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Shelter in Place Relaxes

Miller Report for the Week of June 15, 2020; by William Miller, MD.

Most of us are grateful that the Shelter-In-Place requirements are beginning to relax and, perhaps even more importantly, that the process of relaxing the requirements is being conducted in a thoughtful and step wise fashion. There is no question in my mind that it has protected us from an onslaught of cases that would have overwhelmed our health care system. There are those who scoff at this and demand to see the research that proves it worked. To them, I would say that the proof is that we are now well into June with still no COVID admissions at our hospital. A far cry from the original predictions made by epidemiologic models that by mid-May we would have as many as 80 patients in our small, 25 bed hospital.

Regardless of whether we agree on the need for such extreme public health measures, I think we can all agree that it did come at a significant financial cost. In particular, the lost revenue to our community from tourism. So, now that we are starting to relax the restrictions and tourism is starting to slowly pick back up, let’s be careful. It would be a shame to have paid such a high price to now loose any gains by going to the other extreme and refusing to wear face coverings, refusing to practice social distancing and refusing to limit the size of gatherings. COVID-19 is real and it is going to creep into our coastal community, so now is not the time to throw caution to the wind. Please, be mindful and wear your mask.

On the other hand, we should not be excessively fearful of efforts to return to some degree of normalcy either. Yes, there will slowly be more cases of infection here as a result. That is unavoidable. However, if we continue to take basic common-sense steps such as wearing our masks, washing our hands and not crowding together, the rate of transmission will be kept at a low level. This is the world we now live in and we will likely be dealing with this for at least another year or two to come. Hopefully, it will eventually burn itself out, but if SARS-1 is a good example (COVID-19 is caused by SARS-2), then it will take about that long to die down.

In the meantime, there is increasing concern that folks with other health problems are avoiding getting healthcare out of fear that they will catch COVID if they go to the hospital or a doctor’s office. A public poll conducted in May for the California Hospital Association reported that more than 40% of Californians are “not too willing” or “not at all willing” to seek care in a hospital emergency room due to fear about COVID-19. Additionally, 37% said they were reluctant to seek inpatient and outpatient hospital services for the same reason.

This is concerning because people with non-COVID health problems might experience unnecessary worsening of those conditions as a result. Our hospital, our ER and clinics (both North Coast Family Health Center and Mendocino Coast Clinics), carefully follow all the CDC guidelines to protect our patients and staff from transmission of COVID. Our lab and x-ray departments are fully open for services. We are working on re-opening our surgical services and this week resumed performing colonoscopies and injections for chronic pain.

Another important change that the relaxing of Shelter-In-Place mandates are allowing is for us to start allowing visitors to come see patients in the hospital again. This is such a crucially important step in the healing process. As with other steps towards normalcy, we will have to do this in a stepwise fashion starting with allowing just one visitor at a time and between the hours of 1:00 PM and 8:00 PM daily. Patients at end of life can have up to six family members as visitors.

Thank you all for your patience and support of our hospital, clinics and healthcare providers.

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