Banner Health COVID-19 Update
Marjorie Bessel, MD
Chief Clinical Officer
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Can you give us an update on capacity at Banner’s Arizona hospitals? We’re hearing that many of them are full.
We are absolutely seeing an increase in our census in all of our hospitals in the state of Arizona. We are absolutely experiencing a surge of COVID-19 patients that are coming in for care. And we are starting to get full.

We do have plans, however, to continue to increase our capacity so that we can meet the demand of the communities and all the people that we serve in there. But we do ask everybody to follow all the things that we can do to try and reduce the curve of spread. Wear your mask. Wash your hands. Stay home when you're ill.

Do you currently have enough beds, staffing, equipment and supplies? Are you short on anything?
So as we're experiencing a surge in our capacity in all of our hospitals, we are starting, of course, to feel the tightness of what that is like. So we have been a little bit short on our staff, but have been able to contract with external agencies that are actually bringing nurses and other types of providers into our Banner Health System.

Currently we have over 200 nurses who are very experienced. They have ICU experience. They have PCU experience. Some of them have even worked in New York. So we're augmenting our staff, and we have some more coming next week, as well, to assist us.

What things have you done or are you doing, specifically, to address capacity in those areas?
As we start to get full, there are certain things that will become tight for us, and we are absolutely working on that. So staffing is one of them. We've brought in over 200 nurses, some of whom have worked in New York, to assist with our staffing. In addition to that, we meet every single day and make sure that we have enough PPE, make sure that we have enough equipment. Sometimes we need to move equipment around from one hospital to another to make sure that we're best positioned to meet the needs of the community.

When all your hospitals are at or nearing capacity, what happens next?
If all of our hospitals get to capacity and exceed the surge capacity that we have been building and making plans for to be ready for this COVID-19 pandemic, we go into different types of modes. So first of all, I want to just go on record as saying we certainly do not want to get there. That is not a good thing when hospitals exceed their surge capacity.

So I'm going to urge everybody, like I always have, wear your mask. Wash your hands. Stay 6' away from everybody. Don't go to large gatherings. Don't go out when you're ill. Those things will help us not get to a point where our hospitals and the hospitals in the entire state of Arizona get beyond their surge capacity.

However, if we were to get to that type of scenario, we would have to do other things to attempt to still take care of the people who need us. You've seen them on TV. You've seen them in other countries. Those would be things like building hospitals as field hospitals, hospitals that are outdoors. It would mean asking for the federal government to help send additional people to help staff those hospitals, looking at every other type of place where we can provide care.

Churches, alternative sites of care in our surges centers and things like that would have to be looked at if we got to that point. Again, I want to stress, we do not want to get to that point. And we ask everybody out there, you can play a role to make sure the hospitals do not get to that point. Please mask up, Arizona.

Elective surgery
Are you still performing elective surgeries?
As we've talked about with the surge that we are experiencing, I do want to say that we still are providing elective surgeries. We remain a safe place for you to come get care if you need it. So I would ask, if you have an emergency, or if you have a surgery that has been scheduled and it's continuing forward, please do continue with that.

However, given the surge that we are starting to experience, we are needing to take some steps back from how much elective surgery we are going to be able to provide. So if you have a surgery scheduled coming up, I would ask you to call your surgeon or your provider to check in. We are going to adjust as we go through the rest of this pandemic.

We might need to do a little bit more some weeks if we have capacity, and other weeks, we're going to have to do a little bit less. It's going to be a constant managing of the elective surgeries. We want to be here for you, so please, mask up, Arizona, so we can create capacity in the hospitals, not only for our COVID patients, but for all the other patients who need us, including those that need surgeries.

Have you made any changes to your surgery process or decision-making as a result of the rising number of COVID-19 cases and hospitalizations in Arizona?
With a rising number of cases that we have in our hospitals at Banner Health and within the entire state, we are having to make some adjustments to our surgery schedules. So first, I do want to clarify, we often use the term elective surgeries. And for those that maybe haven't had a surgery or don't understand that term, it does not mean cosmetic surgery. Banner Health is not doing cosmetic surgeries.

We are doing medically necessary surgeries for patients who need their surgeries. So as we make adjustments, what that means is that a surgery that maybe can be delayed for a week or 30 days, we're going to try and push those off in conversation with the surgeon who will have conversation with our patient in the safest manner possible so that we can take care of all the patients, those that are COVID, and those that need surgeries, as well.

Can you walk us through the testing process? What happens from the time your sample is collected to when you receive your results?
If you're out there and you need to have a test or you're about to have a test, once you have your appointment secured, you know that you will come and you'll get a specific type of swab. It goes through your nose, and we take a swab of that, and then we send it off to the lab. Within the state of Arizona, ambulatory patients or those that are in an outpatient setting are currently having a relatively longer time before they get their test results.

So we're going to ask you that if you are sick and you went and got your test because you were symptomatic, to self-isolate. So what that means is please do not go out for anything other than medical care. If you live with others, try and stay in your own bedroom. If you have to go out, wear a mask in your own home so that you're not getting your other family members or your other companions that live with you in the house ill. That's a very important piece of this.

All the test results for Banner Health will flow through the SQL portal or the Banner Health portal. So as an individual patient, you can go and check on that each day waiting for your test result to come back. Right now, those test results are averaging about five to seven days. In those five to seven days, you should be monitoring your symptoms, making sure that you're not getting worse.

