Gov. Jim Justice announced Monday evening that he postponed previously planned events in Huntington and Point Pleasant on Tuesday due a medical issue.
Gov. Jim Justice announced Monday evening that he postponed previously planned events in Huntington and Point Pleasant on Tuesday due a medical issue. He does plan to reschedule the events later.
In a statement he said he traveled to Morgantown for a meeting and planned appointment at Ruby Memorial Hospital to address pain in his lower back. He received an injection to address the pain and the doctors told him not to drive for 24 hours.
“I would like to extend my heartfelt appreciation to the entire team at WVU Medicine for their professional and dedicated care,” Justice said. “As a state, we are truly fortunate to have such an incredible healthcare resource available to us.”
Justice said he does still plan to speak at the Gas and Oil Association meeting on Tuesday morning at the Greenbrier and will be in Charleston for events on Wednesday including his media briefing.
State Health Officer and Commissioner of the West Virginia DHHR’s Bureau for Public Health, Dr. Matt Christiansen, announced Martin will replace interim director, Dr. Beth Toppins who served since April 2023.
The West Virginia Department of Health and Human Resources (DHHR) named Dr. PS Martin as the new medical director for the Office of Emergency Medical Services (OEMS).
State Health Officer and Commissioner of the West Virginia DHHR’s Bureau for Public Health Dr. Matt Christiansen, announced Martin will replace interim director Dr. Beth Toppins who served since April 2023.
“Dr. Martin brings a wealth of knowledge to this critical position with hands-on experience as a physician in emergency departments and as the medical director for multiple EMS agencies,” Christiansen said. “His unique and specialized background in the field of emergency medical services will be an asset to West Virginia, and will continue the work of Dr. Toppins. We are grateful for her service during a period of transition.”
Martin is an associate professor of emergency medicine at WVU’s School of Medicine and an emergency room physician at West Virginia University’s Ruby Memorial Hospital.
“I am honored to lead this office, which does incredible work to support West Virginia’s EMS systems and residents,” said Martin. “I look forward to working with OEMS staff and partners to optimize the quality of emergency care across the state and improve the job satisfaction of our dedicated EMS providers.”
Dr. PS Martin
Credit: West Virginia University
Martin earned his bachelor’s degree and doctor of medicine from West Virginia University.
Many people across West Virginia and the nation are breathing a sigh of relief as a coronavirus vaccine is being distributed and administered — at medical facilities and to frontline workers.
State leaders say the arrival of vaccines won’t make the pandemic disappear immediately — and for residents to continue wearing a mask, social distance and remain cautious.
“I tell you over and over to wear your mask and do all the things,” Gov. Jim Justice said Monday. “If you just stay really tough for just a little bit longer and everything, I think we’ve got something on the way right here that’s going to really stop this thing in its tracks.”
But the vaccine’s arrival is certainly welcome after a long, exhausting nine months that’s seen the virus kill more than a thousand West Virginians and more than 300,000 Americans.
Last week, about 2,000 nurses, doctors and other employees of WVU Medicine got a call asking whether they would be interested in taking the vaccine.
The call went out to staff directly treating patients diagnosed with the coronavirus and other frontline workers who are most exposed — including those working in designated COVID units, intensive care and the emergency department.
Over the weekend, federal regulators with the Food and Drug Administration authorized Pfizer’s vaccine for emergency use, a final step needed for it to start shipping around the country and for inoculations to begin.
By Monday afternoon, healthcare workers in West Virginia were getting the vaccine, including Dr. Kishore Challa, a cardiologist at Thomas Memorial Hospital in South Charleston.
“I’m privileged to be the first person in the state of West Virginia to get the vaccine,” Challa said. “I always I tell people, ‘Don’t be afraid of the vaccine, be afraid of the virus.’”
Challa joined a live stream event Monday, in which the governor and other state officials leading West Virginia’s response to the pandemic received the first of a two-dose shot of the vaccine on camera.
Justice remarked on the toll the virus has taken on the state.
“The last 10 months have been tough on a lot of people, especially those that we’ve lost — and all their loved ones,” Justice said.
Dave Mistich
/
West Virginia Public Broadcasting
Dr. Alfred Gest (pictured left) waits with medical assistant Hayden Carmody before Gest gets a dose of the coronavirus vaccine at Ruby Memorial Hospital in Morgantown on Tuesday, December 15, 2020.
Healthcare Workers At Ruby Memorial Rush To Get An Early Dose
The rollout of the vaccine in West Virginia — at least Phase 1A, which accounts for critical healthcare workers — appears to be moving as quickly as possible.
