Nantucket Cottage Hospital Covid-19 Information

Nantucket Cottage Hospital Press Release:
Coronavirus Response Update

March 27, 2020

We first want to express our gratitude to the Nantucket community for the countless acts of generosity, goodwill and support for our hospital that we have witnessed over the past week. We thank everyone who has donated medical supplies or took the time to manufacture homemade masks, not to mention the many other offers of food, housing, and funding. Seeing our community rally around its hospital as we respond to the coronavirus (COVID-19) pandemic has been inspiring for everyone at NCH.  

As our hospital has prepared for this unprecedented situation and changed the way we do business, we realized that the measures that have been implemented to protect patients and our staff may have created the perception that NCH is essentially closed to all but those suffering from COVID-19. That is far from the truth, and we want the community to know that we are open and here to care for you. While we have indeed rescheduled things like well visits and cancelled elective procedures to reduce the number of people coming through our facility, we continue to see patients at NCH for urgent, non-COVID-19 healthcare needs. We are taking every infection control measure to protect patients and staff, and are screening potential coronavirus cases outside the hospital at our drive-through evaluation site at the main entrance. If you have a medical need, please call us and we will do our best to serve you and your family. Our doctors are able to schedule visits with their patients via telephone as well, and we are working on rolling out video visits.  

We now have five confirmed cases of coronavirus on Nantucket. These patients are quarantined at their homes and monitoring their symptoms with our clinical team. As we know, the majority of people diagnosed with COVID-19 have mild symptoms, and we have not yet had anyone on Nantucket become significantly sick or require hospitalization due to coronavirus. But we cannot let that fact lead us to become complacent. We must do everything possible to prevent the spread of this virus in the community, so we continue to urge Nantucket residents to follow all aspects of the town’s stay at home order and construction ban, limit trips to the grocery store, practice social distancing, as well as vigilant hand-washing and hygiene measures. The actions all of us take now and in the days and weeks ahead will determine whether we are able to reduce the impact of COVID-19 on our island and avoid a surge of cases that could overwhelm our hospital. We need the help and support of every member of our community to limit the potential spread of this virus. 

Many people have asked about our plans to care for people who become infected, and we wanted to share a few details of what we have done to date, and what we will be doing moving forward. 

We have already implemented numerous measures to prepare for coronavirus patients at Nantucket Cottage Hospital. The drive-through evaluation site at our main entrance opened on March 16 and was one of the first drive-through testing sites in the state of Massachusetts. We have identified an internal triage area for patients with suspected cases of coronavirus. NCH has also created a “high risk zone” in the Emergency Department and inpatient unit that will help isolate COVID-19 positive patients from others, including utilization of negative pressure rooms. Other actions include:  

·      NCH has brought in additional personnel to serve in its Emergency Department and inpatient unit.

·      NCH is cross-training physicians and nurses from other units to assist in areas impacted by COVID-19.

·      NCH is bringing in a new respiratory therapist to assist with COVID-19 specific treatments and train additional NCH personnel on ventilator use and other respiratory procedures.

·      NCH has recruited auxiliary physicians and nurses to aid in the event of a surge as part of a reserve team.

·      NCH has created cohort teams of physicians and nurses to reduce the number of exposed team members if one becomes infected.

·      NCH is assisting with the town Health Department’s effort to recruit and train “tracers” to identify points of contact with confirmed COVID patients. 

Another topic that has generated significant interest is the medical equipment available on-site at NCH and personal protective equipment (PPE) for our staff. NCH currently has adequate supplies of PPE based on current usage for roughly two weeks, and we continue to receive shipments from Partners Healthcare to bolster those reserves. We do anticipate that our usage will increase, which is the reason we have put out the call to the island for homemade masks and other medical supplies. We wanted to mobilize our community to preclude any possibility of running low, or running out. Meanwhile, we will use our approved, medical-grade PPE first and foremost, but continue to accept supplies from the community. Two items of note with regard to equipment:  

·      NCH has rolled out telemedicine capability in the emergency department and inpatient floor so physicians can communicate and check on COVID-19 patients without entering their room and contaminating scarce PPE.

·      With the support of Mass General and Partners Healthcare, NCH has acquired 5 additional ventilators to care for patients who are in serious respiratory distress prior to transfer to a higher level of care. We are now working actively with our physicians, anesthesia and nursing staff to ensure we have the equipment as well as staffing levels and expertise to deploy them effectively.  

