing masks, washing their hands and keeping social distance, he said, would help even more.
“We’re kind of trying to survive the short term, and we’re trying to plan for the long term, too, but it’s kind of hard,” Vargas said.
The numbers may seem small, but they’re reflected in weariness, exhaustion and sacrifices made by hospital staff to make treatment available to people in need.
Nurses are pulling extra shifts, tacking another eight or 10 or 12 hours to their days. Elective, non-emergency surgeries requiring an overnight stay were suspended Thursday to shift personnel to other areas. Hospital administrators are searching out nurses who can pick up shifts at the hospital, including former employees, local retirees and supporters from health care coalitions at the state level.
“We’ve got folks who are dealing with this every day,” said Louis Bass, hospital CEO. “Some have done things like not getting close or not seeing their grandkids, and staying away from their parents.”
Employees have kept a stiff upper lip, though; they clock in, they clean up, they treat COVID — they don’t complain.
“They’ve taken it head-on,” Bass said. “I can’t say how proud it makes me just to be a part of RMC and work with them; the sacrifices they make, the folks who come to work every day. They haven’t complained, they haven’t run away from it.”
Refreshing the ranks
Michael Barton, director of the county Emergency Management Agency, said the EMA has been working to find nurses to act as pinch hitters, putting more labor hours into the pool and offering relief. The two hospitals in the county, RMC and Stringfellow Memorial, need about 38 more personnel to make ends meet, able bodies the EMA has requested from state health care coalitions and ADPH. If those avenues don’t pay off — Barton said only one or two nurses have become available to RMC so far — the EMA will petition the Governor’s Office of Volunteer Services.
But health care workers are a coveted resource in the COVID pandemic, and state numbers are high, too. Alabama had another 2,107 positive cases confirmed by Friday morning, bringing the cumulative total up to 74,365 since March. There had been 23,334 cases in the prior 14 days, just over 31 percent of all cases in the state. Another 38 people died due to the virus, bringing the state death total to 1,395.
“Everybody needs folks right now, and that’s the challenge,” Barton said. “But the difference here from other hospitals is that RMC Health Systems is a local health system, not owned by a larger parent company that could send personnel in from other hospitals in this state or other states.”