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Johns Hopkins Bayview Medical Center latest to activate crisis care standards

Following several other medical centers in the state, Johns Hopkins Bayview Medical Center activated Wednesday emergency protocols to deal with a rise in patients seeking treatment and a shortage of staff able to care for them.

The crisis standards of care will enable the hospital to ease some of its more bureaucratic processes for now, redeploy staff as needed, convert hospital spaces to new uses and modify some elective surgical procedure schedules.

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It’s a difficult decision to make, said Kevin Sowers, president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine.

“Unfortunately, we’ve seen Johns Hopkins Bayview’s census of patients with COVID-19 and non-COVID-19 clinical needs spike dramatically in recent days,” Sowers said in a statement. “Working closely with the Johns Hopkins Medicine Unified Command Center staff, we have agreed that moving to [crisis standards of care] is the right decision.”

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The Baltimore hospital has seen a 360% increase this month in patients hospitalized with COVID-19, the highest increase the hospital has experienced since the start of the pandemic, according to a Wednesday news release. Hopkins and the University of Maryland Medical System jointly created the state’s crisis care standards activation model to enact during emergencies, following Hurricane Katrina in 2005.

The shift to crisis standards signals the gravity of the situation to both the public and internal staffers, said Dr. Gabor Kelen, director of the department of emergency medicine at The Johns Hopkins Hospital.

“It gives notice that we’ve done everything reasonably possible, and then some, to keep operations going in a standard-of-care sort of way,” said Kelen, also a Hopkins professor of emergency medicine and the director of its office of critical event preparedness and response.

“We’ve been... very stretched, and it comes to the point where that stretch can’t be maintained with what we’re dealing with. It admits that contingency standards don’t do it anymore, and we have to take other types of action. It admits reality, and it’s a message to staff that we’re not just piling on more work.”

Several Maryland hospitals have changed their protocols in response to a surge of patients seeking hospital treatment for COVID-19 this week, as the more contagious delta and omicron variants wreck havoc.

The University of Maryland Upper Chesapeake Health declared a hospital “disaster” Friday for its operations in Harford County, followed by the University of Maryland Baltimore Washington Medical Center in Glen Burnie and the Luminis Health network, which includes hospitals in Annapolis and Lanham, which shifted Monday to “crisis” and “contingency” standards of care.

Late Tuesday, University of Maryland Harford Memorial Hospital said it also would implement crisis standards of care in response to the “substantial increase of COVID-19 positive patients over the past month,” according to a news release.

On Wednesday, Maryland health officials logged record-breaking case counts and hospitalization volumes, with 10,873 new COVID-19 infections and 2,046 COVID-19 hospital patients. Almost 48,000 in Maryland, or roughly 1 in every 125 Marylanders, have tested positive for the coronavirus since Dec. 23.

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