For the past two years, I have served as the medical director of Mid Coast Senior Health Center. This organization includes assisted living, memory care, skilled nursing, and acute rehab communities. You’ve likely been hearing a lot about “nursing homes” in the news lately. Since the onset of the novel coronavirus, organizations such as ours have been identified by public health officials as highly vulnerable. We’ve seen storms of COVID-19 in congregate elder care communities around the country, and this concern has hit home in recent weeks as several outbreaks have impacted Maine facilities.

The purpose of this column is twofold: 1) To reassure the community that we are focused on keeping the patients, residents, and staff here safe, and 2) To thank my colleagues, coworkers, family members, and community members who have sacrificed to help us do just that.

I and other leaders at the Senior Health Center are engaged in daily strategic meetings among our staff, hospital administration, long-term care medical directors around the state, and the CDC. Among many complicated issues, questions include who to test, how to best utilize limited personal protective equipment (PPE), when to transfer patients to the hospital, when to accept patients to rehab who are recovering from COVID-19 and other illnesses, and how to prepare for an outbreak.

Before it became widely accepted to do so, we made the decision to lockdown our facilities to visitors, except in cases of compassionate care at the end of life. We also stopped communal dining and activities. These were difficult choices, given the importance of social connectivity to the wellbeing of our residents. We also appreciate how difficult it is for families who have not been able to see their loved ones face-to-face.

Weeks ago, we began screening employees prior to entry with temperature checks and exposure and symptom questions. As PPE became more available, we implemented universal masking for staff, patients and residents. When individuals develop concerning symptoms they are immediately placed on isolation precautions, cohorted to reserved areas, and allocated specific staff to provide their care.

Even with all of these precautions, we recognize that it is very possible that we will have an outbreak of COVID-19 in this setting. I hope this isn’t the case, but I feel fortunate to be part of a greater network that can offer emotional and practical support. In recent days, I’ve been able to communicate through Zoom meetings with other medical directors who have dealt with outbreaks in their organizations and learn from their successes and struggles.

My advanced practitioner colleague and I continue to see dozens of rehab patients on a weekly basis, as we try to offload the burden of the hospital to make beds available for the sickest patients. This amounts to a significant amount of patient care, but pales in comparison to the time and sweat that CNAs, nurses, and physical and occupational therapists are putting in with direct patient care every day. These workers continue to do their job to help patients recover from acute illnesses as they always have, now with the added threat of COIVD-19. Our housekeepers, kitchen staff, maintenance crew, front staff, nutritionists, safety officers, IT team, mental health professionals, social workers, and other essential workers do the same. Something I’ve often appreciated about this setting is the interdisciplinary teamwork required to make things run, and that’s never been more apparent than now.

At a time when you hear about employees being fired for speaking out against their hospital administrations, I’ve never felt more supported by this medical community. The administrative team at the Senior Health Center and at Mid Coast Hospital and Maine Health at large have emphasized collaboration and connection every step of the way as we’ve faced this challenge together. My position as medical director can, at times, be isolating, and in a stressful situation such as this means a lot to have the guidance and support of my colleagues. We continue to need federal support, but at the end of the day, it is individuals and local organizations who get the job done.

Lastly, I want to thank the wider public for its support. Everybody is making their own sacrifices during this pandemic to keep each other safe. It means a lot to see signs of support or a nod of encouragement as I enter work. When I think of my friends working in large city hospitals or my colleagues in the emergency department and ICU, I sometimes feel that I should be doing more. But I know our team at Mid Coast Senior Health Center has a vital role in this fight, and we are taking it on with our full heart and mind.

Dr. Ben Young is the medical director of Mid Coast Senior Health Center.

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