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With the Rise of Covid-19 Infected Patients, Sheba and Israel Prepare for the Surge

Infected Patients
Sheba Medical Center explores innovative ways to maintain an effective healthcare system without endangering staff and other patients.

Hospitals in Israel are hastily getting into position to handle the expected the rise of COVID-19 patients. Sheba is poised at the forefront of this scene, taking steps such as designating special isolation hospitals, implementing telemedicine technologies, and using robots as part of a zero-physical contact policy.

The rise of COVID-19 infected patients is being diagnosed daily in Israel, and Prime Minister Benjamin Netanyahu has warned that the potential number of deaths from the virus is very high. In a massive effort to avoid overstretching the country’s health system, hospital officials are investigating the best ways to cope with the expected increase in patients.

“In the last week we have completely changed the emergency process,” said Prof. Eyal Leshem, infectious disease specialist and Director of the Center for Travel Medicine and Tropical Diseases at Sheba Medical Center.

Now, everyone who arrives at Sheba for emergency care is first assessed for the likelihood that they have coronavirus. If the virus is determined to be a possible diagnosis, the patient is immediately separated entirely from other people. This practice minimizes the chances of spreading the virus to others in the hospital.

The lowest risk categories of patients are people who are coming in from quarantine for complaints unrelated to coronavirus symptoms and people who are unlikely to have the virus. Higher risk categories include patients arriving with fever or respiratory symptoms who have not been verified corona-free.

“For example, if you have a patient who is supposed to be quarantined but they broke their leg and need casting, their risk is relatively low, and we don’t need to mix them with people who are high risk.”

If someone is regarded as high-risk, they are admitted to a tent set up outside the emergency room, where a doctor in protective outfit checks their heart rate, blood pressure, and temperature. If coronavirus COVID-19 is suspected, a lab test is ordered. At present, the labs are overwhelmed with the multitude of coronavirus tests being performed.

The Health Ministry is considering an alternate idea that involves the appointment of one or two hospitals in Israel to be dedicated only to coronavirus.

“It’s something that was tried and tested in Singapore, and we should really learn from another nation’s experiences,” Prof. Leshem explained.

But not every medical professional in Israel supports this idea. Some physicians contest that if the country reaches a stage where there are thousands of patients, one hospital will not suffice. The staff at that medical center will be tired and demoralized by the need to take all the pressure of the rise of COVID-19.

Sheba was the first Israeli hospital to receive coronavirus patients, and the doctors are currently dazed and disturbed by the announcement that an emergency room doctor at Sheba was diagnosed with the illness. The physician had returned from France on March 2, and Israel only instructed those returning from France to enter quarantine on March 4. But prior to that order, he had worked a shift in the emergency room. The doctor, who was admitted to Sheba’s isolation unit, clearly represents part of the challenge hospitals are currently facing.

Sheba’s isolation hospital features robots scooting around with carts, equipped to take over many bedside tests and treatments that would normally be conducted by doctors. Instead of face-to-face meetings, the medical staff speaks with patients via digital screens or using phone apps.

“The only time doctors really have contact is if they swab them, otherwise most of the work is done remotely,” said hospital spokesman Steve Walz. In addition to relying on robots, doctors are also guiding patients via live feed on how to properly perform self-testing.

“The doctors can see how the patients do the testing, if the throat is red, and if they have a fever. All of this is done remotely,” Walz said.

Maintaining the isolation hospital at Sheba poses diverse challenges. Cleanliness and hygiene are obvious necessities, and cleaning teams must enter in protected suits. Patients also need fresh air, so a strict schedule for when they can visit an adjacent garden is set. Also, patients in the coronavirus units may have unrelated health issues that require treatment. For example, an infected woman who is pregnant will require a birthing room in the isolation unit.

Proactive, detailed planning helped Sheba to confront the different hurdles involved in dealing with coronavirus. “We had a full drill a month before the first coronavirus patient was diagnosed in Israel,” Walz said.

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