As the COVID-19 pandemic stretches on across the commonwealth and the country, medical professionals in the Poconos are preparing for potential case spikes and second waves.

Though each of Pennsylvania’s 67 counties have made their way through Governor Tom Wolf’s reopening strategy to the green phase, concerns are mounting as COVID-19 cases begin to spike in previously heavily-hit areas like the southwest and southeast regions of the state.

This has inevitably raised concerns about the northeast, which may not have seen infection rates like Pittsburgh and Philadelphia, but still experienced more than enough pandemic problems.

On Wednesday, Wolf and Secretary of Health Dr. Rachel Levine singed off on new targeted mitigation efforts to address the increase in case counts, with the governor citing the potential for a new peak in infection rates as a concern.

"During the past week, we have seen an unsettling climb in new COVID-19 cases," Wolf said. "When we hit our peak on April 9, we had nearly two thousand new cases that day with other days’ cases hovering around 1,000. Medical experts looking at the trajectory we are on now are projecting that this new surge could soon eclipse the April peak. With our rapid case increases we need to act again now."

Spikes and second waves have been a hot topic as the summer stretches on in Monroe County, with some residents worrying that the threat of COVID-19 may only increase as time goes on.

Both Lehigh Valley Hospital-Pocono and St. Luke’s Monroe Campus have been working diligently to make sure that the county’s health care systems can handle whatever the near future may hold.

Though both hospitals were fortunate to not reach capacity even during the height of the pandemic thus far, resting on their laurels is not an option – many professionals fear that spikes could interfere with recovery and reopening efforts, and a second wave could prove to be more dangerous than the first.

Elizabeth Wise, president of Lehigh Valley Hospital-Pocono, and senior vice president of Lehigh Valley Health Network, said that her staff has been debriefed on "things that we did well, (and) things that we could do better," and have since developed an action plan to address those gaps.

Processes were established for the pandemic, such as the screening of patients before they enter facilities, along with consistent cleaning schedules for high-touch surface areas.

"Additionally, across LVHN, we’ve been preparing for a second wave, which we hope does not happen, but in the event it does, we are making sure even during the initial crisis that we have adequate equipment," Wise said. "Obviously ventilators, adequate medication supplies, and adequate resources."

Lehigh Valley Heath Network has developed a surge plan to ensure that a proper amount of space and equipment would be available for COVID-19 patients, and there was even an overflow facility established by PEMA and the Pennsylvania National Guard at East Stroudsburg University in case non-COVID-19 patients needed to be protected. Though it was never used, the infrastructure remains in place in case it may be needed in the near future.

Don Seiple, president of St. Luke’s University Health Network’s Monroe campus, said that his staff developed similar plans during the onset of the first wave, and those protocols and procedures could go a long way toward helping patients during a potential spike or second wave.

"During the first wave the St. Luke’s Monroe Campus, with the assistance of the St. Luke’s Network, was able to develop an effective surge plan," Seiple said. "We created additional critical care capacity, retrained/reassigned staff, and addressed PPE (personal protective equipment supply and usage). Also, very early into the pandemic, the St. Luke’s clinical team developed treatment protocols that kept the majority of patients off ventilators and out of the intensive care unit."

Seiple said that St. Luke’s also developed surge care units during the first wave, doubling their intensive care capacity, and procuring enough ventilators for patients. With planning and preparation already complete, they will be able to quickly create capacity to address increased caseloads.

Both hospitals are carefully monitoring COVID-19 data – locally, statewide and even in bordering states – to stay on top of any developments.

"One of the important things during this pandemic has been the ability for hospitals or health care systems to take care of the volume of patients," Wise said. "So, I follow not only ‘is there a spike?’ but ‘what is the number of people that need to be hospitalized as a result of the exposure?’"

Wise said that in order to get a good idea of how prepared a county is, one needs to look at some of the points of interest highlighted by the Department of Health – how many critical care beds are available, how many patients are being hospitalized, and can care be provided for patients

"If the answer is yes, then even if there is a spike, we can still provide the care that’s needed," Wise said.

One of the biggest issues to hit health care providers during the pandemic was scarcity of personal protective equipment. Highly-coveted N95 face masks were near impossible to find, and not too long thereafter, surgical masks and even bandanas became rare.

Wise said that community support helped get her staff through the pandemic, especially local groups that provided masks to hospital workers.

"For those employees that do not care for patients, they wear cloth masks," Wise said. "We had many community members sew masks for us, and generously donated their time and materials, so we were grateful for that. For those that are taking care of patients, they wear a mask, goggles, a gown and gloves, depending upon what’s required."

Wise said that she wears a cloth mask at work like other employees who do not interact with patients in order to maintain an adequate supply of personal protective equipment.

Seiple said that the staff at St. Luke’s has been focused on maintaining a sufficient supply of personal protective gear for all as well.

"In addition to our development of treatment protocols, we continue to focus on our management of PPE," Seiple said. "It remains a top priority that our employees have the appropriate PPE when they need it. We continue to source and manage PPE responsibly and aggressively."

In order to stay ready for any spikes or second waves, medical professionals from both health networks have been adamant to stay on top of new developments, as we continue to learn more about COVID-19 the further the pandemic continues.

"We continue to monitor the rates of new cases daily and hospitalizations," Seiple said. "Currently the 10 counties in the Northeast region have done and continue to do a good job of reducing and maintaining the rate of new positive cases."

Some of that success could be thanks to a weekly broadcast presented by LVHN and St. Luke’s, who joined the Pocono Mountains Visitors Bureau and key local business leaders to present important pandemic information to the community over a number of weeks.

While the hospitals have strived to prepare for the continuation – or second wave – of the pandemic, it is incredibly important for average citizens to take simple steps to protect their own health and that of others.

It comes down to staying informed and vigilant, which will go a long way toward protecting community members from falling ill, and ensuring that hospitals will be capable of treating the most severe cases. And all it really takes is those same mitigation tactics you have been hearing about for months.

"The three most important things the residents of the Poconos can do are: Hand washing, social distancing and masking," Seiple said. "Masking is more about protecting others, and I am encouraged when I see people in the Poconos masking. This will help keep our hospitalization rate low and ensure healthcare is available for those who will need it."