By Tuesday morning, health care workers at WVU Medicine’s Ruby Memorial Hospital trickled into a conference room that’s become a makeshift vaccination center.
Dr. Alfred Gest, a physician from Ruby Memorial’s neonatal intensive care unit, wasn’t necessarily supposed to be the first person at the hospital to get the shot.
Other employees who showed up moments earlier had some trouble getting into the CDC’s Vaccine Administration Management System — known as VAMS — and Gest became the first to take a seat and roll up his sleeve.
At that point, all eyes in the room turned to Gest and Hayden Carmody, a medical assistant from the neurology department who was readying to administer what would become the first dose given at Ruby Memorial.
“Ready?” Carmody asked Gest, before acknowledging the small crowd that stepped closer to watch the moment.
“Okay,” she said. “That’s it.”
“That’s it?” Gest asked.
An applause took over the room.
Gest said he has been ready for some time to get inoculated from the coronavirus.
“I know there’s a lot of fear of this — a lot of people are afraid of vaccines. But vaccines work — they save lives. It’s the thing to do,” he said.
As a physician working with children, Gest said vaccines have a long and proven history in his field.
“I think that’s one of the things about pediatrics. I think all of us are used to the vaccine culture,” he said. “So we’re used to childhood immunization — we’re used to taking vaccines. We get flu shots every year.”
Carmody — who said she will get the vaccine as soon as her turn comes — was fully aware of the historic nature of her task.
“I was very nervous,” she said. “I wasn’t expecting to be the first one — but, it felt good.”
Boosting Confidence: Turning ‘Maybe’ Into ‘Yes’
Of the more than 32,000 doses of Pfizer’s vaccine sent to West Virginia in an initial allocation, 1,100 went to employees of Ruby Memorial. Officials at the hospital told West Virginia Public Broadcasting that appointments for the first run of doses were booked up within 48 hours of becoming available.
Greg Kolar, a registered nurse who works in the medical intensive care unit, was another employee at Ruby to get the coronavirus vaccine on Tuesday. He sees the severity of the pandemic first hand every day that he comes to work.
“We’re a COVID unit now — MICU — so all of our patients are COVID positive,” Kolar said. “The past several months, it’s been much more hectic. The first wave, it wasn’t as bad. But this time around, it’s much worse.”
Kolar said he hopes the acceptance of the vaccine becomes widespread. With public sentiment seemingly split on wearing masks, he says he hopes the vaccine is the key to turning the pandemic around.
“It’s kind of a relief in a way, seeing that and seeing all this unfold how it is,” Kolar said. “It’s kind of hard to explain. But it’s just nice to see the positivity with the vaccine.”
While the first doses of the vaccine going out at Ruby Memorial on Tuesday were cause for celebration and hope for an end to the pandemic, hospital officials say not everyone is on board from the start.
“We’ve been doing a lot of polling of staff and what we’re seeing is about 55 percent of staff are, you know, 100 percent ‘Yep, I’m in — I’ll take the vaccine,’” said Todd Karpinski, who serves as chief pharmacy officer at WVUM Medicine.
He said another 25 percent of employees have said they refuse to get the vaccine.
“The remainder are those ones that are really in the middle,” Karpinski said. “They’re a ‘maybe’ — and it’s really our job to try to get those ‘maybes’ to move over to ‘yeses.’”
Dave Mistich
/
West Virginia Public Broadcasting
Greg Kolar (pictured seated), a registered nurse at Ruby Memorial Hospital, waits to receive a dose of the coronavirus vaccine on Tuesday, December 15, 2020.
Phase 1-A: Just The Beginning For The Rollout Plan
State officials running the vaccine rollout say Ruby Memorial is housing one of five vaccine storage hubs around the state.
Karpinski said WVU Medicine will disperse doses to its own employees, but will also unload stock to other hospitals and healthcare systems in the surrounding area to get their essential staff vaccinated as part of Phase 1A. Stock will be redistributed to more than 20 hospitals in the region, he said.
“The biggest reason for that is, not everyone could afford to buy these ultra-low freezers which store vaccines at about negative 70 Fahrenheit,” Karpinski said.
Inoculations of critical healthcare workers at Ruby are expected to be completed in three weeks, before moving on to other staff. Karpiniski said other vaccinations of other, non-critical staff, could be completed in the next eight to 10 weeks.
State officials say they expect the vaccine to be made available to the general public by late February or March. Karpinski said, as that point draws near, people around Morgantown may be able to actually see some logistical changes taking place.
