COVID-19 update: A message from Marschall S. Runge, M.D., Ph.D.

November 3, 2020  //  FOUND IN: Strategy & Leadership

Dear colleagues,

As we begin November and colder weather pushes us to move our activities inside, we are seeing the anticipated increase in COVID-19 inpatients. The good news is that we are prepared and fine-tuning plans based on lessons learned. As importantly, we are committed to keeping you informed and providing transparent and timely data on COVID-19 admissions, staff infection rates, equipment supplies and overall occupancy.

Plan overview

Our COVID-19 Resurgence Plan has transitioned from the Chronic level, where we were seeing a census of fewer than 20 inpatients/day, to the Acute level, where we are caring for more than 30 inpatients/day, including 10-20 inpatients in our Intensive Care Units in University Hospital. During this phase, we are increasing ICU capacity by flexing to staff an increased number of ICU beds in 8D. At the same time, we have added moderate care capacity on 6C and 5A. In the event that the number of inpatients with COVID-19 in our ICUs approaches 30 patients, we will be evaluating reopening the Regional Infectious Containment Unit (RICU).

Currently, there is no need to modify scheduled clinical activity. However, this could change in the next several weeks and we are closely monitoring our inpatient census, as well as statewide hospital data, to continue to evaluate any needed adjustments to scheduled clinical and procedural activity.

The virtual Command Center has begun meeting each morning to address the day-to-day issues of safety, policy, staffing, supply chain, PPE training, vaccine management planning, influenza tracking and other key issues related to the pandemic. Our top priority is staff and patient safety during the pandemic.

Current status at national, state and Michigan Medicine

The U.S. is reporting 90,000 new cases on a daily basis. In the state of Michigan, the surge we are seeing now is more gradual than what we experienced in the spring. Last week, the state saw the highest number of confirmed cases since the pandemic began with 2,548 positive tests on Oct. 26. West Michigan has seen a big increase in hospitalizations; on Oct. 30, Spectrum reported 167 inpatients and Metro Health, our affiliate in Grand Rapids, reported 27 inpatients.

At Michigan Medicine, we are well prepared and have been managing the influx of ICU and general hospitalizations without a great deal of facility changes. However, we know that we will need to institute changes in both facilities and staffing as numbers climb. We are monitoring this around the clock and have daily calls with our clinical operations leaders so we can remain agile and execute plans as needed.

We are concerned that we have seen an uptick in positivity rates among staff. During the week of Oct. 25, 60 employees tested positive for COVID-19, a 1.81% positivity rate. We are asking all staff to be particularly careful when they remove their masks in break rooms or the cafeteria to eat and drink. Please maintain six feet of social distancing and put masks back on as soon as possible. In addition, everyone must wear a mask when they arrive on campus and enter our buildings, even if you will be using a different mask once you are in your department or unit. 

Dashboard/communication

We are creating a new COVID-19 dashboard for all staff available for review 24-7. Ops Update will still feature inpatient statistics and employee positivity rates, and we have increased publication to three times/week on Mondays, Wednesdays and Fridays. We will also be increasing Town Hall meetings to every other week, and we are finalizing plans for this week’s meeting on Friday, Nov. 4. We will publish details on the upcoming Town Hall and how to submit questions in Wednesday’s Ops Update. Our goal is to continually provide timely, transparent information.

As we approach our eighth month of caring for COVID-19 patients, we remain in awe of the incredible amount of courage, strength and stamina that we have seen in all of you. We are so grateful for all that you have done and continue to do to live out our values each day. 

Sincerely,

Marschall

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