Healthcare Heroes and Lessons Learned
Miller Report for week of May 18, 2020; by William Miller, MD.
I am happy to report that as of today we can conclude, with a high degree of confidence that we have no evidence of community spread of COVID-19 here on the Coast and certainly no outbreak in Mendocino Coast District Hospital. We have tested 153 people; 124 staff and 29 patients. So far, 139 are negative, zero positive, with 14 still pending. Our testing strategy was based on doing internal contact tracing and identifying individuals who might have had a moderate or high risk exposure. This is what we recommended, but we went a step further and expanded testing to include low risk exposures as well. Community staff and patients, who had no exposure were not tested. Equally important, I am happy to report that the initial staff member who did test positive is recovering well. We learned several things from this experience.
First, we learned that the processes we have in place at the hospital to prevent transmission of COVID-19 worked very well. Having everyone, including staff, patients and others, all wearing a mask really was effective. I believe that our hospital is a very safe place to work and to get healthcare. I encourage people who need our services to not be fearful and to come forth and get the care that they need.
Second, the majority of the 153 are local residents. This sampling, coupled with the 80 or so negative tests done previously for other reasons, including those done as screening tests through MCC, are a sampling of the Coast. While we still desire to do more broad screening, these negative results, coupled with the fact that we are not seeing any patients sick with COVID, reinforces that we have a very low prevalence. This is useful information to help guide public health decisions for our city and county leadership as to how and when to begin to roll back shelter-in-place.
Next, it was good practice for us on how to investigate a potential outbreak and perform contact tracing. That is not something that we get to do every day and from an infection prevention standpoint, is valuable experience. Also, it helped us to examine our policies and procedures around screening of staff, including those that may travel here from farther away. We have made changes to such procedures as a result.
Lastly, we learned that the old adage that times like this bring out the best of people and the worst of people is true. The majority of our community has been wonderfully supportive of our hospital and our healthcare workers. However, we also experienced a few of our travelers receiving threats from members of the community. This is a sad note and I know that is not the face of our community that we wish to present to the rest of the country.
I feel that there is a lot of misunderstanding around having staff, including physicians, who work for us while calling somewhere else home. The simple reality is that most rural hospitals in the US are not able to draw from their own communities to completely staff highly specialized roles. Since only a small percentage of the community is currently trained in healthcare, we draw from staff that live elsewhere while we recruit to meet our local needs. Yes, that comes at a premium, however, the benefit is beyond just filling positions. Travelers bring a breadth of experience from having seen how things are done elsewhere that is extremely valuable.
These people travel here, leaving behind their homes and families, to help us out. At a time like this, with the challenges of COVID constantly looming over us, all of our staff are heroes, regardless of where they call home.