“[We’ve] talked about using our COVID testing tent now that we have — like at the [University Town Center] — and make that into a COVID vaccination tent to really get the vaccine out to the masses once we have adequate stocks,” Karpinski said. “So we’ll certainly do whatever we can do — and work with the state to help push that effort forward.”
Karpinski and others at WVU Medicine acknowledge the massive undertaking in front of them. While they’re used to vaccinating employees for things like the flu, never before has a vaccine been developed so quickly and its rollout seemed so dire.
“We’re building the airplane as we’re flying here. But health care workers are pretty good at responding to these types of situations and making things work,” he said. “And if we have to pivot — because something’s not going the right way — we certainly can do that in a pretty quick fashion.”
Karpinski said his biggest task is getting the word out on the safety and efficacy of the vaccine.
He said he hopes the fact that those on the front lines are getting it first will help boost confidence before a rollout to the general public is made available.
Colton Mearkle is a registered nurse at Ruby Memorial Hospital in Morgantown, West Virginia. When the pandemic began, his floor was converted to caring for COVID-19 patients.
He spoke with Eric Douglas recently about treating coronavirus patients and what he wants the rest of us to know.
This interview has been lightly edited for clarity.
Douglas: Describe for me the care that you provide for a COVID patient.
Mearkle: We come in in the morning and get our assignment. Pre-COVID we would go and introduce ourselves to the patient. Now, with COVID, we do that outside the room. We stand at the window and talk about the patient. When we’re going in to introduce ourselves, we have to wear a CAPR, a gown, double gloves, booties and a mask.
We also assess where they’re at in terms of their sickness. So, for instance a patient comes in and they developed symptoms three days ago. They’re clinically getting worse. We say, “Okay, let’s see if we can give them some convalescent plasma” or if they’re ready for Remdesivir, stuff like that. It just all kind of depends on where they are symptom-wise and where they are clinically.
Douglas: What are your thoughts when you see the big parties and people refusing to wear masks? How does that strike you?
Mearkle: I can look at it both ways. I can see it as a healthcare worker that there are people in here every day that are extremely sick, having to be intubated. And people that are going out, not really caring about wearing a mask. I personally wear a mask. I think we should wear masks, but I’m not going to judge them and say that they should wear a mask. I am wearing a mask because it’s protecting me. But if they don’t want to wear the mask, then I guess that’s their choice.
Douglas: I’m sure you’ve lost a few patients with COVID. We’ve heard all the stories about families not being able to be with their loved ones. What’s that like for you guys? How much of a burden is that on you?
Mearkle: That’s probably the hardest thing and something we see more than people realize. I think we’ve had a mother; a mother and a son; a mother, father, son; a mother, father and two sons; and a husband and wife. I can think of four or five families off the top of my head. And that’s just familywise. I think the saddest part is to see that one of these patients gets critically ill, one of them has to go to the ICU, and the other one isn’t taking the virus as hard. And they can’t see each other. They can’t communicate with each other.
Some patients can be in the hospital for 50 days. I think the longest patient we had on our floor was 55 days, and he didn’t see anything outside of his room. Staring at four walls and a window for 55 days, it’s pretty terrible.
I think the saddest thing is, we had a patient in here, his wife passed away from COVID and his son passed away from COVID. He couldn’t go see either of their funerals. So, we did FaceTime for him to watch both of his son and his wife be buried. When you tell people about it, they obviously know what happens, but until you live it and see it, it really hits home. It’s definitely real, and I wish everybody could see it for one day. I feel like a lot of people’s ideas of this thing and people’s views of it would change.
Douglas: Is there anything that you want add?
Mearkle: There probably will be another time where we can get back to reality. But I think that what we’ve done as a country, as a state, in terms of following these guidelines, whether you agree or disagree, I think it’s helped maintain a bridge where our hospital systems aren’t getting overwhelmed. So even just the general public knowing that following these guidelines, wearing your masks, has helped the hospital tremendously. So we, as frontliners, would like to thank the people who have been abiding by these rules.
This story is brought to you by Appalachia Health News, a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
The costs of treating COVID-19 patients are mounting, and they present a significant burden on the healthcare system in West Virginia, a state already hit by lost revenue from reduced visits to the emergency department and the canceling of non-emergency surgeries.
Many COVID-19 patients require long periods in the Intensive Care Unit and longer stays overall. Jeff Sandene, the executive vice president and chief financial officer at the Charleston Area Medical Center, pointed to one patient who was in the hospital for 34 days earlier this year. The total charges were $470,00.
