There was a time when local health officials were preparing for tens of thousands of Limestone Countians to be infected with the novel coronavirus. While the community is by no means out of the woods, hospital staff are saying community response has been a huge help in keeping that expectation from becoming a reality.

“I thought we were going to see a big surge of patients, but the community has done such an excellent job with social distancing initially, and then after the stay-at-home order from the governor, we have not seen a very large surge in Athens,” said Dr. Matt Hanserd, COVID-19 medical staff response leader at ALH.

Hanserd said there have been “seven or eight” people who were hospitalized due to the disease since the first case was confirmed, and only three remained in the hospital Friday. He said one of the worst case scenarios brought up at the start of the COVID-19 pandemic was for 30–40% of Limestone County, or 30,000 to 40,000 residents, to end up with the disease.

“We prepared for that, and that did not materialize because people did what we said from a public health standpoint, before you started seeing patients arrive in the hospital,” Hanserd said.

However, the hospital has not relaxed its standards. Everyone wears a mask, regardless of their job in the hospital, and employees must have their temperatures taken before each shift. It hasn’t completely prevented employees from contracting the disease, but it has prevented a large outbreak in the hospital.

“Just like the rest of society and anybody else that is going to work right now, we have had some employees that were tested positive,” Hanserd said. “Some had to be sick enough to be in the hospital, and other were fine and had no symptoms at all.”

Community support

Hanserd was born and raised in Athens. He moved away to earn his doctorate and train in the medical field, but he returned to work at the hospital. He said he’s not surprised at the outpouring of support from his hometown during the pandemic.

“It does not surprise me in the least,” Hanserd said. “… The amount of community outreach we have had has been outstanding.”

He said people have been calling regularly for the last month to see what they can do to help. Residents and organizations crafted homemade masks to donate. Local restaurants donated food or delivered meals purchased by others in the county. They prayed for staff to be safe and rejoiced as patients were discharged.

“All of these things are so important to us,” Hanserd said, “and we are so grateful for it.”

He said the homemade masks in particular “are a very useful way to reach out and give to your community hospital.” The hospital is not facing a shortage of personal protective equipment, he said, but homemade masks allow for an additional level of protection in patient care settings that do not require PPE.

Moving forward

While the community has done a great job of following health guidelines so far, Hanserd said it’s important they continue to do so even as the state reopens. He believes the best thing people can do is define their personal risk and make decisions based on that.

“As we start to see reopening in the next week or two, I think it’s going to be important for everyone to understand their individual risk,” he said. “If I’m 21 and healthy, the chances of me getting sick enough for this to really change my life are low — present, but low. For the people who are in their 60s or older, have diabetes, have high blood pressure, or are overweight, those patients have a higher risk of bad outcomes. People who take immunosuppressant medications are going to be at risk.”

The majority of people who become infected with COVID-19 will have mild or no symptoms, but experts have warned the virus that causes the disease can be spread by individuals with or without symptoms.

“Like with any other respiratory tract or viral infection, there’s a risk you can get it when you’re out in public,” Hanserd said. “Chances are, when you get it, you’re not going to be ill enough to be in the hospital, (intensive care unit) or on a ventilator, but a certain percentage who do get sick do, just like with the influenza that we deal with every year.”

When those patients arrive at the hospital, ALH has implemented patient cohorting to reduce their exposure to others in the hospital.

“That’s where you take patients you know are positive with COVID-19 and put them in certain units in the hospital where staff can take care of them just in those units instead of spreading them throughout the hospital,” Hanserd explained.

He said as the hospital works to resume normal operations, it’s important that residents not let fear of possibly being exposed keep them from seeking treatment for issues unrelated to the coronavirus.

“If you need help, please come to our hospital,” Hanserd said. “We are built to take care of people with medical problems. We are learning how to take care of people in the setting that this virus presented, and we will do that for some time, but we are not going to to forget about other patients.”

Heroes from home

The hospital has greatly reduced its daily staff to further reduce the spread and risk. Hanserd, who also serves as the hospital’s vice chief of staff and director of the Athens-Limestone Hospitalist Group, said he’s still not happy about having to tell doctors with decades of experience they were no longer allowed to come to work, but he has been extremely grateful for their help in other ways during the pandemic.

“Between all of them helping with community outreach and public health focus on all of this, that’s the reason we didn’t become overwhelmed with patients in the hospital,” Hanserd said. “We did a good job with that early on.”

He thanked several doctors for helping in every way they could: Nauman Qureshi; Paul Fry; Jon Bignault; Tracy Pool; Matt Caldwell; Melissa Gray, Samantha Ross and William Woodall; Belinda Maples and Sasha Acelajado; and Paul Noel, Keith Hill and Patrick Boyett.

He said COVID-19 has been a “different kind of bad,” but it’s a bad that most employees have been training their entire careers to handle. He likened it to military soldiers preparing for battle in a war that hasn’t happened yet.

“This month has been terrible for everyone involved, including me, but at the same time, it’s like we went to war,” he said. “It’s exactly what I trained for, so I felt a lot of purpose, and I know others in health care felt the same.”

He said some of the physicians helped guide surgical services or emergency response, while others helped with inpatient services so their coworkers could focus on COVID-19 patients. He thanked the crews at Waddell Family Medicine and Medical East for stepping up in the fever and flu clinic and in testing patients.

“Most of all, I want to thank the doctors, nurse practitioners, ICU nurses and respiratory therapists who worked on our COVID teams for their selfless work,” he said.