The Dobbs Ferry Pavilion of St. John’s Riverside Hospital is back to conducting business as usual. As of May 1, the Pavilion is Covid-19 free and providing its usual care, apart from elective surgery.
All Covid-19 patients well enough to go home were discharged; the remaining dozen were transferred to St. John’s Riverside’s Andrus Pavilion on North Broadway in Yonkers.
According to Dr. Mark Silberman, chief of emergency medicine for both facilities, at the peak of the spread of the coronavirus, the Dobbs Ferry hospital housed 20 cases while St. John’s had 200, approximately 55 deemed critical, with patients on ventilators. That number has dropped to 21. Between March and May 1, there were 163 deaths altogether.
“We saw every age group,” Silberman said on May 4. “We had two deaths of patients in their 20s — the youngest — and some in their 40s and 50s… When people get older and have more co-morbidities, the death rate does go up significantly, but it [Covid-19] doesn’t spare the young.”
The 12-bed Dobbs Ferry Pavilion, at 128 Ashford Ave., has been sanitized from top to bottom, in a procedure called “terminal cleaning.” Every surface is sterilized with disinfectant, then exposed to ultraviolet light, and each space is subjected to an air filtration process.
Rather than admitting patients with Covid-19 symptoms to the Dobbs Ferry emergency room, the hospital will have an ambulance transport them to St. John’s. Both hospitals still recommend calling a physician first rather than going straight to an ER.
Silberman emphasized that his number-one message to the community is that the Dobbs Ferry Pavilion is safe for emergency treatment.
“If you have abdominal pain, chest pain, symptoms of a stroke or heart attack, don’t stay home; come in for treatment… It is safe to get care there,” he urged. “We want to stop the situation where patients are presenting at a very advanced stage of illness. We don’t want people to suffer the consequences of a heart attack or ruptured appendix at home. We want to see them in a timely manner, without fear preventing them, before they’ve advanced to a bad stage.”
Both hospitals now provide urgent, as well as emergency, surgery. For example, breast cancer patients who were awaiting surgery now can be treated. St. John’s is working with the state government to determine when both hospitals can resume elective surgery. Reopening of hospitals is coordinated on the state level, requiring special protocols to ensure that people are Covid-free before they have urgent procedures done.
“It’s likely the Dobbs Ferry Pavilion will be able to do elective surgery before other hospitals, because we are Covid-free,” Silberman stated. “It will be done in an appropriate, safe, and timely fashion.”
He described how the hospitals coped during the first surge in coronavirus cases, starting in mid-March. St. John’s added four temporary ICU units to its permanent one. In Dobbs Ferry, the average number of doctors and nurses on ER duty doubled, from a normal crew of five to 10. In addition, ER beds for non-Covid patients were added to the lobby. Covid patients were segregated. Since the Pavilion has no ICU, critical patients were transferred to St. John’s.
Most staff members worked seven days a week; nurses sometimes put in 14-16 hours per shift rather than their usual 11.5 hours.The hospitals brought in staff from elsewhere in the county and deployed people who usually worked in outpatient units. Pharmaceutical products were back-ordered across the globe, so the hospitals obtained medications from outpatient ambulatory surgical centers, doctors’ offices, and the national stockpile.
“The teamwork from every department was amazing,” Silberman noted.
A procurement and logistics team worked nearly around the clock, scouring local, state, national, and international sources for personal protective equipment (PPE). Because some international suppliers were price gouging, St. John’s sometimes paid 10 times the normal cost. The hospitals also had to scramble for more ventilators, because their need was 11 times greater than usual. The administration rented and purchased ventilators and obtained some from the State.
“Our greatest fears were running out of ventilators, but we managed to get enough for every patient who needed it to have one. It was a Herculean effort,” Silberman recounted.
Treatment options for Covid-19 have been expanding since the pandemic began. Remdesivir, an intravenous antiviral drug manufactured by California-based Gilead, received emergency use authorization by the Federal Drug Administration on May 1. “It’s not a complete game-changer,” Silberman cautioned. “It has modest beneficial effects, but it is mostly helpful for selected patients who have a lot of lung inflammation.”
“Convalescent plasma” is proving effective. Recovered Covid-19 patients have antibodies in their blood, and if that blood is given intravenously early after the onset of severe pneumonia, the plasma helps prevent even worse illness. The New York Blood Center is collecting convalescent plasma.
Since there’s no telling when a vaccine may be available, Silberman stressed that people must rely on the safety measures of hand washing, social distancing, wearing a mask outside, and wearing hospital gloves to protect against being infected by touching doorknobs, supermarket carts, and other public surfaces.
“Many people are cavalier about it. If the majority of the population takes precautions, they won’t be increasing the risk of everyone around them,” he advised.
Asked if he expects a second wave of infection, Silberman replied, “It really depends on how citizens behave.”
Silberman gave a “shout-out” to the Rivertowns community for donating PPE and food. “Everyone in the hospital is thankful… I thank all the volunteer ambulance corps for their courage and dedication to continue serving the members of our community despite putting themselves at risk for catching this infection.”
A resident of Dobbs Ferry, Silberman serves as the volunteer medical director for the Ardsley, Dobbs Ferry, Hastings, and Irvington volunteer ambulance corps.
“We’d like to thank both the businesses and the citizens of the community for providing food to the hospitals,” he continued. “Some of the local restaurants are suffering, but they stepped up and delivered food to doctors and nurses who were working exceptionally long hours. Families donated food, and that has helped so much. Some stores made special hours for health-care workers. The support was really something that helped us. We’re eternally grateful to everyone who stepped up, and I want to express that.”