What happens when a city's hospital closes 'without warning' during a pandemic

The frontline in the battle against coronavirus has shifted a couple of hundred yards down the main road through the Kansas city of Wellington.

Two weeks ago, as the virus crept closer and people in other parts of the state started dying, the owners of the city’s only hospital thought it a good time to close down with just a few hours’ notice on the grounds the facility was losing money.

“We lost our hospital abruptly and without warning,” said Dr Lacie Gregory, a family practitioner in Wellington. “Even as the healthcare providers here in town, we did not hear that it was closing until it was a done deal. We received a text message from the director of nursing saying as of now there’s no hospital. So really, really unfortunate timing.”

That has left Gregory and a small group of other doctors and nurse practitioners at the city’s Family Care Center at the forefront of preparing for the coming pandemic with little guidance and not much equipment.

The physicians had assumed the 63-bed Sumner community hospital’s emergency department would deal with people contracting coronavirus while they went on treating more routine conditions of cuts, broken bones and high blood pressure, and that the two would remain safely at a distance. But now the Family Care Center is the first line of defence for the city of 8,000 people.

The doctors improvised, setting up a separate drive-thru clinic at the back of their building for people complaining of coughs, fever or showing other symptoms of Covid-19. But even finding the protective equipment for the physicians handling those patients is a challenge.

The county’s emergency management office in Wellington has put in orders for masks, visors and gowns but been told by the state that only part of the request will be delivered. So far nothing has arrived.

The doctors at the health centre went looking elsewhere. At the local farmers cooperative they found masks designed to protect workers on the city’s grain elevator from dust. At another store they bought face shields farmworkers use when working with chemicals. They are not medical grade but better than nothing. The doctors still face a shortage of gowns and gloves.

“It’s been really frustrating. It’s been what we have been able to piece together,” said Gregory. “All of us as physicians are reading and researching and relying on colleagues across the country for information on where they are getting equipment and what’s working for them. This is going to overwhelm our system and we won’t be ready to to treat people. We won’t have the resources to treat people.”

The makeshift clinic is seeing about 20 people a day but even then there is only so much they can do. The director of the Sumner county health department, Laura Rettig, said that at any one time it has only a handful of coronavirus test kits for the entire county of 25,000 people. They have to be sent to the state laboratory and the results take days.

Gregory said in the absence of a confirmed diagnosis or identification of something else, such as flu, all doctors can do is tell a person to self-isolate. “The testing is so limited and that’s been a huge frustration,” she said.

Gregory said she knows the virus is coming, if it is not already in Wellington, but that not everyone in the city is taking it seriously. “Especially for small towns and small communities, it seems so removed. It seems like it’s a New York City problem and it’s a Seattle problem and it’s a Kansas City problem. I think we have this inappropriate sense of protection because we’re rural and we’re isolated,” she said.

But, Gregory noted, there are students returning from around the country and families who have been on holiday in places already hit by Covid-19. “But I think it’s getting better. Seeing us walking out to the cars in full masks and gowns and protective gear makes people think if the doctors are taking it this seriously, maybe I should too. But I don’t think we’re taking it seriously enough yet,” she said.

The county health department is principally relying on Facebook to get its message out although Rettig said that has its downsides. “Sometimes there are a lot of rumours on Facebook that are not, um, accurate,” she said. Rettig said she was worried that some residents continue to believe that Covid-19 is no worse than flu. “I have heard that here in this town. Even if it was the flu they should be taking precautions, and there is a lot of flu around. All I can do is provide education and try to explain,” she said.

Gregory said the mixed messages from the White House have not helped.
“It’s been really complicating because it just doesn’t feel like there has been a consistent message,” she said.

Some local officials in other parts of Kansas have not helped either. Rick Whitson, emergency management director and fire chief of a county to the east of Wellington, drew scorn for a Facebook post denouncing what he called “panicked hysteria” around coronavirus which he said has “been around since the 60s”.

“This is not the bubonic plague, and we are not digging mass graves and burning the bodies,” he wrote. “Unless there is a dramatic shift for the worst, (and I doubt it) when this is past we will reflect on it and shake our heads, realizing that it was a ridiculously disproportionate overall response to the threat.”

The Republican chair of a Kansas county commission north of Wellington resisted measures to combat coronavirus on the grounds there were not many Chinese people in his area.

All this also comes at a personal cost for Gregory. She has had to isolate herself from her husband and children even though they live in the same house.

“I’ve not been around my kids. Even though we’re home and we’re in the same family unit, I am a high-risk person right now because of my contact and so my family is staying away from me as well. I’ve set up shop in the bedroom-bathroom area, and that gives them the rest of the house to live,” she said. “There may come a time where as healthcare workers we’re not even going home.”