We have been working simultaneously to solidify plans to transport those patients who may need ICU-level care, while also working through options to expand capacity inside our hospital and on the island outside our walls. 

Nantucket Cottage Hospital’s Incident Command has a task force dedicated to surge planning that has been meeting for several weeks. This surge task force has met daily to develop plans to address all of the issues presented by a potential surge of coronavirus patients, including hospital personnel, equipment and supplies, internal and external facilities, logistics and transportation. The Task Force has coordinated closely with our colleagues at Mass General and Partners as well as the town Health Department and local, state and regional emergency management agencies. 

The surge task force has developed a strategy to maximize our internal capacity at NCH, if necessary, beyond our licensed capacity of 14-beds. The NCH surge plan includes four phases based on the number of COVID-19 patients requiring hospitalization, and methods to increase capacity including doubling-up patients in inpatient rooms and/or utilizing other areas of the hospital, including pre- and post-operative rooms and other areas typically used for outpatient care for COVID-19 positive patients.  

Our expectation is to transfer any critical patients in need of hospitalization beyond our in-hospital capacity as well as patients in need of ICU-level care. NCH is in regular communication with Boston MedFlight and the United States Coast Guard regarding their operational readiness to transport COVID-19 patients to existing and emergency off-island facilities where there is a critical mass of providers, equipment and supplies.  

NCH has prepared a back-up plan in conjunction with the town as well as state and regional agencies for additional space for COVID-19 or non-COVID-19 patients in the unlikely event these patients can’t be accommodated at the hospital or off-island facilities.  

We wanted to provide this information to demonstrate our planning efforts during this unprecedented situation, and continue to be transparent with the community regarding our capabilities and resources.  

We all have a part to play during this challenging time, and the best thing we can do now is stay home, practice social distancing, keep washing our hands, and support each other as much as possible – but at a distance. We thank everyone for supporting us.

Gary Shaw, FACHE, President & CEO, Nantucket Cottage Hospital

Diane Pearl, MD, Chief Medical Officer, Nantucket Cottage Hospital

Our future single-use plastics ban

Nantucket is saying no to "single-use" plastics. And nearly every resident, visitor, and business operating on the island will be affected by the upcoming ban on the sale of plastics intended for just one use.
Island voters approved the ban, to go into effect on June 1, 2020, at a special Nantucket Town Meeting in fall of 2018. Forbidden products include plastic straws, plates and eating utensils, drinking cups and lids, and plain water in PET/PETE containers. Those plastic “yokes” holding together bottled and canned drinks, which can end up strangling wildlife, are also banned. All eateries will need a substitute for plastics, and retail stores will be barred from selling single-use items likes cups, forks, spoons, and knives. The town is letting business owners and consumers know what’s involved in the island's ban on single-use plastics tomorrow at 6 pm in the Community Room of Nantucket's Public Safety Facility at 4 Fairgrounds Road. It’s a good thing for Nantucket.

Plastics like rolling stones

Much has been reported and written about the great amount of debris showing up in earth's oceans from the disposal of non-biodegradable or slow-to-degrade plastics. In its excellent ongoing series, National Geographic poses the question simply as Planet or Plastics? Micro-particle plastics are entering our food chain, in amounts that researchers call "staggering." Increasingly, biological scientists are discovering fired plastics washing up on shorelines looking like natural rocks. These "pyroplastics" have appeared on shorelines in Great Britain, Hawaii, Antartica, and elsewhere. A single-use plastics ban on Nantucket might seem to be a minuscule effort compared to the hugeness of the problem. But it's a start.

Listicles like us, they really do

Their entries are breezy and brief— who are we to criticize?— but travel company websites often put Nantucket on their lists of preferred destinations, and many of us appreciate it. Just this week WhereverFamily.com from Trazee Travel
praised our island for its family and kid-friendly activities and beaches. Big Seven Travel named Madaket Beach among Best East Coast Beaches in the U.S. Who doesn't love a Madaket sunset, even when the beach is brushed with snow?

Squall at Folger's Marsh

An increasing number of photographers have turned their lenses to the landscapes and seascapes around us on Nantucket. Among the most experienced, with a deep catalog of impressive images, is Daniel Sutherland. You might have seen his gorgeous, expansive photographs on the website and in publications of the Nantucket Conservation Foundation.

This month he donated three of his photos to Nantucket Shipwreck & Lifesaving Museum, including this dramatic portrait of a squall approaching Folger's Marsh by the museum.

