Tag Archives: covid-19

Mammoth Hospital Sees First COVID-19 Hospitalization Since March

COVID-19 Positive Patient Hospitalized at Mammoth Hospital.

Mammoth Hospital has hospitalized its first patient since late March due to COVID-19. While the Eastern Sierra has seen relatively few infections over the last few months, the pandemic continues to be a threat to Mono County. This patient is now hospitalized and being treated for coronavirus.

“This new hospitalization is a reminder that the pandemic is still a very real crisis, on both a local and global level,” says Mammoth Hospital CEO, Tom Parker. “Many restrictions have been eased and we have seen a reopening of many businesses, giving us a sense of normalcy. Mono County’s ‘Stay Safe to Stay Open‘ campaign speaks to the need to stay vigilant in our efforts to cover, distance and wash. We have seen a significant increase in the last two weeks in the number of people testing positive for COVID-19. This is not the time to let our guard down. Mammoth Hospital has taken great steps to prepare for a surge of COVID patients, and we remain prepared to care for anyone who presents to our facility.”

Northern Inyo Hospital is Running Low on COVID-19 Tests

Interim Chief Medical Officer, Dr. Will Timbers and Chief of Staff, Dr. Stacey Brown held a press conference Friday afternoon to discuss the current situation relating to the COVID-19 pandemic at Northern Inyo Healthcare District.

Nothing major has happened this week according to Dr. Brown, which is something he is relieved about. “I am super happy that we don’t have anything earth shattering to report on today, which shows that we are doing what we can to put a lid on this thing,” Brown remarked.

The discussion shifted toward antibody testing, which is being offered to essential workers throughout the community. “I think we are getting some traction finally on the testing front. I believe we will expand our net of antibody testing before these tests expire on the twenty-fifth of this month. Personally, I have signed off on eight to ten tests for my patients in the past few days. We will hear from our Director of Diagnostics, Larry Weber on how many tests have been administered by next Wednesday,” Brown said

Though antibody testing is available for many in the community, the same can not be said for the hospital’s supply of nasal swabs that detect active COVID-19 infection.

Northern Inyo Hospital has a short supply of PCR nasal swabs due to the rise in cases throughout the United States.

Dr. Timbers remarked that the supply chains are starting to waver, which has made it more difficult for the hospital to acquire testing kits. The Chief Medical Officer said, “We are down to twelve tests, so we will likely run out of them in the next few days. We will be receiving more of them in the next 5-7 days. The reason for a lack of tests goes back to the conversation at beginning of pandemic. We need to have systems in place, so when we do have a crisis situation we can respond accordingly.”

Inyo County Potentially “Sitting Ducks” for Next Wave of COVID-19

Northern Inyo Healthcare District has good and bad news pertaining to COVID-19. The hospital has conducted 279 antibody tests for its employees, and discovered that only two individuals out of the 279 tested had antibodies to the coronavirus.

Interim Chief Medical Officer, Dr. Will Timbers talked about the widespread testing saying. “279 employees have been tested and only two people have tested positive so far, which suggests we are somewhat of a naive community.”

The lack of exposure is a double edged sword. Though it is positive that coronavirus has not had a large presence in Inyo County, it could be problematic down the line since the community cannot rely on “herd immunity.”

The employee antibody test that has been distributed to nearly three-quarters of the healthcare district’s employees is likely a safe measurement when it comes to assuming that the general population does not have a large amount of immunity. “This is a warning sign as we reopen and recirculate. We shouldn’t kid ourselves that we have herd immunity in the community.” Chief of Staff, Dr. Stacey Brown said. “We are sitting ducks for another wave of infection just like we were in February and March with the lack of herd immunity.”

Both Dr. Brown and Dr. Timbers both acknowledged that the community cannot be shut down for forever. However, Dr. Timbers believes that a fine line must be walked when it comes to reopening. Timbers said, “We are going to need to find a steady state between opening things up and living our lives.”

Bishop Union High School Prepares for Unorthodox Graduation

The 111 graduates from Bishop Union High School will get the chance to receive their diplomas from BUHS Administration over the course of three days next week. Though there won’t be a traditional ceremony in light of the COVID-19 pandemic, students will get the chance to drive to the high school’s parking lot with their family members and receive their diplomas.

This makeshift ceremony will be taking place starting May 26, 2020, until May 28, 2020. A maximum of four family members will be allowed to accompany the graduating seniors.

Graduating seniors will be assigned a specific time to pick up their graduation certificates on one of the three aforementioned dates. There is no specific time relating to when the celebration will start each day, but it will be some time during the evening.

During the three day ceremony, students will be filmed receiving their high school diplomas. After all of the footage is compiled, the high school will post it online for the general public to view on June 5th, 2020.

Northern Inyo Hospital Update: Dr. Brown Implores Public to Wear Masks

Rural Health Clinic Director for Northern Inyo Hospital, Dr. Stacey Brown, spoke to the media on Friday, May 15, 2020, and provided the latest on how hospital is managing in its fight against the COVID-19 crisis.

Brown said that the hospital has the capability to test almost anyone who is feeling symptomatic. “The vast majority of people we test are relatively healthy. However, there are some symptoms people show, and we will test them for coronavirus. If someone has a subjective fever, we will test them. The bar is low for testing,” Brown remarked.

