William Miller, MD
Local COVID Update
Miller Report for the week of April 13, 2020; by William Miller, MD.
The most important news this week is that we remain without any new cases in the County beyond the first four of a couple of weeks ago. We still have not had any COVID patients admitted to any of the three hospitals thus far. The County Health Department has also expanded testing to the most vulnerable populations in our community. They have now tested 29 staff and residents at Sherwood Oaks, our local nursing home, and as of this writing 17 are negative with the remaining 12 still pending. The County also tested 28 people at Plowshares, the homeless shelter in Ukiah, all of whom were negative. Mendocino Coast Clinics has done 7 tests with 6 negative and one pending. Here at our hospital, we have tested 21 patients and 3 staff, all negative as well. While this may not seem like a lot of tests, it is still significant because all of these tests were either in high risk populations and /or people who had symptoms that could have been COVID. These results, along with the fact that we have not seen any sick patients with the disease, suggest a very low prevalence of the infection here on the Coast at this time. This will likely change once Shelter-in-Place restrictions are loosened, however, we are certainly in a better place now to handle cases that may come to us and at this point, I expect that the numbers will be manageable when that happens.
Our hospital remains on track to affiliate with Adventist Health on May 1st. The COVID crisis has already given us several opportunities to build good relationships with our colleagues in Ukiah and Willits. We have been in frequent communication exchanging ideas, information and protocols. We have shared with them some of our COVID sampling kits (used to get the sample, but not run the test) and they have recently sent us a supply of face masks in return. Ukiah and Willits both now have a small supply of COVID test kits (used to actually run the test) and are running same day COVID tests for us to use for admitted patients and symptomatic health care staff. We expect that to increase in the weeks to come following the affiliation and as more test kits become available.
We have been successful in preserving our supply of N-95 respirator face masks, which will be crucially needed if and when we get any appreciable number of COVID patients. We received a shipment from the State of 1,000 masks to add to our exiting supply of 4,000. While that number may seem like a lot, it is just sufficient to get us through a modest influx of COVID patients, which is what we are expecting.
We have been receiving donations of homemade cloth facemasks from the community and this has been very helpful as we are using them in low risk settings and that is helping us preserve our remaining medical and surgical face masks, which are running low. We can use more of those cloth masks and we also know that Sherwood Oaks and MCC would appreciate them as well. If you are going to make them, there are a lot of patterns on the Internet. The best fabric is a higher thread count of 600 or above, and it should be double ply. Try out the fabric by attempting to breathe through it doubled over and see if it is easy to breathe through or not. Also, avoid fabrics that have a lot of lint. Consider making them in different sizes and with some that have ear loops while others have head bands or tie strings. This is helpful in folks finding a mask that fits effectively and comfortably. A pocket in between the two layers is nice so that filter paper (such as a coffee filter) can be inserted for added protection. A wire to help form the mask over the bridge of the nose reduces fogging up of glasses and face shields. Lastly, while wild colors and patterns are fun, please make at least some of them in tamer colors and without patterns for those of us who wish to make a subtler fashion statement. But, hey, thank you so much for whatever you provide!