The beds face north and south, alternating throughout the gym. Some are green with futon padding. Others are blue and thin, like pool loungers. There’s an IV hook attached to each of them, a sign that incoming patients could have medical needs beyond a simple place to rest.
A second floor window allows hospital staff to observe from above.
Eight weeks ago, this gymnasium hosted presidential hopefuls, with supporters and cameras packed into an MSNBC candidate forum days before voting day. This week, it’s filled with hospital beds in preparation for a surge of patients infected with COVID-19.
As state and federal officials work to set up flexible facilities for the expected spike in coronavirus cases, New Hampshire Technical Institute is racing to do its part. For more than a week, maintenance staff, firefighters, National Guard service members and hospital officials have trickled in and out of the abandoned NHTI student center, carting beds, affixing plastic sheet entranceways and ventilation systems.
The plan is basic: Transform the gymnasium at Sweeney Hall and the Langley dormitory into a makeshift hospital in two weeks. NHTI is one of 14 facilities across the state created to absorb additional COVID-19 patients that can’t be placed in the state’s hospitals. Altogether, it will provide nearly 300 beds.
The results are still to be seen. The hospitals in the Concord and Lakes Region aren’t sure how many extra beds they’ll need if a surge in COVID-19 patients hits. But they hope the flex center at NHTI will be enough to absorb the worst of it.
“It’s going to be extremely challenging,” said Dr. Christopher Fore, the associate chief clinical officer at Concord Hospital. But, he added: “All of this has been a dynamic, moving target.”
Concord’s flex facility is meant to handle two distinct populations, Fore says: those with minimal medical needs that test positive COVID-19 and can’t go back in the hospital and others who should be quarantined at home but can’t be.
The dorm will house people in that second category — people that meet the discharge criteria but have nowhere to go because they should be in long term care. That building can house around 115 patients, Fore says. The hospitals are not planning to double up any of the rooms.
“That will likely be some socially vulnerable people, but primarily people from long-term care facilities that can’t go back,” Fore explained.
NHTI has been pulling out the stops to get it done. Dorm rooms have been cleared and deep cleaned. Trucks with window fans and furniture sit in the empty parking lots.
Getting the beds into the gym took days of set up work, aided by the National Guard and the Concord Fire Department.
“We’re a support agency,” said Concord Fire Department Interim Chief Guy Newbery. “We assisted in the initial set up on Saturday, the planning phase, the incident command pieces. And now we’re just tracking and getting updates.”
To construct the facility, hospital officials have been using national guidelines. Staff will be wearing droplet and contact protection. They’ll also making sure there’s plenty of airflow.
As far as ventilation, the guidance is clear: air should enter on one side of the building and leave through the other.
It’s not an ideal set up, medical professionals admit. Ideal would be to have a “negative pressure room” for each patient, where air is removed from the room without mingling elsewhere. But under the circumstances, the ventilation should still make a difference.
Staff at the facility will be diverse, including employees from the Concord Regional Visiting Nurse Association, which has offered hospice services for hospital patients. That generally means those with a prognosis of six months or less, CEO Beth Slepian said.
“It may be clients who are already on hospice who contract the disease,” Slepian said. “It may be community members who have special needs and just require the services.”
The Concord VNA has 400 nurses and administrative staff, many of whom are continuing to make home visits throughout the crisis, Slepian said. Its presence in the flex area will likely be light — potentially just a hospice nurse and a spiritual care provider, she added.
The Concord spot is one of more than two dozen in New Hampshire, Gov. Chris Sununu announced Friday, expanding the total number of hospital beds in the state to nearly 5,300 overall.
But not all of the beds will be at the same level. New Hampshire’s flex facilities are coming online as hospitals still clamor for ventilators, machines necessary for certain high-priority patients.