A rehabilitation gym on the first floor of Nemours A.I. duPont Hospital for Children in Rockland has been converted into a 38-bed surge unit if hospitals have to send patients elsewhere to deal with an influx of COVID-19 patient with a surge of cases--as many as 3,000--expected mid-month.

"It's a mix between very high-tech hospital beds, stretchers and cots, depending on the patient's need. We run this unit basically with IV pumps, if we need them. There will not be any ventilators in here because those patients would be too sick to be in this unit, but we have the ability to give oxygen and give medicines--either orally or by IV--and we have our computer systems. We have a pharmacy built down here," said Dr. Christopher Raab, who directs the alternate hospital site.  

The beds came from Nemours' supply and an emergency state supply.

Mark Lorenz, administrator of support services for Nemours, has decades of experience working in health care, setting up similar sites after earthquakes in Los Angeles and deploying crews to Haiti following that country's devastating earthquakes. But this is a first for Wilmington.

"We've got a great team; everybody pitched in and did it, actually, within a couple of days," said Lorenz.

Plus they have all the services of the children's hospital at their disposal as well. Raab said the unit, away from pediatric care, won't impact the care children are getting.

"We'll be treating the children from the community the same way that we always have," he said.

The alternate site is set up to handle non-COVID19 patients and all patients will be administered a COVID-19 test before they're admitted.  

The field hospital is staffed by nurses and medics from the Delaware National Guard and ChristianaCare in addition to the Nemours complement of doctors and nurses, and volunteers.

"It's been an absolutely wonderful show of support from everyone in the area," said Raab.

Lt. Col. Rachel Stephens, a flight nurse with the Delaware Air National Guard is on-site at the field hospital, integrated with civilians, to help.

"It's very similar to a military field hospital, only you guys have walls, we have a tent," she said.  

Stephens has also done similar work during hurricane response.

"It's what we signed up for," she said. "The fact that we can all come together and work together and integrate for the best patient care possible that's the best."

Stephens said most logistical issues with the site have already been addressed.

"The folks at A.I. duPont did an absolutely amazing job converting a gym into a 38-bed ward. They've thought of everything; what they already don't have in place, they're working on. It's not going to be like private hospital rooms--it can't be--but for a field hospital environment, they've got it. They're on top of their game," Stephens said.

Governor Bacon Health Center in Delaware City has also been selected as an alternate hospital overflow site--one that could handle COVID-19 positive patients, if necessary, state emergency managers said. Downstate, DEMA said a pop-up field hospital would be established based on the location of need.  

The mission of the alternate care site differs a bit from Nemours' standard mission, but remains in their wheelhouse. 

"We're going to do our best to provide care to adults as both Christiana and St. Francis fill up...with the expected surge. It's a little different challenge for us since we're used to dealing with children, but we will give the adults the same great care," said Lorenz.

But Raab hopes the 24/7 operation is never needed.

"Hopefully, we've done all this work and gotten everything prepared, and we never have the need for it, but the idea is that we are ready when we're needed, and we could take patients whenever they call on us to take them," he said. I think the feeling overall is a little bit of apprehension because we've not done it before, but once you get working on the project and you kind of see how everybody is pulling together. I think everybody's...getting ready to get down to work if we're needed...it really makes you proud to be a part of the medical community in Delaware," he said.