Though there is a low requirement when it comes to a person receiving a COVID-19 test, the bar is still not low enough for an asymptomatic person to be tested. Brown said, “We can’t do testing for asymptomatic individuals; it is just not possible at this time.” The reason it is not possible to test those who do not show symptoms is because there are not enough tests available.

It is no secret that the United States is behind the curve when it comes to administering tests compared to some other countries in the world. Brown gave an explanation as to why acquiring a sufficient number of tests has been so difficult at a federal, state, and local level.

Brown said, “There are so many factors involved when it comes to lack of testing. I think we underestimated the impact that COVID-19 would have. It is what it is though, and we have to deal with what we’ve got.”

With that being said, Dr. Brown believes Northern Inyo Hospital will catch up when it comes to having sufficient testing. “I am a cautiously optimistic person. With the amount of regularity that we are getting relating to antibody testing and nasal swabs, things seem to be much more secure now. We aren’t getting much extra testing, but we are receiving tests, which makes me more comfortable than where things were a month ago.”

The discussion shifted toward the importance of wearing a mask when going into public. On Friday, May 8, 2020, Inyo County Public Health Officer, Dr. James Richardson issued a mandatory face mask order for all Inyo County residents who are out in public. When speaking about the mask order, Brown expressed approval for business owners not allowing individuals to enter their businesses without a mask. “I am happy that a lot of the places that are essential businesses have not been allowing entry to customers who do not have masks on,” Brown remarked.

Though appreciative of the public’s efforts in complying with the mandatory mask order, Brown said he has been seeing a lot of masks with valves on them, which defeats the point of even wearing a mask in the first place. “If you go back to why we are masking in public, it is not about inhaling the virus, it is about spewing virus,” Brown said.  “One-way exhale valve masks are not the tool for what we call source control. Folks come into the district wearing these valve masks, and they are still asked to cover up when they come into the district. It is not doing the job,” Brown said.

Brown thinks it is necessary that the county provides a way of enforcing the public health order issued by Dr. Richardson. “There has to be some teeth on it [the facial cover order.] We need to trust people to do right thing, but verify that they actually are. There should be mechanism or hotline that the public can call and report businesses who are not complying with the order. There has to be threat of a shutdown or a fine if people do not listen,” Brown said.

Inyo County Has First Coronavirus Death

INYO COUNTY, April 24, 2020 (5:00pm) – Inyo County’s Public Health Officer, Dr. James Richardson, received notification late afternoon from Northern Inyo Healthcare District regarding a COVID-19 positive patient fatality. This is the first death in Inyo County associated with COVID-19.

“It is with great sadness that I share this news with the public,” stated Dr. Richardson. “Everyone in the local medical community extends their most sincere condolences to the patient’s family and friends.”

Inyo County has had a total of 19 COVID-19 cases confirmed, with 13 recoveries. Of the 247 tests administered to date, 17 tests are pending, and 211 have been negative.

It is essential that the public practice preventative measures, such as avoiding contact with sick individuals, washing hands often with soap and warm water for at least 20 seconds, practicing social distancing, wearing a cloth face covering when in public and adhering 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.

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.

Mono Public Health Officer Orders All Essential Workers to Wear Masks

April 13, 2020 – Effective immediately, all individuals working in essential sectors throughout Mono County and the Town of Mammoth Lakes are required to wear a face covering or mask to reduce the chance of spreading COVID-19. Under Governor Newsom’s Stay At Home Order issued on March 19 2020, only workers in essential sectors should be currently working and this order applies to all, from essential retail operations, construction, utilities, medical, food service, etc., to public safety and government personnel.

Physical distancing and staying at home is the most effective way to control the spread of COVID-19, and it is working both locally and across the state. Mono County experienced a dramatic 55 – 70% decrease in the average mobility (based on distance traveled) of residents during the past few weeks that has drastically new infections. Masking or wearing cloth face covers is expected to further diminish the number of new infections, primarily by reducing the spread by infected people who have no symptoms. The CDC states that about twenty-five percent of people with COVID-19 have no symptoms.

LOOKING AHEAD

Mono County Public Health Officer, Dr. Tom Boo, anticipates issuing a follow-up order requiring everyone to cover their nose and mouth with a face covering when in public, which should go into effect before the Stay At Home Order expires.

We anticipate masking to become our new normal in the time of the pandemic, and that physical distancing and other mitigation must continue even after the Stay At Home Order is lifted. We are experiencing some respite, but we are clearly not out of the woods yet. You may say we have a bit of a cease fire, but the war is not over,” stated Dr. Boo.

Dr Boo further stated that “The virus is still out there and can be expected to rebound with diminishing physical distance measures and vigilant hand washing, as we try to get more people back to work. We cannot eliminate the virus without a highly effective vaccine. When we move into the next phase, some social restrictions must stay in place. We are still a long way from being able to go back to normal life.”

In anticipation of the continued spread of the virus through Mono County and the impacts to our residents, the Health Department has increased staffing levels. The Nurse Hotline, accessible by calling 211, combined with improved testing capacity will be essential to our combined efforts to identify people affected by COVID-19. In addition, Mammoth Hospital continues to work with public agencies to coordinate hospital care with follow-up monitoring and patient support at home. A primary area of focus for Mammoth Hospital and medical teams across the country is the expansion of testing for quick results to know if someone is ill and antibody testing to know if some has already had the disease. To determine the effectiveness of these aggressive mitigation measures, the Mono County IT Department has built a new database for tracking cases that will greatly enhance a well-coordinated response enhancing our level of patient and family care

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.

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