Doctor’s coronavirus closes a pediatric ICU in Philly to new patients; how many were exposed is unknown

St. Christopher’s Hospital for Children closed its intensive care unit to new patients and the Level 1 trauma unit shut down Friday, March 13, after a physician tested positive for coronavirus. The rest of the hospital remained open, according to a memo sent to Drexel staff and students by the university’s president, John Fry, on Saturday and obtained by The Inquirer on Sunday.

St. Christopher’s is jointly owned by Drexel and Tower Health, and operated by Tower.

The doctor was last seen at the hospital March 11 and began to feel unwell that day, Fry said in the memo. He said officials know the virus was not contracted within the hospital, but did not elaborate.

Richard Wells, a spokesperson for Tower Health, said the doctor returned from travel in Europe on March 8. Sources close to St. Christopher’s who were not authorized to speak publicly told the Inquirer that the doctor had recently traveled to Germany — which has been hard-hit by the virus with nearly 4,600 cases as of Sunday morning — but did not have symptoms when she returned to the United States.

The level 1 trauma unit was shut down because the ICU is not able to accept new patients, but current ICU patients will continue to be treated at the hospital, Wells said. It was not clear how many patients are currently in that unit, but hospital sources said the 26-bed unit is typically about 80% full.

“Patients in the ICU will remain there until they are medically able to be discharged to home,” Wells said.

Hospital sources said the ICU is in a newer wing of the hospital, designed as a separate area that allows it to be well-isolated from the rest of the facility, which remains open. The unit has controlled access for patients, visitors and staff, Wells said.

In his memo, Fry said that ICU staff “have been notified of this situation,” and will wear approved protective personal equipment — gowns, gloves, eye protection and masks — when treating ICU patients. They will also wear surgical masks when outside patient rooms.

Wells said the hospital is also performing temperature checks on caregivers and staff to monitor for the virus.

Fry said the hospital is contacting patient families and employees who may have been exposed. Tower sent written notices to affected families and has been “speaking to them directly, as well,” Wells said.

But when asked how many patients and staff had been exposed, Wells said hospital administrators don’t know yet.

“We are working through contact tracing to identify possible exposures and do not have a number at this time,” Wells said in an email.

Meanwhile, Tower and Drexel did nothing to notify the public until pressed for more information by The Inquirer on Sunday — days after the doctor tested positive and the ICU was shut down.

When asked for more information about Fry’s memo, university spokesperson Niki Gianakaris declined further comment, aside from saying that Drexel “is working with all affiliate training sites to ensure the health and safety of students.” She directed other questions to Tower.

As of Sunday afternoon, St. Christopher’s website did not include any notice to patients about the closures and new coronavirus exposure. It comes on top of a report that another, independent physician was quarantined after coming into contact with the virus outside the hospital back in February, and then performing surgical procedures at the hospital. Whether he was actually tested has not been made clear. That earlier news came in the form of a staff memo from Tower Health, issued only after the doctor and contacts had completed a 14-day isolation period.

State health officials — who are tracking all diagnosed and suspected cases — did not respond to a request for comment.

City health commissioner Thomas Farley said he couldn’t give out details on specific cases because of privacy concerns for patients, but said at a media briefing Sunday that he “had heard” that St. Christopher’s had closed its ICU to new patients.

“For all recognized cases, we work with the people involved and employers to try to identify those who are close contacts,” he said, “and make sure those people quarantine so they don’t further spread the infection.”

St. Christopher’s needs to continue to provide services despite the ICU closure, he added: “We think it’s important for us to maintain services for all our healthcare institutions.”

City Councilman Mark Squilla, whose district stretches into Kensington, near St. Christopher’s, said Sunday that a call from a reporter was the first he had heard about the doctor’s case. He said it was difficult for him to comment extensively on the situation without more information, but said he expected to hear from concerned constituents about the ICU closures.

After a Children’s Hospital of Philadelphia cardiologist at the King of Prussia campus was hospitalized with coronavirus, the hospital was forced to temporarily shut down its cardiology office and an adjacent clinic, and several schools with students who were his patients closed. News of the CHOP cardiologist’s exposure similarly became public only after The Inquirer obtained an internal staff email from the hospital’s CEO. Montgomery County officials later confirmed the case.

The CHOP doctor was in critical condition at the Hospital of the University of Pennsylvania on March 9 but hospital and government officials have refused to provide an update on his condition since then.

The virus has been most deadly among older adults and those whose immune systems are compromised. In other countries, most children have appeared less vulnerable, though they can spread the virus to others. But health care settings are of particular concern because those with underlying health conditions are inherently more vulnerable to the virus.

Because the virus can be spread by people who don’t have symptoms, or have only mild symptoms, everyone is being asked to do all they can to protect against a rapid spread that would overwhelm hospitals, leading to more deaths.

“This is a societal problem, and it’s going to be a problem at every level, at all demographics,” said David J. Goldberg, an associate professor of pediatrics in the division of cardiology at CHOP. “We want to keep it out of our hospitals to the degree possible," he said of the situation generally, not of St. Christopher’s case specifically. "We know that won’t be entirely possible but we need to take any precautions to slow it down.”

St. Christopher’s provides health care at all levels, from preventive to critical to young patients, many of whom live near the North Philadelphia institution. Officials said the rest of the hospital remains open for business.

With the trauma and ICU closures, patients who may have been treated there will need to be diverted to other hospitals. Fire commissioner Adam Thiel said that the fire department is used to such changes.

“We are constantly balancing hospital status with demand,” he said. “It’s not unusual to have hospitals change status multiple times in a 24-hour period.”