Kenneth R. Smith has visited the convention center in downtown Worcester many times over the years for trade shows and exhibitions. This month, he was there as a patient during a pandemic.
Smith was among dozens of COVID-19 patients being treated at a field hospital constructed inside the large hall of the DCU Center. Patients lie in beds in long rows across the convention center floor, separated by black curtains. There are no walls and no windows to offer a view of the outside world, just bright overhead lights and the thrum of a busy hospital.
It may be austere, but the facility functions much like a COVID unit in a traditional hospital. Patients receive medications like remdesivir to combat the virus and oxygen to help them breathe. Doctors and nurses keep constant watch. This facility, which is run by UMass Memorial Health Care and was assembled in about two weeks, has treated more than 450 patients since opening Dec. 6, providing a crucial relief valve for a health care system under extraordinary strain.
“You’re not here to get pampered; you’re here to get better and get home and survive,” said Smith, 67, who spent more than a week at the DCU Center. “It’s not pretty, but it gets the job done.”
This field hospital, and a second military-style medical site that opened in Lowell this month, together add nearly 300 beds to the state’s health care system and have been essential components of the plan for managing hospital capacity during the second surge of COVID.
They are stark reminders of the severity of a pandemic that has sickened and killed thousands of people in Massachusetts alone, and is far from over. Yet despite the grim circumstances, there are, perhaps surprisingly, some advantages for patients who end up there.
They can do something forbidden in traditional hospitals during the pandemic: walk around and socialize. In traditional hospitals, patients are confined to their rooms because of the risk of spreading infection. But because all the patients at the DCU Center already have COVID, and all the health care workers wear full personal protective equipment at all times, it’s safe for patients to leave their beds and interact.
They can walk a few laps for exercise, and relax in the lounge, a corner of the convention floor where armchairs are arranged around a big television screen. (A crime show was playing one recent afternoon). They can stop at a snack station for cookies and coffee. They can chat with other patients. Those who feel well enough can ride stationary bikes.
Doctors say the ability to move and socialize helps with patients’ mental and physical recovery.
“We try to provide a little slice of normalcy for patients and give them the opportunity to walk around, talk to people,” said Dr. John Broach, medical director of the Worcester field hospital. “One of the things we’re concerned about is [that] being ill, especially with a highly infectious disease like COVID, can be such an isolating experience.”
Each patient wears a portable monitor on their finger, so doctors and nurses can track their heart rate even when they walk around. Patients can watch TV in their makeshift rooms on an iPad that also tracks their vital signs.
“We try to give them ways to stay busy,” Broach said.
Smith, superintendent of the Auburn Water District, spent one day at Marlborough Hospital before being transferred to the DCU Center, where he received medications and supplemental oxygen. He was grateful not to be stuck in his room and took short walks around the convention center floor. After a few minutes, he said, “You’re pooped. You need to sit down or lie down for a while.”
About half the patients at the DCU Center come from hospitals in the Worcester area, and half from across the state, from as far as Boston and New Bedford. They are sick enough that they need hospital-level treatment, but not so ill that they require intensive care and ventilators to help them breathe. Most get better after a few days and go home.
This is the second iteration of the Worcester field hospital, which was built for the first onslaught of COVID and treated about 300 people last spring. The supplies and equipment sat in storage for months, waiting for the predicted second surge.
To the northeast, Lowell General Hospital reconstructed a field hospital across three basketball courts in a University of Massachusetts Lowell gymnasium. In an upgrade from the spring, each patient can now receive IV therapy, which is critical for administering the antiviral drug remdesivir.
The Lowell patients also are encouraged to walk around and visit the lounge. When they’re admitted, they receive a kit with headphones and an eye mask. They can request a white-noise machine.
Patients are nervous about the unusual setup before they arrive, said Amy Hoey, chief operating officer at Lowell General. But based on patient feedback, “when they actually get there and are admitted, they love it,” she said.
Last spring, the Lowell site was readied for patients but never saw any. Two other field hospitals in Bourne and Dartmouth also closed without treating any patients. A 1,000-bed field hospital at the Boston Convention & Exhibition Center, half of it dedicated to the homeless, treated more than 700 people last April and May. But as the number of people hospitalized for COVID across the state stabilizes, state officials have no plans now to reopen the Boston site or build additional field hospitals.
At the DCU Center, the medical staff wear masks, eye protection, gowns, and gloves throughout their shifts because the entire floor is a COVID “hot zone.” But they find ways to let their personalities peek through. Dr. Dejah R. Judelson, a vascular surgeon who volunteered to work a week at the field hospital, wore a different scrub cap every day, three of them picturing the iconic Supreme Court justice Ruth Bader Ginsburg.
Judelson, 37, last visited the DCU Center for a Dead & Company concert several years ago. This month she was treating patients there, watching their breathing, reviewing their lab results, and prescribing medications. “It’s a little bit of a surreal environment,” she said.
The greatest challenge in building the field hospitals was not logistics and equipment but the availability of health care workers, who are in high demand and short supply. A shortage of staff delayed the opening of the Lowell field hospital by a week. Both facilities rely on travel nurses working temporary assignments.
Caitlin Lynch, 33, usually works as an urgent-care nurse on Cape Cod, but when she heard about the Worcester field hospital last spring, she quickly signed up to work there, and returned when the site reopened. She wanted to help with the COVID crisis and liked the idea of being part of history: How many nurses can say they have experience working in a field hospital?
There are “lots of bays, lots of hardware to step over, piping exposed,” Lynch said. “Apart from the differences in aesthetics, it really is like being in a hospital, except much bigger and much more open.”
Lynch has been staying in a nearby hotel, working four 12-hour shifts a week. She goes home to Mashpee to see her husband when there is time.
“It’s kind of like being back in college,” she said. “You try to figure out what you can cook in the microwave.”
Monique Pappas, an artist from Leicester whose entire family contracted COVID, went to the emergency room at UMass Memorial Medical Center when she felt sick earlier this month and was transferred to the DCU Center. She didn’t mind; she said she was glad to be at a facility that specializes in her illness.
Through the fog of illness, Pappas, 46, binge-watched “America’s Next Top Model” on her iPad. When she felt bored, a nurse brought her a notepad and pens so she could draw. When she had the energy, she left her room and walked to the lounge.
She wasn’t bothered by the lack of walls, even though she could hear the patient next to her playing music. She even enjoyed the food: pasta primavera, roast beef with vegetables, chocolate brownies.
“The medical professionals … have done everything they can to put an actual hospital inside that space,” Pappas said. “If you have to stay away from home, it’s not a bad place.”