New Steamship schedules planned

Want to weigh in on when Steamship Authority boats sail to and from the mainland? The formally named Woods Hole, Martha's Vineyard and Nantucket Steamship Authority proposes changes to its 2020 boat schedules for both Martha's Vineyard and Nantucket. A public hearing about the changes will be held next Monday, September 9, at 4 pm in the auditorium at Falmouth High School. A quick read of the proposed Nantucket changes show a change in starting dates to accommodate planned vessel repairs and a three-day shift in the summer vs. fall schedule for the high-speed Iyanough. The changes aren't significant for most of us, but for super-organized, long-range planning types and businesses a rundown of proposed changes is here. Written testimony can be submitted electronically to the email address
schedules@steamshipauthority.com or in writing to General Manager Robert B. Davis, Steamship Authority, P.O. Box 284, 228 Palmer Avenue, Falmouth, Massachusetts 02540.

Today's weather thoughts

The sun and clouds will mingle today, but
temperatures should be around 70° or so, says. Nantucket Radio weather guy Russ Murley. Let's be honest, most of us are eager to know the future path of Hurricane Dorian. Surprisingly, the storm restrengthened overnight as it approached the coast of the Carolinas, reports Washington Post. Our area is now under a tropical storm watch.

Haul your boat to dry land today
Town of Nantucket Harbormaster asked late yesterday via social media that all boats at Town Pier be removed by 7 pm today, in advance of Hurricane Dorian's projected brush by, however close that might end up. Expect a line for the boat ramp at Children's Beach.

Up in the air, it's a bird...

Birdwatching on Nantucket has many year-round participants. Birding groups roam the island several times weekly with binoculars in hand and ears cocked for familiar and new avian sounds.

Birding Nantucket takes groups aged from their teens to retirees into woods, fields, and bogs then reports their sitings on their Facebook page. In a recent post on Facebook you'll learn how to distinguish crows from ravens, for now and evermore. Or join local ornithologist and lifelong expert birder Ginger Andrews, at 6:30 am Friday at Maria Mitchell Association, for a trip to the fields and marshes of Nantucket.

Hidden Asian treasures

It's not visible from any road, although friends, neighbors, and colleagues of the owners know about it. A lush garden surrounds it, with architectural findings, statues, glorious flower beds, and koi ponds. This small private museum on Nantucket includes over 1,000 objects spanning 5,000 years, all from the owner's collection of Asian art gathered from around the world over 40 years.

This Thursday you can tour this hidden gem with its owners as tour guides. Tickets with box lunch and a glass of wine are just $25, but to attend you'll have to join the beneficiary organization of the tour, Nantucket Lightship Basket Museum. Feel protected sitting between barkless foo dogs or find good luck and happiness under the red Chinese gate.

Over the sands by car again

The Trustees, oversight group of Nantucket's Coskata-Coatue Wildlife Refuge including Great Point and its iconic lighthouse, announced vehicle access is open again through The Galls section of the refuge and out to the lighthouse. The area was closed to vehicle traffic to protect nesting terns.

Twice daily natural history tours of the area have resumed from the gatehouse at 111 Wauwinet Road, but the access has restrictions including no dogs until September 16, and passage through some areas could change depending on weather. Tickets are $50-$70 for adults and $30-$40 for children 8-12, with the lower price for members. In-town pickups at Maria Mitchell Association are an extra $5. Can't make it out to Coskata-Coatue? Watch the Great Point wildlife cam from the comfort of your desk or living room sofa.

They're here

To your ears, is that a loud annoying buzz or a musical trill being heard on Nantucket? Naw, that's not electric hedge trimmers down the road but the rhythmic rubbing together of legs by nearby cicadas. Think sounds of crickets but raspier and less melodic. FWIW, the noise is a call by males to females up to a mile away. Dr. Sarah D. Oktay, former director of the UMass Boston's Nantucket Field Station, favorably considered cicadas among the many seasonal sounds of insects on Nantucket in her late summer 2015 column in Yesterday's Island. "When I reflect upon a quintessential summer, I think of June bugs, grasshoppers, butterflies, perhaps on more cynical days, deer flies, mosquitoes, wasps…back to good days…fireflies, moths, and as the dog days of summer come, the cicada," wrote Oktay.

Cicadas fascinate many and frighten others. Some of us might have stored away a childhood collection of their exoskeletons left clinging to trees by nymphs emerging as adults. A few adventurous readers might have tried them as exotic food delicacies. In considering images for this report, we chose the big-eyed beast enlarged, emerging from its shell, instead of roasted bugs on a stick. Take your pick.