Martha’s Vineyard Hospital leaders urged Vineyarders to not postpone care and to schedule flu shots as the fall begins, breathing a sigh of relief about the summer but preparing for the unknown months that lie ahead for homelessness and drug use prevention.

During the hospital’s biweekly press briefing Wednesday morning, president and chief executive officer Denise Schepici said there is evidence that patients are postponing care and arriving at the hospital with acute illnesses that require treatment off-Island.

“We are continuing to see patients in our emergency room who are sicker than usual because of delays in care,” Ms. Schepici said. “It’s when care is delayed that we see the greatest challenges and may have to shift you off-Island because of your acuity.”

Hospital chief nurse and head of operations Claire Seguin added that the hospital has taken steps to ensure safety at the facility. The hospital reopened for routine business in June and July with new appointment rules, cleaning protocols and layout after closing to all but emergency care the pandemic.

“I just would remind folks from my point of view that the hospital is a safe place,” Ms. Seguin said. “We’ve put practices in place to ensure that.”

Both Ms. Schepici and Ms. Seguin said while the percentage of patients needing off-Island transfers has increased relative to a decrease in overall patients, the broader problem is the severity of the illnesses being seen.

“Things that we would normally be able to treat here . . . like an x-ray or ultra-sound, they waited,” Ms. Schepici said, speaking of ill patients. “Their condition was to point that we didn’t want to take the chance and felt we wouldn’t have the ability to care for them in an acute situation, so they got sent off.”

The cost of off-Island transfers can depend on the patient’s insurance, Ms. Seguin said.

“It’s not inexpensive,” she said.

Hospital officials also urged patients to schedule flu shots now that fall has arrived, calling it more important than ever to receive the vaccine due to the pandemic. The hospital is offering flu shots to all its primary care patients. The shots can be scheduled by calling either 508-684-4500 for adult care or 508-693-3732 for pediatrics.

Ms. Schepici said because of limited doses, the hospital would be starting with a “blitz” of shots this week for employees and then work with the boards of health to expand to at-risk patients, frontline workers and beyond.

Staging for the first blitz has begun, Ms. Schepici said, and she added that the state DPH would be making a special program available to increase accessibility.

Gov. Charlie Baker announced earlier this year that all public school students going back to in-person learning are required to get a flu shot by late December.

“In short, we’re trying to team up with boards of health and [Tisbury health agent] Maura Valley and do a full public outreach,” Ms. Schepici said. “We’re not going to turn people away if they don’t have insurance. We want to get as many people vaccinated as possible.”

Hospital officials also said a moment of silence was held Tuesday to honor lives lost during the opioid epidemic. September is national recovery month. Although officials said they had seen a leveling of opioid death numbers over the past few years, they expressed concern about the oncoming winter.

“What we’re worried about is what’s coming in the winter months,” Ms. Schepici said. “It’s dark, it’s dreary, and we’re really, really concerned. And we want people to reach out to our services and know that they are not alone.”

Officials also expressed a deep concern about homelessness with winter approaching. The Island’s Houses of Grace homeless shelter will likely have to stay closed this winter, Ms. Schepici said, prompting the hospital to offer assistance.

Without shelters, individuals who are homeless and cold on the Island will have to go to the hospital’s emergency room — although the hospital will not have a place to discharge them.

In new information relating to homelessness, Ms. Schepici said five homeless individuals living in the woods died last year from hypothermia after the shelter closed. 

Later in the day, Ms. Schepici clarified her statement a follow up email, writing that the individuals who died last winter were suffering from symptoms of hypothermia along with other health conditions, meaning she could not specifically cite hypothermia as the cause of death.

Ms. Schepici said she would be willing to offer assistance in the form of a grant to assist with hiring staff for homeless shelters, and that preliminary discussions have begun with Island homelessness prevention advocates.

A shortage of staffing and volunteers was part of the issue that prompted homeless shelters to close early last winter.

Ms. Schepici also spoke about the Labor Day surge in coronavirus cases on Nantucket, where 40 cases were reported over the past two weeks. She said after speaking with Gary Shaw, CEO of the Nantucket Cottage Hospital Gary Shaw, there is belief that Nantucket’s surge had quieted in recent days. But she called it a cautionary tale.

“What happened in Nantucket is exactly what we feared could happen here, and that people could let their guard down and it could spread asymptomatically,” Ms. Schepici said. “We’ve done a great job keeping our community safe. We’re not over the hump yet . . . But we’ve been great, the Island has been great.”