If you do, we ask you to reach out and determine if you need to come in and be seen and get medical care. You should continue that self-isolation process. And if you're having symptoms, we ask you to take care of those symptoms. Stay hydrated, get plenty of sleep, while we're waiting for the test results and while we're waiting for you, hopefully, to just get better over your illness.

Tell us about the Banner COVID-19 testing process. How many appointments do you have available per day? How many days a week do you operate? What is your criteria for testing? How could someone go about getting tested at these locations? What is the wait time for appointments?
If you're out there and you believe that you need a test, there's a couple different ways that you can obtain a test. So if you want to go to one of our collection sites, we have 1,000 appointments a day, and we run that six days a week. You do have to call ahead and make an appointment. When you come for that, you'll go ahead and get a specimen collected. We'll ask you to self-isolate, and you'll wait for your test result to come back.

If you think you've been exposed, so for instance a co-worker or maybe even somebody in your own family has tested positive, you can go to one of the collection sites, as well. Even if you're not yet having symptoms, make an appointment, go to the collection site, and you can be tested.

If, however, you feel like you're having symptoms, maybe your symptoms are a little bit more severe, and you think you might need to actually be evaluated by a physician or an advanced practitioner, you can go ahead and go to one of our clinics. You have to call for an appointment for that. You can go to one of our urgent cares. We ask you to make an appointment, but you can also walk into those.

At our clinics and at our urgent cares, you can also be tested if you meet the criteria, which would mean that you have symptoms consistent with possibly having COVID. We'll go ahead and obtain that specimen, and we'll send it off. During that time, if you're tested while you have symptoms, were going to ask you to self-isolate. That's a very important piece of this. Stay home. Don't go out to work. Stay away from family members. Take care of yourself. Stay hydrated, get plenty of sleep and all of that.
If you're really feeling like you're very, very ill and you have, potentially, an emergency condition, we will, of course, ask you to go to the emergency department if you believe you're having an emergency condition. There you'll be screened. You'll be seen by an appropriate provider. They will make a determination as to whether or not you need testing.

If you need testing, that will be done. If you need to be admitted to the hospital, of course that would be taken care of at that time. And if you're admitted to the hospital, your test result will likely come back in a day or so, and you'll know within that time frame whether you have COVID. And if not, then your physicians will try and determine what else is going on with you.

Are you experiencing any issues currently?
Testing in the state of Arizona, just like it has been across the entire United States, has been a difficulty for us. We need more testing. We've needed more testing for a long period of time. At Banner, we're working very collaboratively with the Arizona Department of Health Services as a partner in addressing that, as well Sonora Quest Laboratories, which is our partner for our lab testing. We just actually had a phone call this morning trying to work out how we can expand testing. We're working very carefully to obtain additional equipment, reagents, testing kits so we can provide the testing in the state of Arizona that's going to be necessary while we're experiencing the surge.

What is your turnaround time for COVID-19 test results?
If you get tested for COVID-19, your turnaround time is going to average 24 hours to 5 to 7 days, depending on where you got your test done. So for patients that are in the hospital, they are of the highest priority. We have got to know whether they have COVID or not. So those tests do get run first. For patients that are out there in the ambulatory setting, the current turnaround time for those is about 5 to 7 days. However, if you're in the ambulatory setting and you're getting tested because you're symptomatic, we're going to ask you to self-isolate. So important.

If you're symptomatic and you get a test, you should not be going to work. You should not be going out and about and potentially infecting people. So we ask you to take care of yourself, manage your symptoms, stay hydrated, get plenty of sleep. And then when that test result comes back, hopefully you're mostly over your illness. You'll know the results of that test, and then you can, per protocol, make decisions with your employer as whether or not you're able to go back to work.

What is your advice for people who want to be tested?
My advice for those that want to get tested or think they need to get tested is to go ahead and you can call Banner Health, you can go to the Arizona Department of Health Services website and access some of those other testing sites, and go and get to test. My advice, though, is to remember that it's going to take about 5 to 7 days for most of our labs to get you a test result, and if you're symptomatic, it's so important to self-isolate while you're waiting for that test result. You're going to need to self-isolate for a week anyways. And so while it takes that 5 to 7 days to get that test result, please follow those instructions.

If your test result turns out to be positive, it's going to be very important that you didn't go out and potentially spread to other people. And if your test result turns out to be negative and you had something else, please remember, you could have been contagious with something other than COVID-19, and staying home while you're not feeling well is an important piece of keeping everybody in our communities healthy, as well.

What is the importance of masking when in public?
Part of my messaging is making sure that we're all taking care of each other. I wear my mask when I'm out and about, and I think it's really important for everybody else to do the same. And it's also important to make sure the mask is working well for you and for others. So I'm just going to close by just showing how you put a mask on appropriately so that we all do that correctly.

So I have my mask off to the side here. I kind of put it on a paper towel or a piece of paper to keep it clean. And before I put my mask on, I always go ahead and sanitize my hands to make sure that they're nice and clean before I put my mask on. And then what I'm going to do is I'm going to grab the mask just by the ear loops. If you have ties, you would pull it by the ties. And I'm going to try not to touch the mask at all as I go ahead and put it on my face.

I'm going to then carefully put it over my ears. And then as I do that, I'm going to make sure that the nose is really tight here, and also that the chin is underneath. After I've done all that, I'm going to try to not touch it again. I'll sanitize my hands.

And then I'm going to be out and ready to go, and try not to touch the mask at all while you're out and about. If you do touch your mask, if you have to adjust it again, go ahead and sanitize your hands afterwards, because remember, what's on the outside of the mask is an area that could be contaminated. So keep your hands really clean anytime you have to touch it.