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NIH Record - National Institutes of Health

Clinical Center Prepared to Deal with Coronavirus Patients, Gilman Says

View of CRC main entry lobby with white sheets hanging from tall racks used to separate screening areas.

Screening booths for patients and visitors were erected at the entrance to the Clinical Center on Mar. 12. It became mandatory, later in the month, for everyone to be screened.

Photo: Rich McManus

As cases continue to surge nationwide, the Clinical Center is well equipped to take care of coronavirus patients, said Clinical Center CEO Dr. James Gilman.

“We have the facilities to take care of the patients, but our fundamental mission is research so that’s the backdrop for anything else that happens here,” he said.

Supporting NIH researchers as they work toward bringing treatments and a vaccine from bench to bedside, the Clinical Center is currently one site of a multi-center clinical trial of a potential drug for coronavirus patients. The hospital began accepting such patients on Mar. 24, when two research participants began a randomized, controlled NIAID clinical trial of the antiviral remdesivir. 

In preparation for this eventuality, the CC recently took stock of its quarantine capacity. There are a total of 11 rooms in strict, airborne isolation: 7 in the special clinical studies unit and 4 inpatient rooms. These rooms meet optimum quarantine standards: negative pressure to outside air, HEPA filters and anterooms where staff can safely put on and remove personal protective equipment such as gowns and masks.

“Eleven is the number of patients, in terms of our facilities, that we could take care of the best,” said Gilman, adding that there are additional, negative-pressure rooms that could house patients.

At the local level, the CC, which often collaborates with Walter Reed National Military Medical Center and Suburban Hospital, may expand that relationship to take in some of their coronavirus patients should the need arise during this viral pandemic. An agreement among the three hospitals, drafted after 9/11 and renewed ever since, fosters an even greater exchange in the event of a natural disaster or other national emergency, said Gilman.  

“We have contingency resources for taking care of patients who may have to come to us from Suburban or Walter Reed,” he said.  

The hospital’s leadership has been preparing for this pandemic at a precipitous pace. They engage in multiple meetings daily, making quick decisions and problem-solving as they go along. Gilman likened the pace to that of a critical military operation.

“I’ve been a physician over 40 years, and I’ve been through some pretty interesting times, including a lot of time in the Department of Defense taking care of young men and women [injured in battle], but I’ve never been through anything like this,” he said. “I have a lot of experience with military operations and I would say that the pace here equals that of even the most well-organized military exercises and operations.” 

In addition to preparing for coronavirus patients and protocols, the CC is making significant changes every few days to help protect patients and staff while providing optimal patient care. One such change is updating its visitor policy.

“We’ve begun to tighten the visitor policy significantly, with the idea that we will tighten it even further should we have to,” said Gilman. 

As of mid-March, the CC was limiting each inpatient, even children, to one visitor at a time.

“It cuts down on the number of people we have to screen,” said Gilman, “and helps protect not only our vulnerable patients but also our staff.”

And, since Mar. 13, all patients and visitors entering the CC are screened for symptoms at the door [this policy became mandatory for all entrants to Bldg. 10 later in the month]. Staff who have a fever or other coronavirus symptoms first get screened by the Occupational Medical Service; some then get tested. 

“Our department of laboratory medicine has done a great job of developing the ability to test patients and staff,” said Gilman.  

“We will do whatever the NIH, HHS or national leadership decides,” he concluded. 

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