Pandemic Purgatory: Inside Israel’s Largest COVID-19 Ward (with VIDEO)
Underground parking lot converted into medical facility as Rambam Hospital becomes ‘first in the world’ to integrate command and control technology
The descent into the underground ward at Rambam Health Care Campus is marked by twists, turns and several metal doorways.
Once inside, the only sounds audible through the hazmat suit and layers of protective gear are those of dozens of people coughing all at once, as well as the beeps and pings of various medical devices.
Situated 50 feet beneath the earth’s surface in the northern port city of Haifa, the facility was once a fortified parking lot but has now been converted into Israel’s largest coronavirus ward in order to cope with the seemingly endless flow of patients.
Inside there are no windows, no sunlight and absolutely no family members allowed. COVID-19 positive patients that are able to walk can wander about the concrete maze freely without wearing masks or other protective clothing.
The same, however, cannot be said of the staff that must attend to them.
After donning gloves and full hazmat suits to seal them off from the dangers of infection, physicians and nurses make their way down to the area to continue the war of attrition against the novel coronavirus.
“The older people are being taken care of in bed by the nurses … and yes, there are a lot of older people but not only older people,” Dr. Avi Weissman, deputy director of the Rambam Hospital, told The Media Line during a recent tour of the facility.
“We also have a nice group of 50- and 60-year-olds that are here,” he continued. “Most of them walk around here and are very mobile but the difficulty is that a lot of them need oxygen constantly. So even to go to the bathroom it’s an issue because they need to carry the oxygen with them.”
Fully equipped with emergency rooms, operating areas and an intensive care unit – the Sammy Ofer Fortified Underground Emergency Hospital was originally built as a possible shelter from Hizbullah rockets following the 2006 war with Lebanon.
But with the global pandemic battering Israel, the space has instead been conscripted for the war on COVID-19.
As of Monday night, there were 75 coronavirus patients in the ward and 22 on ventilators, according to a hospital spokesperson. The facility can hold up to 770 patients in total, including 170 on ventilators, and is therefore not yet in danger of being overwhelmed by the pandemic.
“At this [rate], it’s going to grow very fast beyond our ability to [cope] with it,” Weissman said of the second wave currently hitting the country. “We’re not there yet. We can take care of everybody that’s coming in for now so we’re not collapsing.”
Hannah, age 66, checked herself in to the hospital last week as a precautionary measure because she also suffers from several serious underlying medical conditions, including breast cancer and amyloidosis.
“I was infected by my husband,” she told The Media Line. “He was in the synagogue and apparently a person with the virus went there too and infected almost 30 other people.
“I was feeling a bit unwell and my doctor, who works here at Rambam Hospital, told me to come to this ward as soon as possible because my symptoms could worsen very quickly and with my other illnesses it wouldn’t end well,” she added.
At this [rate], it’s going to grow very fast beyond our ability to [cope] with it. We’re not there yet. We can take care of everybody that’s coming in for now so we’re not collapsing
In this pandemic purgatory, doctors and nurses are on call 24/7, as are physical therapists, radiologists, social workers, cleaning teams and lab technicians.
Nurses generally work in 12-hour shifts, Alex Kramsky, a senior nurse in the ward, told The Media Line. The second wave of the pandemic has been particularly difficult for staff to cope with, he said, noting that there has been a huge spike in the number of new patients coming in on a regular basis for treatment.
“I barely have time for family or friends because everything is going towards taking care of these patients,” Kramsky said. “The biggest challenge is to treat patients in an optimal way when we find ourselves working under less-than-optimal conditions.
“We don’t have the equipment we need or the entire infrastructure that we’re used to getting in regular hospital wards,” he revealed. “It’s very difficult for us to work while wearing this protective gear over a long period of time.”
Rambam ‘First Hospital’ in World to Adapt Wartime Tech
In the war against COVID-19, Rambam Hospital is pulling out all the stops.
The hospital has collaborated with Israeli defense company Elbit Systems to adapt a command and control system that is normally seen only on the battlefield. Known as EX-TEAMS, the cloud-based technology allows for staff working in the ward to seamlessly communicate with one another hands-free by using an earpiece that is worn beneath protective suits. Moreover, the system provides the hospital with an overall picture of the situation on the ground thanks to real-time data on every staff member’s location.
Normally used by the military, it took Elbit took months to properly integrate EX-TEAMS into Rambam’s existing facilities. In fact, the hospital only fully adopted the system in late September, according to Haim Teichholtz, vice-president of Technology Commercialization at Elbit Systems.
“Rambam might be the first hospital worldwide that’s changed its mode of operation to this kind of command and control [system],” Teichholtz told The Media Line. “What does it mean? That every staff member is actually connected now.
“We’re not very involved in the medical market so for us it’s very new,” Teichholtz added. “Six months ago, I had no clue about how hospitals work but had a very good understanding of how the army works. It’s not so different.”
Under a nationwide lockdown since mid-September, Israel is battling a record number of cases. Many have criticized the government for re-imposing a lockdown and issuing rapidly-changing regulations in the face of a worrying spread of the virus.
Dr. Weissman believes that only a “true lockdown” can help decrease the number of infected people.
Nevertheless, he also stressed that such measures are “not a medical treatment so you need a very good plan for the day after. … Because if you have a lockdown and then everybody behaves exactly as they did before, it just delays the problem. There’s going to be a second wave, a third wave, and so on.”
One of the difficulties in conveying the seriousness of the pandemic is that much of the illness remains invisible to the general population. Many of those infected display little or no symptoms at all, while more serious cases are ushered into hospital wards that are completely sealed off from public view.
But for many of those working inside Israel’s COVID-19 wards, the conditions are dire.
“Right now the situation is really serious,” Kramsky, a head nurse at the Sammy Ofer facility, warned. “We are giving everything we can to help everyone here in this ward but if the public won’t take precautions and act according to [health] guidelines, we will simply collapse.
“We’ve been working like this for already six months; the staff is worn out and giving their souls to help people,” he added. “There are no more [doctors or nurses] available so if this continues we won’t be able to give patients the proper care.”