Rush University Medical Center is an academic medical center located in Chicago. Illinois is experiencing a rapid escalation in COVID-19 cases. On the day of this interview, 134 new cases were reported in the state, bringing the total number of confirmed cases to 422. Over half these cases were in Cook County, which contains Chicago and is the second most populous county in the nation. Drawing on the experiences of hospitals in early outbreak areas, Rush moved quickly to prepare for an expected surge in COVID-19 patients. Dr. Omar Lateef, DO, President and CEO of Rush University Medical Center, shared his thoughts on why it was essential to act early and how his organization has been affected.
 

Q: How has Rush prepared for the growing coronavirus outbreak in Chicago?

A: I was chief medical officer of Rush before I became CEO of our medical center. We learned from our colleagues in other cities and countries that were hit before us.  Hospital leaders in Seattle and in Germany said they had wished they stopped elective surgeries sooner to prepare and save supplies and beds.

Based on these conversations, we proactively stopped elective procedures and surged to create a potential 180 negative pressure beds. Several years ago, Rush built a new medical center facility. With funding from the state, we built a building that can do a hazmat triage area, and we drill with the National Guard. When we saw what was coming, we also made a negative pressure forward triage area outside our ER.  That’s how we are able to have so many negative pressure rooms. 

Q: What are you seeing today?

A: We’ve gotten to the point where it is difficult to keep track of what we’re seeing. Every batch of tests comes back with five or six positives. Some of these positives are now severely ill people in our ICU. 

Tracking is very difficult as well. There’s a process on paper for tracking infected people’s contact with others, and then there is the reality. A patient comes in, he later tests positive, but the doctor has gone home. He may have met some friends at a bar after work or seen patients the next day on a moonlighting job. That is a nightmare for epidemiologists.

Q: How are you holding up on supplies?

A: We are not facing supply shortages today, but we have concerns based on predictive modeling, so it certainly may happen. We’ve been very clear with city and state officials that we’re happy to serve and are dedicating tremendous resources to this effort, and we believe they will help us get the support we need.

Q: What are the financial implications for Rush?

A: We are spending money to care for our community and city.  By stopping elective procedures we are negative everyday in a challenging health care economy.  At this point, I don’t think it’s possible to entirely predict what our budget is going to be. I don’t think we ever envisioned modeling something like this out financially. I know we have a responsibility to care for everyone in our our community, city and state. I think we have to trust and have faith that the government will provide the funding that we need to compensate for the financial hit we’re taking to respond to this crisis.

Q: Will there be enough ICU beds to meet future demand?

A: I don’t think that chapter has been written. Right now, we agree with the World Health Organization that if we get serious in our response, we can change the trajectory to fall beneath our healthcare capacity in the city of Chicago. But that is going to require a foundational culture change. As a society we must make sacrifices now in order to protect our society.  This is really a life and death issue.  If we do not contain and mitigate future spread we will run out of ICU beds as did countries that did not do this early enough.  Our failure will be not learning from history.