HUDSON—Covid-19 is nothing if not dynamic. There were 47 new cases of the illness reported by the county health department as of Saturday, January 23. There will be more cases by the time this issue reaches newsstands January 28. There may be more deaths too, increasing the 63 recorded since the pandemic emerged exactly a year ago.
Columbia County, with a population of 60,000, has nearly 500 active cases of the illness and 35 patients currently hospitalized, all of whom depend on Columbia Memorial Hospital to help them survive this virus.
Dr. Clifford J. Belden, MD is chief medical officer at Columbia Memorial Health (CMH), which operates the hospital in Hudson. In a phone interview last week he said the hospital staff is in a “constant planning process” for ways to treat Covid-19 patients. The hospital is licensed to operate with 192 hospital beds, but at present it has only budgeted for staff to handle about 100 beds, including some for psychiatric patients. The hospital doesn’t need more beds at the moment because “we’re not at capacity,” he said.
It’s not as if cases couldn’t suddenly appear driven by new variants of Covid-19 like those discovered in England, South Africa and Brazil. Cases of the more contagious British variant have already appeared in Saratoga County. So to address possible bed shortages and other potential problems, CMH participates in a nine-member group of Capital District hospitals. The group includes all the hospitals in Albany, Schenectady and Troy, and stretches west and north to other facilities. Dr. Belden said medical personnel from all the group’s members speak twice every day to discuss Covid patient care and track capacity. (CMH and the Saratoga hospital are affiliates of Albany Medical Center.)
CMH is the largest employer in Columbia County, 1,100 people in total. Dr. Belden said 70% of the staff has received a Covid-19 vaccination. He declined to estimate how many members of the CMH staff are caring for Covid patients, noting that there are specialists whose services are used for Covid care and for patients hospitalized for conditions not associated with the virus.
“We’re not an island here,” he said, adding that patients are moved between hospitals in the Capital Region when there’s a need. And for young, otherwise healthy adults with mild symptoms, their care is “best managed at home,” avoiding hospitalization, he said.
Advice on the CMH website www.columbiamemorialhealth.org mirrors this approach (click on the green “Covid-19 Vaccination…” link and scroll down to the heading that reads):
“WHAT TO DO IF YOU FEEL SICK
“If you aren’t feeling well, the best advice is to stay home and rest. Drink plenty of clear fluids. If symptoms persist or worsen, call your primary care physician or other health care provider.”
But some cases require more outpatient care. One of the treatments that may prevent progression to more severe disease and reduce the death rate is the infusion of monoclonal antibodies. CMH has used this therapy in 50 cases so far. The procedure is done in the hospital Emergency Department rather than on a patient floor.
Among the other therapies for Covid-19 are convalescent plasma, steroids and the antiviral drug remdesivir, though Dr. Belden cautioned that remdesivir is “not a panacea.”
For some hospitalized Covid patients who are at risk of respiratory failure, treatment includes prone placement—placing the patient face down to help oxygenate the lungs.
Recently the hospital has seen some changes in patient profiles. “We have had a number of younger cases,” Dr. Belden said, adding, “They tend to do better.”
‘We’re not an island here.’
Dr. Clifford J. Belden, M.D.
Chief medical officer
Columbia Memorial Health
But not all of them. Some get “very sick,” he said, describing this aspect of the illness in younger patients as “still a bit of an enigma.”
One aspect of Covid-19 that is known is the higher risk the virus holds for older patients. Of those who are over 65 years old who contract the illness, one-third are likely to end up in the hospital and more likely to die from the virus.
He said he has not seen any CMH data on whether Black and Latinx communities are disproportionately affected by this pandemic. Tests for Covid-19 taken by the hospital are being processed by the state Department of Health Wadsworth Center Laboratory in Albany.
The hospital does not offer tests for the virus nor does it vaccinate the public. Those tasks fall to the county and state Departments of Health.
Dr. Belden, a neuroradiologist who lives in Rensselaer County, says the staff at CMH has adequate supplies—90 days worth—of personal protective equipment. Often referred to as PPE, these materials include face masks, which were in short supply last year.
In the January 22 interview Dr. Belden struck an optimistic note about the pandemic, saying, “We think this is our peak.” He based his assessment on his familiarity with hospital data, which he said “always lags behind” because of the way it is processed.
He’s proud of the information CMH caregivers are sharing with the Capital Region hospital group, saying that in some cases other hospitals in the region have adopted practices in place at CMH.
“The staff in general has a lot of pride in what they’re doing,” he said. “I know it’s hard on them… not having a respite.”