HUNTINGTON — Hospitals are preparing for a possible second surge of COVID-19 patients while balancing serving all patients again.

State officials in West Virginia said last week that COVID-19 hospitalizations are trending down, on average. There were 24 people hospitalized for COVID-19, with three in intensive care units and two on vents.

The hospitalization rate has dropped in half since the start of May.

“We keep a very careful eye on that,” said Dr. Clay Marsh, state coronavirus czar, during Gov. Jim Justice’s daily press briefing Monday. “We know the hospitals have increased their activities … therefore there are more people in hospitals today than at the nadir that we had asked the hospitals to do to open up capacity if we had the first surge. By doing that, the hospitals have really learned a lot.”

Mountain Health Network, which consists of Cabell Huntington Hospital and St. Mary’s Medical Center in Huntington, canceled elective procedures and restricted its visitor policy in March to prepare for COVID-19 patients and to conserve scarce protective equipment like gowns and face masks.

Elective procedures have now resumed, and the visitation policy is more relaxed. But moving forward, hospitals must remain on alert as the virus continues to spread across the country.

“(Mountain Health Network) had a well-developed, but untested, plan for responding to the first wave of COVID-19 illness prior to the first patient’s arrival and diagnosis on March 20,” said Dr. Hoyt Burdick, chief clinical officer for Mountain Health Network. “While few battle plans survive first contact with the enemy, we have been continually refining and adapting this plan to match our evolving knowledge about this virus, the illness it causes and how to treat infected patients while keeping other patients, visitors and staff safe.”

Infection prevention measures have changed “dramatically,” Burdick said, including self-screening of all staff for symptoms or exposure, eliminating then restricting visitors who are also screened, and proper personal protective equipment for all patient contact in the health care setting.

“We rapidly adapted to more earlier identify potential patients through EMS protocols, telephone interviews prior to patient arrivals and early direct screening questions,” Burdick said. “Patients under investigation were quickly removed from public areas and placed in isolation for evaluation. We learned that some patients with COVID-19 illness may not require hospitalization, while others may require various levels of supportive care, from just supplying oxygen to long-term critical care with multiple-system organ failure.”

There were other lessons learned, including the importance of communication — inside the hospital, with other local and state agencies, and with the public.

The hospitals also now have a system to adapt to new guidelines, a system to disinfect high-touch surfaces and methods to conserve PPE, as well as keep real-time track of the number of beds, vents and other data.

Burdick said they also now have a tested process for immediate discontinuation of elective procedures and visits if necessary to focus on patients with COVID-19, as well as a surge plan to address any rapid influx of patients, with the ability to open and staff additional hospital or ICU beds.

“West Virginia, Ohio and Kentucky were all determined to be vulnerable to the novel coronavirus pandemic due to population risk factors and available hospital and health care services,” Burdick said. “As a tertiary academic medical center with critical care and infectious disease services, MHN is also able to provide a higher level of care for any patients transferred from our rural hospital partners. Both the leadership and the front-line staff of Mountain Health Network are much better prepared now for any surge in COVID-19 illness than we were when the first case arrived here three months ago.”

Marsh and state health officer Dr. Cathy Slemp said they continue to monitor the capacity in the state’s hospitals. Marsh said they are also working with the National Guard to stock up on PPE.

Marsh said he is still hopeful there won’t be a second surge in West Virginia if everyone continues to stay cautious, wears a face covering and maintains physical distance.

Follow reporter Taylor Stuck on Twitter and Facebook @TaylorStuckHD.