Tag Archives: covid-19

Ninth Case of Coronavirus in Inyo County Confirmed

INYO COUNTY, April 1, 2020 – Inyo County’s Public Health Officer, Dr. James Richardson, received notification this morning from Northern Inyo Healthcare District regarding a positive COVID-19 test for an Inyo County resident. This is the ninth positive COVID-19 case in Inyo County. The patient presented to Northern Inyo Healthcare District’s Rural Health Clinic with symptoms associated with COVID-19, and was tested for COVID-19 based on symptoms and other risk-factors.

 

Inyo County Public Health is working to determine the source of the infection, and conducting a thorough investigation to identify potential exposures and notify contacts. At this time the patient is currently isolated at home. As of March 31, Inyo County has 19 tests pending and 63 negative cases. Due to the volume of tests being analyzed currently in California, the turnaround time can take several days.

 

The public must continue to practice preventative measures, such as avoiding contact with sick individuals, wash hands often with soap and warm water for at least 20 seconds, practicing social distancing, and adherence to State and County Orders. If you are experiencing symptoms of COVID-19, such as fever, coughing or shortness of breath, and think you may have had contact with a person with COVID-19, call your health care provider before seeking medical care so that appropriate precautions can be taken.

 

Please familiarize yourself with Inyo County’s Public Health Orders and CA Executive Order: https://www.inyocounty.us/covid-19/orders-directives

·        Prohibition Of Certain Short-Term Rentals

·        Businesses Operating During COVID-19

·        Self-Isolation & Self Quarantine Order

·        Temporary Prohibition Of Non-Essential Public Gatherings

·        CA Stay At Home Executive Order

 

The County of Inyo, Northern Inyo Healthcare District, and Unified Command partners are committed to keeping Inyo County residents up to date with the most accurate information. You are encouraged to visit https://www.inyocounty.us/covid-19  for the most recent press releases and community updates. You can also register your email so you receive all Inyo County COVID-19 information by clicking either Situation Update or Press Releases from the left-side menu.

Students Not Likely to Return to School Campuses This Year

SACRAMENTO—State Superintendent of Public Instruction Tony Thurmond released a statement Tuesday regarding the 2019-20 school year.

“Due to the current safety concerns and needs for ongoing social distancing, it currently appears that our students will not be able to return to school campuses before the end of the school year. In order to allow schools to plan accordingly, and to ensure that learning still occurs until the end of the school year, we are suggesting that schools plan and prepare to have their curriculum carried out through a distance learning model. This is in no way to suggest that school is over for the year, but rather we should put all efforts into strengthening our delivery of education through distance learning.

“With that said, we are doing everything we can to support our schools and their distance learning opportunities for our students. We have been providing webinars, with one coming up this week to specifically focus on serving our students with disabilities in a distance learning model. We have guidance coming out this week to address the concerns of our seniors, and even our juniors, in regards to grading and graduation requirements. We also put out a survey to all districts in the state to determine their technology gaps and are now working to ensure that all students have access to devices and internet if they need it for their distance learning requirements.

“We are in unprecedented times, and it’s hard to tell what the future holds as we are all doing our best to flatten the curve. From what we know right now, our schools will be closed longer than we originally thought, and it will be best if our schools are prepared for that extension, by having their distance learning models prepared to go until the end of the school year.”

Please join State Superintendent Tony Thurmond for a media check-in about his recent recommendation and upcoming guidance from the California Department of Education tomorrow, April 1, at 3:30 p.m.

Due to social distancing guidelines this will not be done in person, but rather virtually. Email communciations@cde.ca.gov by noon to receive login information.

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Teamwork and Preparation Most Important in NIHD’s Response to COVID-19

It is an overused analogy, the war against novel coronavirus, but as any employee at Northern Inyo Healthcare District will tell you, the battle is real. Ironically, it is a battle most have prepared for throughout their respective careers.

“Every team member brings something to the fight,” says Dr. Stacey Brown, Medical Director of NIHD’s Rural Health Clinic and current Vice Chief of Staff. “Every department plays a role.”

For NIHD Board President Jean Turner, the show of teamwork fits right into the District’s operational design. “When I came onto the Board, I was told our basic structure is that of an inverted pyramid,”
Turner says. “Leadership at the bottom, the workforce at the top. The top is where the real work goes on; it’s where things really matter. If I wanted our community to remember one thing at this point in time, it’s this: Our staff is disciplined, well-trained, and ready for this challenge.”

The District’s fight against coronavirus began in mid-January. For weeks, Infection Preventionist Robin Christensen, RN BSN HIC, kept an eye on what was transpiring in China. On January 28, she called the first team meeting to talk about coronavirus and its potential impact on NIHD and the community. Everyone in the room knew the odds, had watched the numbers coming in from China.

“It is safe to say we wished for the best, but as healthcare workers, we always prepare for the worst,” Christensen says. “It’s who we are; it’s what we do; it is what the community expects from us at a time like this.”’

As the NIHD team developed needed plans, they carried on with providing day-to-day care. Hallway conversations and internal emails began to refer to coronavirus more frequently. The District conducted a pandemic disaster drill on February 13. The tipping point came March 6 when a two-hour coronavirus meeting gave way to a day-long review of staffing levels, supplies, policies, plans, and shared concerns.

The group met the next afternoon again for several hours. They got a late start, beginning at noon. It gave those who volunteered to help at the Eastern Sierra Cancer Alliance’s Blue Ribbon Walk & Run a chance to meet their commitment. For many at NIHD, it was the last “normal” day of the month.