“When I looked at the ICU stays, they were anywhere from one day to 49 days of stay,” Sandene said in July. “A lot of times they’ll start off in the medical/surgical bed and then have to be intubated in an ICU. We had quite a few that required 30 to 40-plus days of ICU care.”
David Sanders is one such patient. He spent two months in the hospital and 32 days on a ventilator. He lost an entire month of his life with no memories of what happened.
“When I first got off the vent, I still had the trach in so I couldn’t talk,” Sanders said. “That was very, very frustrating when I was trying to communicate with friends, family members and with the medical staff. I basically had to pass notes back and forth.”
Now that he is back home, Sanders’ medical bills continue to mount. After being physically inactive for nearly two months he requires physical therapy four days a week.
“The physician told me in the hospital that for every day that I was inactive, it takes three days to get my muscle back,” he said.
He expects it will be about 90 days until he is fully recovered since he did get some physical therapy in the hospital before he was discharged. A nurse also visits him once a week at home as well.
Sanders is a state employee and has PEIA insurance. He said his out of pocket expenses are approximately $1,500 and insurance paid the rest. He wasn’t able to provide a grand total of the charges the hospital billed for his care.
The West Virginia Hospital Association tracks patients in hospitals throughout the state. The latest numbers they have are for the month of April, but those figures show that charges for the average COVID patient are $21,000 higher than other in-patients and COVID patients stay in the hospital more than four days longer.
Data from the hospital association for April covers the average charges by primary insurance providers.
Medicare: 48 patients with average charges of $59,000
Commercial Insurance: 25 patients with average charges of $64,000
Medicaid: 10 patients with average charges of $53,000
Government: 6 patients with average charges of $71,000
PEIA: 3 patients with average charges of $98,000
Self-Pay: 2 patients with average charges of $180,000
That list, while likely not reflecting additional, out-of-hospital care, accounts for more than $6 million in healthcare costs and only covers April before the pandemic really took off in West Virginia. Highmark Health replied in an email that the company had spent more than $40 million on COVID-19 treatment and care throughout West Virginia, Pennsylvania and Delaware as of June 30.
News reports indicate that men are more likely to have severe outcomes from COVID-19. In April, 48 women in West Virginia were hospitalized compared to 46 men, but the average charges for men were $73,700 versus $54,800 for women, for a difference of just under $19,000 per patient.
Even the relatively small numbers of deaths and hospitalizations in West Virginia add up to millions of dollars in expenses that will affect the healthcare and insurance industries. According to the hospital association statistics, of the 17 patients who died from COVID-19 in West Virginia hospitals in April, the average charges for each was $129,000.
Sandene said that many COVID patients in southern and central West Virginia have government-backed insurance. And that is a problem for the hospitals.
“Medicare and Medicaid, PEIA have always paid less than the cost of the care that we provide. COVID just compounded that because our length of stays are higher and we’re using much more resources,” he said.
In the earlier example that Sandene provided of the $470,000 patient, the insurance provider paid $440,000, leaving a $30,000 bill.
Colton Mearkle is a charge nurse at Ruby Memorial Hospital in Morgantown, West Virginia. His floor in the hospital is dedicated to caring for COVID patients that aren’t in ICU and on ventilators. But even those patients require additional care and precautions. And that’s where the drain on resources comes in.
Before being converted to a COVID-19 floor, he and his team provided care for thoracic patients. They had one nurse for every three patients. They have lowered that ratio to 1:2 meaning they have added another 4 nurses per shift.
There has been much talk about the additional costs of personal protective equipment for health care providers. Mearkle detailed what he and his fellow nurses wear for each patient contact.
“We wear a capper, which consists of a helmet, that circulates the air on top of that, a shield hooks to it,” he said. “It filters the air inside this helmet. On top of that we have to wear the yellow gown. We double glove. And then we have shoe covers that we wear as well.”
For Sandene, the challenges are varied, but they all come down to forecasting the future.
“The thing that keeps me up at night is trying to understand and project what does the new normal look like,” he said. “I think everything I’ve read, that’s exactly what healthcare across the US is doing. How do you right-size the organization to take care of the new normal new volume that you have?”
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
The Volunteer Office at WVU Medicine and the West Virginia University Music Therapy Program have launched a volunteer program to provide music for patients and families at Ruby Memorial Hospital in Morgantown.
Professor Amy Rodgers Smith says trained musicians, both individuals and groups, are starting to play in designated public spaces and waiting areas.
Rodgers Smith says research has shown that music encourages patients to be more motivated in their treatment.
She says it also provides emotional support for patients and families and an outlet for patients to express their feelings.
Musicians who want to play at the hospital are asked to contact the Volunteer Office.
