William Miller, MD
Community Outbreak Continues in Mendocino
The number of new COVID cases continues to rapidly rise throughout the county. This has significantly affected many local businesses, public services, hospitals and schools. With many children out from school, this further impacts businesses and services as parents must stay home with sick kids. Many of those parents may then, in turn, become infected. Before we get into the details, I want to remind everyone that the vast majority of people who get COVID have only mild symptoms, approximately 80% since the start of this pandemic and that Omicron seems to be somewhat less virulent so that number is probably higher now. However, because a percentage of people will still get very sick, we all need to do our part in reducing the spread of this illness.
The seven-day average for the county last week was 94.66 which is very high. This has also been reflected in the numbers from the Ft Bragg Unified School District (FBUSD). According to their website, for the months of August through December, they were averaging about 25 positive cases per month in students and staff combined. However, there have been 204 positives as of January 14th for the preceding one month. It is likely that Omicron makes up a substantial explanation for the dramatic increase in cases. Many in our community have pointed to the recent basketball tournament as a super spreader event that kicked this off. This may be true due to the large number of fans in the bleachers who were unmasked. It is always easy to point fingers in retrospect, however, to be clear the decision to have the event was one made jointly by all nine of the superintendents and it was felt that sufficient safety measures were in place.
“In the weeks prior to the tournament, we had very few cases leading us to believe that it was safe to hold the event. What we have learned is that getting people to follow our expectations around masking is very difficult. In the future, we may have to resort to not having spectators to our games at all if we can’t get compliance with this requirement,” said Becky Walker, superintendent of FBUSD. “We know this is a difficult situation and we also know that together we will get through this,” she added.
This surge in the community has led to a surge in our hospital. We have many staff who are out sick and who have tested positive. About a third of those are nurses. This is putting a significant strain on our already exhausted healthcare workers. Most of these positive staff will isolate for the standard ten days before returning to work. Where a critical shortage exists that impacts our ability to provide effective services in the hospital, we are following the CDC and state health department guidelines to potentially bring some staff back after five days of isolation. This is done on a case-by-case basis, only when there is a critical shortage or need and if done then extra precautions are taken to ensure the safety of other staff and patients.
According to a recent statewide hospital call, in addition to significant healthcare staffing shortages, many California hospitals are reporting cases of in-hospital transmission to patients. The coast hospital has not been exempted from this and is taking extra steps to address mitigation. Dr. Ramesh Nathan, our infectious disease consultant who is based in the LA area, told me yesterday that all of the hospitals he works at down there have experienced something similar. “Omicron is just so contagious that it is spreading despite all of the usual steps we have been taking to contain previous variants,” Nathan said. “This is why we are now taking extra ordinary measures to prevent in-hospital transmission. Fortunately, it does appear that Omicron is causing less serious illness,” he added.
Some of those extra ordinary measures include further limiting our already restricted visitor policy to immediate next of kin at end-of-life and parents/guardians of pediatric patients. We have canceled all elective surgeries for this week to reduce risk of exposure as well as to free up staff to be used elsewhere thus reducing the need to bring positive staff back early. We have asked that all our staff wear an N-95 while at work. We are asking that persons who come in for services such as having lab work done, have x-rays taken or to be seen in the ED wear a medical grade paper mask (which we can provide if needed) and not a cloth mask. These steps are helping us keep our hospital in a condition where we can provide the needed services to our community. The hospital, including our lab, x-ray and ER as well as our clinic, remain open. I firmly believe that the hospital and clinic remain a safe place for members of the community to receive their care.
In closing, I ask the following of all of us. Please, get vaccinated and boosted if you have not yet done so. Please, wear an N-95 or KN-95 if you will be in a crowded space indoors. Please, avoid large gatherings, especially if people will be unmasked. Finally, perhaps most important of all, please continue to treat each other with kindness and respect. Let’s face it, we are all really tired of this pandemic. However, as Becky Walker stated, “… together we will get through this.” I would add that when we look back on how we did, it should be with pride that we respected and cared for each other, truly helping us all get through this together.