NIHD initiated an internal Incident Command on March 10 and continues working under it today. Incident Commands use a standardized approach to direct, control, and coordinate emergency response. More importantly, it brings people together to reach a common goal.

Like her co-workers, this was not the first time Allison Partridge, RN MSN, worked under an Incident Command. Partridge, the Director of Nursing for the Emergency and Medical-Surgical departments, knows the system well and aids Chief Nursing Officer Tracy Aspel in keeping the daily meetings on task.

Partridge now spends much of her days working with others to put together workflows for the departments that will be most affected. With guidance from Infection Preventionist Christensen, Partridge
and others closely watch the Centers for Disease Control and Prevention and the California Public Health Department for direction. No area or service escaped review.

“We track daily our current availability of Personal Protective Equipment (PPE), and the recommendations for use,” Partridge says. “Additionally, we have made modifications in how we provide services and how visitors access the campus. All of these measures are in place to protect our teams and community. We encourage all employees to adhere both while at work and at home to the recommendations issued by national, state, and local government.”

Carefully crafted plans address the care of Patients Under Investigation (PUIs). Partridge says the standardized workflows are based on the patient’s level of care, whether that be critical care at the hospital or self-isolation at home. Care of multiple positive COVID-19 patients within the hospital remains an area of concern for the small 25-bed hospital.

“A great amount of planning and preparation has gone into every action, and it’s still ongoing,” Partridge says. She notes that just this week, the team was searching every square inch of the facility for places to place more beds. No space is overlooked. An unused and unfinished room located in the two-story hospital was turned into a four-bed safe patient care area within hours.

As for staffing, the level is adequate at this time. The District is working closely with the American Federation of State, County, and Municipal Employees Union on staffing plans should the virus take hold of the community.

As non-essential services are scaled back, staff in those areas become available for use in others. Nurses and caregivers were surveyed to see if they would be OK to serve in other departments they were cross-trained to work in. Recently retired nurses may be considered for voluntary return to bolster staffing numbers. The dedicated care given by generations of NIHD nurses is legendary in the community.

They were also asked who would be willing to work with critical coronavirus cases. No one will be asked to step into a situation they are uncomfortable with — and to date, no one has opted out.

As for the physicians, Dr. Brown and Dr. William Timbers, NIHD’s Chief of Staff, are relying on the aid and advice of many of the District’s Medical Chiefs – Dr. Richard Meredick (Orthopedics), Dr. Charlotte Helvie (Pediatrics), Dr. Sierra Bourne (Emergency), and others. The Medical Support Staff office issued emergency credentials for other physicians in the area should their aid be required at bedsides.

The Rural Health Clinic team launched drive-in coronavirus testing well before some larger, urban hospitals did. The move was based on when the RHC offered drive-in flu shots more than a decade ago.
“Hometown health care can work anywhere, even in the big city,” Dr. Brown smiles.

Dr. Brown’s reliance on RHC Directors Paul Connolly and Jannalyn Lawrence, RN, is evident. Both work closely with the District’s outpatient clinics and played critical roles in clearing barriers for drive-in testing. When offered kudos for the work, Lawrence scoffed. “One Team, One Goal,” she says, incurring the closing line of the District’s mission statement.

Later, as Director of Nursing Partridge studies the endless worklists that paper the walls of Incident Command, she agreed with Lawrence. “Teamwork has played a huge role in managing every aspect of this situation,” she says. “This collaboration has taken place across all disciplines and has included a multiagency approach across Inyo and Mono counties. This great work truly exemplifies our mission of ‘One Team, One Goal, Your Health.’”

Meanwhile, as another day ends for the District team, Infection Preventionist Christensen is in her office. It is quiet in the usually bustling hallway; the result of the District’s temporary telework plan. Almost 80 employees are working from home, practicing social distancing.

Laying across Christensen’s desk are signs of a community lending its support to its healthcare workers: Packages of the valued N95 masks recovered from businesses and home garages, plus several handcrafted face masks. The handcrafted masks, with bright patterns of cacti, cats, and paisley, are especially touching
to Christensen.

NIHD is looking into options that could allow the homemade masks to be used as covers for approved personal protective equipment. That would occur if, and only if, NIHD’s supply of approved masks is
depleted. The covers would help keep the N95 masks free of transferred hand oils, possibly extending the life of the N95s.

“One team,” Christensen says, circling her index finger, gesturing from east to west, north to south. “It’s all of us in the community. Together, we will get through this.”

Mammoth Hospital Encouraging Social Distance After First Coronavirus Case

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?

SOCIAL DISTANCE!

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:

DO:

  1. Work out on your own.
  2. When you need to go out, do what you need to take care of, and get home.  Be efficient!
  3. Call people to talk.
  4. Get out and walk, either with your dogs or on your own.
  5. Arrange an appointment with Behavioral Health if you need help with coping or anxiety.
  6. Get outside. We could all use some Vitamin D!
  7. Email or use social media to connect with friends and family to let them know how you are and find out how they are.

Don’t:

  1. Go out to get coffee, and then stop and socialize.
  2. Have dinner or parties with friends.
  3. Socialize at the grocery store.
  4. Hug or shake hands when you see a friend.
  5. Linger after getting take-out food.
  6. Socialize on Lake Mary Road, the gorge, or in the backcountry.
  7. Have play dates for your kids.
  8. Loiter at the post office.
  9. 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