Did you know there is a six-hour timeframe to give a clot-buster medicine called TPA to someone having a stroke?

Registered Nurse Sherri Dayton, president of the Backus Federation of Nurses, AFT Connecticut, Local 5149, said you have to see it to believe it.

“I have seen (it) work miraculously a zillion times,” Dayton said.

But time is the key. Delay can be critical to an eventual return to normal.

“So when you wait a day or two to come in, when you have that facial droop, or that weakness in one arm, then that will probably be permanent,” she said.

There are also “clot-busting” medicine and catheter procedures that can help people who are suffering a heart attack – if they come in quickly.

“The longer you wait, the more your heart muscle dies, the more your brain matter dies (with a stroke), and then you’re stuck with, you know, whatever the consequences are,” said Dayton, who works at the Backus Hospital Emergency Department in Norwich and the Backus Plainfield Emergency Care Center.

Sometimes, people have cellulitis, a skin condition, somewhere on their bodies, she said, and “they think, ‘It’s not that big of a deal.’ But then it goes into their bloodstream, and then they become septic.”

According to a Centers for Disease Control and Prevention’s website, “Cellulitis is a common bacterial skin infection that causes redness, swelling and pain in the infected area of the skin. If untreated, it can spread and cause serious health problems.”

Dayton pointed out, during a February telephone interview, that cellulitis is “not a big deal if you come in at the beginning of it. It becomes a big deal if you wait too long.”

For the last 11 months, she said she has seen people coming into the emergency department “sicker than they normally would have been.”

When she asks them why they didn’t come in sooner, they tell her, “I didn’t want to come to the hospital because of COVID.”

“Everybody is working really hard in the hospital and we’ve gotten really good at taking care of patients with COVID. We know the cadence,” said emergency room Dr. Robert Sidman, who is also vice president of medical affairs for Backus and Windham Hospitals.

“We practice exquisite PPE (Personal Protective Equipment),” he added. “Virtually everybody has been immunized who works in the department.”

Even though they don’t want this process to become the new normal, Sidman said they have great tools and they’re really good at diagnosing the virus rapidly while wearing full PPE as if it was just regular business.

“We test everybody who comes into the facility, so I think we can do something now that would have been a challenge for us 8 (or) 10 months ago,” Dr. Sidman said.

There is also mandatory point-prevalence testing if staff members on a particular unit have been out COVID positive. Additionally, high-touch areas such as door knobs, railings and door frames throughout the hospital are cleaned with Clorox 360 Electrostatic Spray, which is applied with an electronic device. There is also enhanced cleaning on COVID units.

After a patient with an infectious disease leaves a room, Sidman said, “it is a very lengthy process” to clean it from top to bottom – including the bed itself.

He added that William Gerjes and his environmental services team are amazing, and that he considers them and those around the country “unsung heroes” in healthcare with the all the extra duties they have had thrust upon them during the pandemic.

Like other hospitals around Connecticut, Backus stopped performing elective surgeries around March 17, 2020, Sidman said, then restarted slowly in May.

“We did it slowly because we wanted to make sure that everybody knew exactly what they needed to do to run an operating room in case someone was positive with COVID,” Sidman said. “And that was the presumption you had to make early on. If you didn’t know and it was emergency surgery, you would assume even though there was no reason for them to have it, let’s say, you still would assume that they had COVID.

“So everybody made sure that they were wearing appropriate PPE. We limited it really to just one or two operating rooms. We cleaned out all the equipment that was in there to keep it at a bare minimum. And then every time the operating room was used, we did a terminal clean, even though we didn’t have the results back of the person’s COVID test.”

Because of the prevalence of COVID in the community, Sidman said during a Jan. 27 telephone interview, they have limited visitation to those with “extenuating circumstances.”

As of late January of this year, he said a total of 550 cases of people with COVID had been admitted to the 213-bed Backus Hospital since the beginning of the pandemic. “Certainly there are people who have passed. Some of our elderly citizens and occasionally even a younger person have passed from COVID,” said Sidman, adding that the majority of people recover from this virus.

“Some people have what we call a hyper-immune response to the virus. It’s called a cytokine storm and those people in general just don’t do well.”

On any given day in March, April or May of 2020, 10 to 20 people were hospitalized with COVID at Backus Hospital. That number dropped to less than five during the summer, but spiked in October.

“Some days we’ve approached 50 patients hospitalized. We’ve been able to manage it. We’ve had to change some of our practices – where we put our patients who have COVID, but because of all the learning from the first few months, we’re in a much better position right now for a lot of reasons.”

Precautions now taken include placing people that come into the emergency department in a private room if medical staff does not know if they have COVID, and putting two people known to have COVID together in one room.

“Because the vaccine was approved through emergency authorization, we can’t require anyone” to get the vaccine, Sidman said. “We’ve worked really hard in the hospital to try to get as many staff and physicians to take the vaccine and also for them to be ambassadors in our community. It really is safe, and other than some of the local reactions you can get from any vaccine, it is a remarkably safe vaccine.”

Even though they don’t have years of experience with this vaccine or have long-term data, he said “there’s no reason why there would be any long-term effects from it. And we know COVID has long-term effects.”

Once people are hospitalized with COVID, Sidman said “they are much more aware of how serious the disease is” and how important maintaining social distance, proper hand hygiene, and wearing a mask really is.

“At that point for them, it is a little bit too late,” he said. “But I call that a teachable moment, because those folks when they go home they can certainly help us spread the message of how important it is to do those things, and hopefully how important it is for them and their friends and family to get the vaccine when it becomes available.”

Trying to look at the good in everything, he said the pandemic has challenged medical professionals to become more efficient.

“We’re better and stronger as a health system and as a hospital because of it,” Sidman said. “If you said at the beginning of the pandemic that, ‘You’re going to have 40 patients a day that have COVID,’ I would not be as calm as I am right now with that.”

Still, people’s concern of not wanting to have surgery, go to the emergency department, or visit a doctor during the pandemic when they’re not feeling well is going to set us back as a nation, Sidman said.

“The numbers are showing it. They’re delaying care,” said Sidman.

Dayton, the registered nurse, said not all primary doctors are seeing patients in their offices, but rather talking with them by telephone and sometimes encouraging them to go to the hospital emergency department. “You can’t really do a thorough assessment on the phone,” she added.

Sidman said he worries about people who need knee surgery or have a burning sensation, which could be an ulcer, “and they’re just not coming in. They’re not scheduling appointments as much, because they lost their job and insurance. They’re going to be less likely to be seeking care.”

The concern is that a small problem could become a much bigger problem down the road.