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Speare Memorial Hospital Readies for the Surge

On March 7, the Plymouth State University hockey team defeated UMass Dartmouth 6 to 2. A little more than a month later, a collaborative effort between PSU, Speare Memorial Hospital, the Public Health Network and the National Guard has turned the Savage Ice Arena into a supplementary COVID-19 ward for the hospital. NHPR’s Sean Hurley visited the site earlier this week and sends us this. 

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You can see highlights from the last PSU hockey game on YouTube. The dramatic music pulses as the increasingly excited announcer calls the victory for PSU and the team cheers: “Plymouth State once again champions of the MASCAC! For the second straight year!”

Marlin Collingwood, VP of Communications at PSU, says that was then and this is now. “I think it's important to remember that it was a little over a month ago that we were playing hockey in this ice arena,” he says. “Our students had just left for spring break. And here we are standing here, four and a half, five weeks later, and this place is transformed.”

Credit Sean Hurley
PSU's Savage Ice Arena, now a COVID-19 ward for Speare Memorial Hospital.

Britt McDonald, Chief of Medicine at Speare Memorial Hospital says the rink was so cold when they first arrived to check the site, “We were like, we can't put patients down here. It was so cold.”

McDonald stands in blue scrubs below a glittering disco ball in the middle of the now pleasantly warm rink. “I'm most disappointed that the Zamboni has gone,” she jokes, “because if I'm going to sit down here all this time I'd like to at least be able to use the Zamboni.”

Credit Sean Hurley for NHPR
Britt McDonald on the floor where the COVID-19 patients will stay.

No zamboni, no ice, even the nets are gone, replaced by medical equipment and 40 oxygen-ready beds in three rows. “We plan on having the site be for patients who are Covid positive,” McDonald says, “who don't require high acuity of care that just require a low acuity of care with oxygen.”

While the site isn’t stocked with ventilators, supportive oxygen will be available at every bedside.

Director of Surgical Services at Speare, Eric Murdock, says this ability to provide oxygen to patients marks a significant difference between this ACS, or Alternate Care Site, and the others currently readying across the state.

All the other sites in New Hampshire are using these as step down out of the hospital don't need much, ‘we'd like to watch it for a day before you go home,’" Murdock says. “So this being the only oxygen providing facility makes us quite unique.”

Speare Memorial Hospital serves Plymouth and nearby towns. It's a rural area but the models show it could soon have more COVID-19 patients than the tiny critical access hospital with 25 beds can handle. “

So they're expecting peak in Central New Hampshire around April 17th,” McDonald says, “so we would anticipate that if it's something that we needed to open that it would be around that time, maybe a little bit before.”

Eric Murdock puts it another way: “So we know just to be a little more specific about numbers that we’re expecting hundreds of hospitalized patients potentially over a 12 to 16 week period once the surge starts."

And when the surge does start some of the medical staff working directly with COVID patients here will be moving away from their families to keep them safe.

Collingwood says Plymouth State is ready for that. “There are about 30 rooms in our residence halls available,” he says. “They are cleaned, ready to go for health care workers and first responders. So those are available right now, actually.”

In fact, none of this would have been possible, McDonald says, without the university. “The university offered us so many resources. Like how are you gonna feed people three times a day? How are we going to clean the space? Power, you know we're in a floodplain. All that kind of stuff and every concern we've had the university has stepped up and said this is how we can help.”

Liz Figueroa, a nurse at Speare, will be supervising the site’s 24-hour a day, seven-day a week medical staff. She says that while some of the staff here will come directly from Speare, local community volunteers are still needed. “We definitely need nurses, medical assistants, LNAs, pharmacy techs,” Figueroa says, “we would welcome EMTs or anybody with medical knowledge of that kind would be super helpful.”

Credit Sean Hurley
From left to right: Marlin Collingwood, Liz Figueroa, Angel Ekstrom, Steve Temperino, Britt McDonald, Jack Olmstead, and Eric Murdock.

Figueroa takes me through the expected patient experience. “They'll be processed at Speare's Emergency Room,” she says. “They'll have an ID band. All of the testing will be done there. Testing, X-ray, lab work and assessment by a provider.”

Test result turn-around times, by the way, Murdock says, have improved dramatically at Speare. “Initially, we were seeing a three and four day turnaround, sometimes five,” he says. “We found a really good one in Cambridge, Mass, and we actually physically drive our collected specimens down there, and we usually have within a 24 hour time, the turnaround.”

After being identified as both COVID positive and low acuity, Figueroa says, patients will be shuttled a mile from Speare to the Arena. A good guideline for low acuity, she says, is that patients should be able to walk through the doors under their own power. “So this is an area where COVID positive patients would be,” Figueroa says. “We tried to dress it up a little as you can see that local artist I mentioned earlier painted all of this so that they'd have something to look at.”

Last week, Stacey Lucas, also known as Veggie Art Girl, began painting the plexiglass hockey barriers that surround the rink with vibrant healing images - rainbows and flowers bearing positive messages.  Figueroa reads some off: “‘Into every garden a little rain must fall.’ ‘The sun will come up tomorrow.' All these inspirational sayings. Like I said, I made up a bed over here with donations from the community of colored pillowcases. When you're a patient and you're scared and really sick and here with other people, we want to make sure they know we care about them.”

Credit Sean Hurley
A glimpse of Stacey Lucas's work on the plexiglass.

As we’re leaving, Speare’s Britt McDonald once again stresses the uncertainty of the coming days.

"It feels little bit like we're preparing for a tsunami,” the Chief of Medicine says, “and we don't know if it's gonna be a little wave or a big wave or so we're just doing the best we can to prepare for whatever comes our way.”

PSU’s Marlin Collingwood says the fact that people are coming together now gives him faith that whatever the surge, the hospital will be ready. “I think it's the beauty of a small community,” he says, “I think it's the  beauty of a small town. It's the beauty of rural New Hampshire, that all of these partners were able to get together and very quickly make this happen.”

Health care workers interested in volunteering at Plymouth’s Alternate Care Site can contact Angel Ekstrom at Midstate Health to find out more.

Sean Hurley lives in Thornton with his wife Lois and his son Sam. An award-winning playwright and radio journalist, his fictional “Atoms, Motion & the Void” podcast has aired nationally on NPR and Sirius & XM Satellite radio. When he isn't writing stories or performing on stage, he likes to run in the White Mountains. He can be reached at shurley@nhpr.org.
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