Mammoth Hospital received confirmation today of the first case of COVID-19 in our community. For anyone who is wanting to know who that person is and “did I come in contact with him/her?” the answer is that nearly everyone has a high likelihood of having been exposed in some way to someone with COVID-19. This is only the first confirmed test in Mammoth Lakes, and not the first case. And there is a BIG difference. Everyone in the community must assume that the virus has spread worldwide at this point: in Mammoth, Bishop, San Francisco, Los Angeles, Seattle, the West Coast, the East Coast, the United States, North America, South America, Europe, the Middle East, Asia, Africa, Australia. EVERYWHERE. And with that assumption, everyone must act accordingly. It does not matter if the person was a local, a tourist, or what nationality he/she was. We have to act as if everyone may have it.
The physicians, nurses, and administrators serving on the Hospital Incident Management Team reviewed new projections today showing the growth rate of spread under different conditions. The single most impactful condition is the degree to which the community engages in Social Distancing.
Consider what we know about COVID-19, and how it spreads. Our current best guess is that if we do nothing to change our behavior, the number people infected will double every 4 days. That means today with one patient. In four days, there will be 2 patients. And what follows is this:
|Today on 3/21/2020||1 patient|
|3/25/2020||2 new patients|
|3/29/2020||4 new patients|
|4/2/2020||8 new patients|
|4/6/2020||16 new patients|
|4/10/2020||32 new patients|
|4/14/2020||64 new patients|
|4/18/2020||132 new patients|
|4/22/2020||264 new patients|
|4/26/2020||512 new patients|
So assuming no one dies, in just one month, we will have over 1,000 patients with COVID-19. The challenge is we do not know precisely how many of these patients will actually be sick, how many will need to be hospitalized, how many will need to be in the intensive care unit on a ventilator. That said, our projection at this point is that 5% of infected patients will need to be hospitalized, which means of those 1,000 people, 50 will need to be admitted to the hospital in the next month, and that is when we start with JUST ONE patient! The reality is that we likely have many more people in Mono County who are already infected. So, the numbers are almost certainly much higher than the above example. It is of critical importance to note that Mammoth Hospital is a small hospital with only 17 beds!
So what can you do to prevent this from becoming a situation we cannot possibly handle?
The point of Social Distancing is to keep the illness from spreading so quickly that the need for healthcare resources exceeds capacity. Right now, if we put an estimate on how well we are doing our part to Socially Distance, let’s assume our success rate is 25%, meaning on average we have all cut our social interactions by 25%. If we maintain that rate, and look at a population of 25,000 people (Mono County, Inyo County, and visitors) we will have our absolutely worst day in about two months, which means on that day alone, we will have 23 patients requiring life support (ventilator) in the intensive care unit, and 111 patients needing inpatient hospitalization. These projections far exceed the Hospital’s 17 bed capacity and our ability to care for no more than 4 people on life support at one time.
Now imagine if our success rate for Social Distancing is improved to 60%. So we stay at home, make our own coffee, go for walks by ourselves, and stop going to parties with our friends – a tall order for all of us without question. Now our absolutely worst day is just over three months out. On that day, we have nine people in the hospital, and two people on life support in the intensive care unit. Because of what we all do to Social Distance, our 17-bed hospital now has a much better chance to take care of everyone!
We know this new normal may not be a fun practice or one that is convenient. It’s not your usual routine, and during times of stress we like to be close to our friends and our family members. Do not revert to your regular routines. It is so important to stay the course!
Here are some things you can do to cope. Stay connected to your friends and family through the use of video conferencing. Check in on loved ones who just need a call. Have a Google hangout or FaceTime chat. Exercise indoors or outdoors while maintaining a safe distance from others. Get outside for a walk and refresh yourself with the cool air. We are lucky to have some of the best views in the world just out our front doors.
If you are a “list person” here are our suggested Do’s and strongly advised Don’ts of Social Distancing:
- Work out on your own.
- When you need to go out, do what you need to take care of, and get home. Be efficient!
- Call people to talk.
- Get out and walk, either with your dogs or on your own.
- Arrange an appointment with Behavioral Health if you need help with coping or anxiety.
- Get outside. We could all use some Vitamin D!
- Email or use social media to connect with friends and family to let them know how you are and find out how they are.
- Go out to get coffee, and then stop and socialize.
- Have dinner or parties with friends.
- Socialize at the grocery store.
- Hug or shake hands when you see a friend.
- Linger after getting take-out food.
- Socialize on Lake Mary Road, the gorge, or in the backcountry.
- Have play dates for your kids.
- Loiter at the post office.
- Work out in groups.
As always, we are here to help. If you need someone to talk to, call our Behavioral Health team at (760) 924-4333 and we will schedule one of our providers to talk with you via video chat.
So please, keep in mind that what you do (or don’t do) makes an enormous difference in how we are going to get through this! We are all in this together, literally!
Wash. Cover. DISTANCE