WAUSAU, Wis. (WSAW) -- “When this all came up, I felt it was sort of a calling.”
Registered nurse Vickie Lange inside the newly-created COVID-19 ICU at Aspirus Wausau Hospital, March 25, 2020 (WSAW Photo)
Vickie Lange is a registered nurse at Aspirus Wausau Hospital, with thirty years’ experience in the medical field, most of them in critical care. She volunteered to help staff one of Aspirus’s newly-opened COVID-19 intensive care units, a secure 8-bed unit designed to care for patients with suspected or confirmed COVID-19.
“I know that they needed critical care nurses to work there, and I felt like I wanted to step up and do something different,” Lange explained. Nearly all the staff in the new units are choosing to work there, according to the Wausau hospital’s Director of Hospital Medicine Dr. Steve Phillipson.
“The RNs, the PTs, the ancillary people, the people who come in and clean the rooms. I mean, those people are really heroic to me because they’re volunteering to do this,” he noted.
Another 24-bed COVID-19 ICU for non-critical patients with suspected or confirmed COVID-19 cases will open within the next day or two, Dr. Phillipson said. The units are being repurposed from different facilities inside the hospital, and are negative pressure areas to contain airborne contaminants inside.
“The air goes into the room, but it doesn’t come out. So we don’t move the virus from inside the room to outside the room in the hallway,” Dr. Phillipson explained.
To be admitted to the unit, patients must be exhibiting symptoms that align with COVID-19, Lange said. Everyone inside is being tested for the virus; once a test comes back negative, Lange said, the patient can be moved to a different unit inside the hospital. Positive patients would remain in the specialized ICU. On Wednesday, the ICU was at maximum capacity in the morning with eight patients, but two had been discharged by the time NewsChannel 7 spoke with Lange in the early afternoon.
“The hard thing for me as a nurse is I can’t really spend time with the patients; they want us to have minimum contact with them,” Lange noted; a major component to the ICU is the isolation of the patients to prevent the spread of COVID-19.
The wait time for test results to return can take up to four days—and represents one of the biggest challenges for doctors, in addition to an ongoing shortage of personal protective equipment.
“Without knowing who has the illness, it’s very difficult to determine how to react,” Dr. Phillipson said. “Without being able to get testing back quickly, it’s very challenging to figure out who has what, who needs treatment, and who does not.”
Testing at Aspirus is now prioritized for symptomatic health care workers and hospitalized patients, Aspirus CEO Matt Heywood said, in accordance with new restrictions from the Wisconsin Department of Health as well as guidance from the Centers for Disease Control and Prevention. Due to a national shortage of testing materials, the DHS does not recommend testing for individuals with mild symptoms, and says asymptomatic individuals should not be tested.
For Aspirus doctors and health care systems across the country, Heywood says that means clinical diagnoses for COVID-19 is being utilized for determining treatment, which would include the elimination of other diagnoses like influenza.
“We’re already as a country doing that because of the testing shortage,” Heywood said at a press conference Wednesday. “It’s just a matter of what populations you’re using it for.”
While only one case of COVID-19 has been confirmed in Marathon County as of Wednesday evening, multiple other counties around northern and central Wisconsin confirmed their first cases Wednesday as the state overall experienced a jump of more than 100 positives. Community transmission at this point, Heywood said, should be assumed.
“What [Hubei] found is there’s a significant lag between the testing and the actual identification later of how many people who already had it,” Heywood noted, referencing the Chinese province where the outbreak began. “There was 27 times more at the time who really had it, because of the testing lag.” A report published by the Science journal found substantial undocumented infection was responsible for the rapid spread of the disease in China.
Heywood had a warning for the community, as the state adjusts to Governor Evers’ order for all non-essential businesses and most gatherings of any size to close for April 24—or until new orders are released.
“This is going to be a challenge that we are going to have to face as a community and as a country over a period of time until we get a vaccine, which is about 12-18 months away,” Heywood said. It’s a warning that has been echoed by other experts, including California’s Governor Gavin Newsom who suggested Monday that social distancing measures would need to continue for two to three months.
“Doesn’t mean you’ll be locked up in your homes for 12-18 months,” Heywood said, “But it may mean that we have to go through times that we have to do this in order to keep the surge of the patients and the surge of the spread down over the next 12-18 months.”
Editor's note: NewsChannel 7 did not enter the secure COVID-19 ICU for this story. Some footage was obtained through windows, while footage of the ICU's construction and rooms was provided directly by Aspirus.