By DERRICK DAVIS, Sports editor, The Brunswick News, May 4, 2020
As the medical director of the Southeast Georgia Health System intensive
care unit, a critical care specialist and pulmonologist,
Stephen Chitty, M.D., is in the very front of the line in the battle against COVID-19.
Chitty moved to the area 14 years ago, taking over his duties as the ICU
medical director within the past five years or so.
Even before the world-wide pandemic, Chitty was responsible for the care
of the critically ill. The
COVID-19 outbreak has just upped the numbers.
“Before COVID hit, my partners and I had pretty standard schedules
where one of us would be responsible for the intensive care unit patients
for a week, and we would rotate through the two intensive care units at
Brunswick — that would be variable patients with sepsis and heart
attacks and things like that,” Chitty said. “Then we would
have some time in the office to take care of office-based pulmonary problems.
We’ve really kind of done that schedule for years.
“When we knew COVID was about to hit, we sort of changed everything
in the hospital and intensive care for a surge of patients.”
Hours upon hours of planning and prep work began before the first COVID
patient came to the hospital with SGHS considering where it would put
patients and how it would be able to keep them, and its staff, safe.
Due to the highly infectious nature of the disease, the hospital dedicated
one of its two intensive care units to COVID patients — the other
remaining reserved for the non-COVID critically ill — with spillover
space prepared if necessary, an area Chitty says has already been put to use.
As a pulmonologist, Chitty focuses specifically on disorders of the respiratory
system like COVID-19, but the extra care that has to be put into even
coming in contact with a confirmed or potential carrier makes for an increased
challenge in care.
“Sort of the drastic change in the intensive care unit was just the
intensity and the stress level of having to be faced with critically ill
COVID patients everyday, and sort of the amount of PPE we have to put
on to go in,” Chitty said. “Especially when there is a procedure
involved, the pre-stress level of making sure you’ve got all your
PPE on, face gear, N95 mask or a P95 respirator with a body suit, it’s
a lot of stress when you go in.”
“The nurses and all the respiratory therapists are all pretty locked
in, to say the least, because nobody wants to make a mistake. They don’t
want to infect themselves, but at the same time, they want to make sure
we’re giving the patient a chance to survive because they’re
really sick.”
According to Chitty, it takes about two to three times longer to handle
COVID patients than the standard ICU patient due to amount of extra precautions
the staff must undergo to prevent possible contamination.
But the first encounter Chitty had with COVID-19 wasn’t in the ICU.
It was in an outpatient with symptoms that raised alarms in the doctor’s head.
“It was somebody that I came in contact with that was explaining
to me an illness that had kind of gone through their family, and it started
to sound suspicious,” Chitty said. “So got them tested, and
they were positive. All the people that were involved with that had to
then be tested. I think people in my office have been tested a few times
just because that’s now happened two or three times where someone
has come in unsuspecting and wound up having it.”
The asymptomatic nature of some carriers is the scariest part of COVID-19
for Chitty and his colleagues.
Horrified by the thought of contracting the illness and accidentally spreading
it to someone in their family, doctors in a similar position have taken
extra precautions. Chitty spoke to colleagues in New Orleans who had moved
out of their homes altogether.
While he hasn’t gone quite that far, Chitty has isolated himself
away from his family for the time being.
“We knew it was coming, and so my wife and I, we have teenagers,
and we basically just decided I was going to move into a part of the house
and really not have contact with anybody else,” Chitty said. “And
we’ve really maintained that still. I sort of come home, take a
shower, and stay in my own area. When it’s time to eat, I don’t
sit with them. I don’t sleep with anybody. I’m by myself pretty
much the whole time I’m home.”
Although an extreme decision to self-isolate even at home, it was an easy
one for Chitty, as it likely would be for anyone who has had an up-close
view at the effects of COVID-19.
Chitty’s first encounter with a COVID patient in the intensive care
unit was a memorable one. A critically-ill patient developed respiratory
failure and had to be put on mechanical ventilation.
Though unable to confirm it was COVID-19 at the time, all the symptoms
pointed towards that being the case.
“The first gentleman that we had to place on life support, we were
very suspicious that’s what he had, and he did,” Chitty said.
“I just remember explaining that to his family, and how devastated
they were because of everything they’d been reading in the media
nationally.”
At the time of the first encounter a 10-day delay between testing and results
was the best SGHS was able to do. As a result, the hospital would generally
have 25-30 patients under investigation, with six to eight in the ICU,
that required doctors to prepare and use full PPE as if they were confirmed
positive for COVID-19.
Thankfully, the staff at Southeast Georgia Health System has not faced
the shortage of personal protective equipment other areas of the country
have dealt with, and Chitty doesn’t believe it will be an issue
in the future either.
“We’ve been very fortunate to have aggressive leadership,”
Chitty said. “They’ve really aggressively gone out and gotten
PPE for us, so we’ve never really felt under protected. They’ve
done an awesome job. We’ve been able to stay ahead preparing for
a big surge.
“It was worse because there were so many patients that you didn’t
know if they had it or not. Testing has gotten significantly better in
the last two to three weeks, so we can rule people out quickly now and
quit using so much PPE on them and sort of save it for those we know have
it or the few that we’re still waiting on testing to come back.”
Chitty is unsure of the number of tests administered in the emergency room,
but in-house, he says they’re now testing 30-60 people per week.
Twenty tests per day can be sent to Baptist Medical Center in Jacksonville as well.
And instead of waiting weeks, or even days, SGHS receives results on tests
it administers at the hospital in an hour. Results on the batch of 20
sent to Jacksonville at 5 p.m. are returned by 8 p.m.
The increased speed of test results could be paramount in the future. Despite
the relatively low number of confirmed cases in Glynn County, the state
of Georgia isn’t necessarily out of the woods yet with more than
27,000 cases and counting.
“It’s really hard to guess,” said Chitty of the disease’s
peak. “Our numbers have stayed more steady and lower, which I think
is probably just a testament to our community’s commitment to following
the rules, social distancing and staying home, restaurant owners really
being out front, our clergy being out front with getting everything stopped.
“So we do think it’s going to continue at least at this level,
if not pick up a little bit now that things are relaxing some, but our
citizens seem to be taking it very seriously to say the least. We’re
hopeful that we don’t get that big surge like some parts of southwest
Georgia have had, just really because of the level of commitment we’re
seeing from everyday people here.”
Chitty commended the area for its dedication to social distancing guidelines
and other practices in the fight against COVID-19.
He just asks to keep it up.
“I think the main thing is for our community to know they’ve
done a great job,” Chitty said. “That includes
The Brunswick News, it’s done a great job of getting out in front of this, but really
across the board, we’re seeing commitment everywhere.
“If they would stay vigilant, and like everybody else has said, if
they would continue to realize that in keeping with the social-distancing
rules that they’re protecting not just themselves, but everybody
else. So far, the health care providers really appreciate their commitment,
and if they would keep it up, we would continue to appreciate it.”
Today’s
Frontline Heroes is sponsored by
Georgia Pacific Brunswick Cellulose. Visit their website at
www.gp.com