Its work includes readying the convention center as a hospital site and keeping front-line workers safe.

Dr. Robert Falcone has been a trauma/critical care surgeon all his professional life. “I’m used to ambiguity, and I’m used to chaos,” he says. But the confusion surrounding the COVID-19 pandemic can test even those with the most experience.

Falcone is CEO of the Central Ohio Trauma System (COTS) and its parent organization, the Columbus Medical Association. He worked on the front lines as a trauma surgeon at Level 1 Trauma Center Grant Hospital (now OhioHealth Grant Medical Center), later becoming hospital president and chief operating officer.

COTS is part of a team of agencies preparing Central Ohio for the coronavirus peak, which is expected mid-April to early May, Ohio Department of Health Director Dr. Amy Acton said this week. (The Cleveland Clinic has predicted a later surge.)

“We’ve been building and refining our pandemic plans since 2007. Logistically we’re prepared, but I don’t think anyone is prepared for COVID,” Falcone says. “In the last 100 years, we’ve had four major pandemics, and they’ve all been influenza A. We understand influenza A. We have vaccines, we have treatment, and we are comfortable there. We have none of that for COVID. I think that’s why there’s so much anxiety.”

Stay in touch with the latest developments. Read our latest reporting on the coronavirus response here.

COTS, like other agencies, is preparing for the worst and transforming the Greater Columbus Convention Center into a field hospital in case patient volume exceeds hospital capacity. It’s also working to establish a centralized communication and triage plan for Central Ohio, Southeast and Southeast Central Ohio, with a single number to call for regional referrals.

The convention center will serve as a low-acuity COVID hospital and will be ready to go ahead of the predicted surge, but won’t open until triggered by patient volumes, he says. “At that point, we have committed to opening up within 72 hours.” Electrical service, plumbing and cable are completed; dividers are up; and beds were due the evening of April 9. Each of the three adult hospitals in Columbus is to have its own section.

Falcone says the site won’t look or feel like a typical hospital. “There will be some basic separation and some basic equipment. If we get to the point of surge capacity 3, we’re in disaster medicine. Retail medicine no longer works. It will not look like business as usual, and the paradigm is that retail medicine is doing the most good for each patient. Disaster medicine is doing the most good for the most patients.”

Protecting front-line healthcare providers inside and outside hospitals is top of mind for Falcone. “Their concern is the same concern as you would have. ‘Am I going to bring it back to my family? Do I have enough protection to do my job?’ Those are the pressure points. … If they’re distracted from doing what they’re trained to do, we’re not going to get the job done. Personally, I am very concerned for providers and their families. I am concerned about staff and equipment.”

Morale among first responders in the field is strong and so far, their rate of coronavirus infection is about that of the community, Falcone says. They adhere to guidelines from the Centers for Disease Control and Prevention and other oversight agencies by limiting the number of crew members and their proximity to each other on an emergency vehicle. They are trained to wear full protective gear if they are doing “anything that resembles an invasive procedure,” especially when it brings them close to someone’s face.

Among the most critical guidelines to follow is the same one given the public. “Wash your hands. Don’t touch your face until you’ve washed your hands. It sounds so simple, but it’s exactly right—your mother was right,” Falcone says.

Falcone says healthcare first responders are trained to focus on the immediate situation, but know well what is unfolding around them. The director of radiology at the Ohio State University Wexner Medical Center recently died as a result of the virus, as have other healthcare workers. “We are committed and trained and we tend to push that back, but we are very aware,” he says.

COTS’ mission drives Falcone and sustains him during chaos, and he finds other sources of strength as well. Periodically during the day, “I just stop and stare for three or four minutes. It’s not really meditation but it does the same thing. Stop what you’re doing and take a few breaths.” Perspective also helps, to a point.

“The good news is that very, very few people die of this. Most people have a mild illness, and of those with more serious illness, most don’t die,” Falcone says. “But there are people who die, and they are young. The ambiguity is very disquieting … we’re not sure how virulent this is once it’s transmitted. We just don’t know. What we do know is that with more serious illness, you can go from very sick to dead very quickly.”

Falcone says some have suggested that some communities are overpreparing. “We are preparing for the worst. If we are overpreparing, I’m sorry.”

Laurie Allen is a freelance writer for Columbus CEO.

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