Click here for the latest coronavirus news, which the BDN has made free for the public. You can support our critical reporting on the coronavirus by purchasing a digital subscription or donating directly to the newsroom.
As the state and local hospital systems prepare to erect temporary medical centers in Portland and Bangor over the next week, the purpose for the makeshift treatment sites has been evolving.
At least one of the sites, the one to be set up at the Cross Insurance Center in Bangor, would not be used to treat patients infected with the new coronavirus, according to an official with Northern Light Health, the hospital system that would oversee care at the site.
Instead, uninfected hospital patients who need low-level care but are not ready to return home would receive treatment there, freeing up hospital beds, said Dr. James Jarvis, Northern Light’s incident commander. The patients could include some who need physical therapy or are recovering from a surgery, he said.
That’s a departure from initial plans announced by Maine Center for Disease Control and Prevention Director Nirav Shah last week, when he said the temporary treatment sites would provide quick medical evaluations for people who have symptoms of the new coronavirus.
Gov. Janet Mills announced the locations of the first two sites on Tuesday as part of a strategy to expand the health care system’s capacity as the number of confirmed coronavirus cases in Maine continues to rise. The CDC has said it’s also considering additional temporary treatment sites in western and northern Maine.
On Wednesday, Shah said the best use of the sites is still being worked out. Maine CDC spokesperson Robert Long said the CDC will defer to the health care providers running the sites on their best use.
The sites are meant as a backstop if the state experiences a surge in coronavirus cases, but Mills and other state officials have said they would prefer to use the sites as a last resort — or not at all — and keep coronavirus patients in hospital beds.
The state will provide logistical oversight of the sites but health care providers in the area will staff them. The Bangor site will have 50 beds, while Portland’s, at the Cross Insurance Arena, will have 100.
Treating uninfected patients who need a lower level of care at the temporary site would ensure that patients who need more intensive care, such as heart monitoring, can stay put in hospital beds, Jarvis said. That kind of care is “difficult to stand up in a facility never designed to be a hospital,” he said.
How the sites are used will factor significantly into how much personal protective equipment they receive, Shah said. A site that treats coronavirus-positive patients will need “significantly higher” amounts of protective equipment that has been in short supply worldwide, he said.
Jarvis said he does not know what size staff will be needed for the site, but said resources could be drawn from multiple health care organizations in the Bangor area, including Northern Light Eastern Maine Medical Center, St. Joseph Hospital and Penobscot Community Health Care. If the temporary unit ends up needing fewer beds, that will affect staffing.
Once it’s set up, he said, the site can be operational within 24 hours if needed.
The state would likely activate the Portland site first, Shah said, with the largest number of coronavirus cases concentrated in Cumberland County. It is unclear how that site will be used. A MaineHealth spokesman didn’t have that information late Wednesday.
The state had 537 cases in 15 counties as of Wednesday, and it had recorded 14 deaths. Cumberland County was home to 262 of those cases while York County had 121. Those counties are the only two where the Maine CDC has confirmed that community transmission of the virus is happening.
Hundreds of temporary medical sites are being set up around the country as recorded coronavirus cases increase, according to Reuters. Some locations have been used to keep uninfected patients away from hospitals. The Jacob K. Javits Convention Center in New York City, one of the hardest-hit areas in the country, was constructed with that purpose in mind last week, according to the U.S. Department of Defense.
The U.S. Navy hospital ship Comfort was originally meant to treat medical patients other than those sickened by the virus when it docked on Manhattan’s West Side last week. But its mission shifted on Tuesday, despite previous warnings from the Navy that the ship was not designed to treat infectious diseases, according to the New York Times.
Watch: Janet Mills speaks to people who think they’re not at risk