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'We All Have To Redefine What Normalcy Is': Vt. Hospitals Begin Expanding Operations

A nurse in a cloth mask holds a thermometer to another person's forehead.
Gina Pattison
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Brattleboro Memorial Hospital, Courtesy

Gov. Phil Scott recently said hospitals can begin offering some of the procedures that were put off at the start of the COVID-19 pandemic. And while hospitals leaders are eager to open up their doors once again,  plenty of questions remain about how Vermont’s health care system will look in this strange new normal.

Before you even walk in to Brattleboro Memorial Hospital, you realize very quickly that these are not ordinary times.

Everyone who visits Brattleboro Memorial gets screened for signs of COVID-19.

And once you get in, you realize just how quiet it is with the hospital operating at less than full strength.

It’s been almost two months now since Brattleboro Memorial postponed all elective surgeries and turned its operating room into a 17-bed emergency COVID respiratory unit.

They’ve had some patients with COVID-19 here, but most of the beds have gone unused.

And so hospital CEO Steve Gordon says everyone at BMH is ready to begin serving the community again, even if it’s on a limited basis.

More from VPR: Gov. Scott Allows Some Elective Surgeries And Outpatient Care To Resume

“I think we’ve been incredibly well-prepared over the last several weeks, during this pandemic,” Gordon said. “But I think people are now focused on what the future is going to hold, and how we can get back to normal operations, and reopen the hospital.”

The governor has been slowly opening up Vermont’s economy, and last week, he said hospitals can begin offering some outpatient surgeries and procedures, as well as clinic visits and X-Rays.

The hospital still can’t do overnight procedures, and there is a very long list of precautions both the staff and the patients must follow.

Gordon says it will be a slow shift toward expanding what the hospital can offer over time.

"I think we've been incredibly well-prepared over the last several weeks, during this pandemic. But I think people are now focused on what the future is going to hold, and how we can get back to normal operations, and reopen the hospital." — Steve Gordon, Brattleboro Memorial Hospital CEO

“We want to be very careful, very cautious, so as not to create another surge, or a surge, of additional patients,” Gordon said. “So that’s why we’re going to do it in a very conscious, phased approach.”

But Vermont Association of Hospitals and Health Systems president Jeff Tieman says it’s unclear if the public is ready to come back.

“We now have the ability to safely move back into doing non-urgent procedures and both meet pent-up patient demand and begin to see our hospitals, hopefully, stabilize financially,” Tieman said. “But that could take quite a bit of time, because we also don’t know how fast patients are gonna come back. And several physicians and hospital leaders are concerned that patients won’t be that eager to return, even though it is safe to do so.”

Tieman hopes patients are eager, because Vermont’s hospitals were losing money even before they got  hammered financially by the pandemic.

And when they had to cancel all of their elective procedures to prepare for a COVID-19 outbreak, it deepened those losses even more.

More from VPR: Reporter Debrief: As COVID-19 Spreads, Hospitals Face Financial Woes

Brattleboro Memorial expects to see about $7 million in lost revenue, and the University of Vermont Health Network said it expects to lose about $152 million due to the pandemic.

Tieman said the state’s hospitals have received federal help, but most of it has been in loans that have to be repaid. And when this over, he added, all of those same financial issues that have challenged Vermont’s hospitals over the last few years will have to be confronted.

“It’s not like these dollars put hospitals on a long term stable path. It’s very much a stopgap measure,” Tieman said. “And the hospital association, along with all of our members, will have to do some real thinking along with our state partners about what the sustainability of not just hospitals but the entire system looks like long-term.”

Southwestern Vermont Medical Center chief medical officer Trey Dobson said the added income from allowing the new procedures will have an immediate impact.

“The lost revenue into the system can be measured in millions of dollars per week, which is almost unbelievable,” Dobson said. “Our hospital, like all hospitals, have put in place certain measures. Unfortunately we’ve had to furlough over a hundred staff that we plan to be calling back very soon as these cases, and these patients, return into our system.”

"I think we all have to redefine what normalcy is for us over the next, really measured in months to years until we can get a vaccine in place or herd immunity." — Trey Dobson, Southwestern Vermont Medical Center chief medical officer

Still, Dobson says that even as Southwestern Vermont Medical Center begins to expand its services, he wants patients to understand that they won’t be walking into the same hospital, and that it will probably be a few months before all of the patients who need health care feel comfortable coming in.

“Now as far as getting toward normalcy, I think we all have to redefine what normalcy is for us over the next, really measured in months to years, until we can get a vaccine in place or herd immunity,” Dobson said. “So it will be normal for us to be wearing personal protective equipment. And it will be normal for us to have patients spaced apart and actually waiting in the parking lot, in their cars, until they’re called to come up and be seen, so we can keep everybody safe.”

While the hospital will be taking down its emergency COVID respiratory unit, Dobson said the hospital will also be keeping the equipment nearby in case there’s a surge in the fall.
 

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