William Miller, MD
The First Miller Report
Miller Report for the week of March 23, 2020; by William Miller, MD.
At this time, we have our second identified case in our County and still no patients at any of our three hospitals. We do expect that to change over the next week or so. The most important strategy remains “flattening the curve”. By asking people to shelter-in-place, practice social distancing and frequent hand washing, we want to spread out the number of sick patients in hospitals at any one time. If we do this successfully, then we predict that our hospital will be able to manage the expected numbers of patients. So, thank you all for staying home and only going out when essential.
As you probably already know, this pandemic has caused a national shortage of medical supplies, medications, ventilators and protective garb for health care workers. The companies that normally supply us with such items are on back order for most of these items. So that we are better able to keep our staff healthy and safe, we are calling on all members of the community to donate any face masks, N95 masks, exam gloves and disposable gowns/aprons that you might have stored away, such as when you bought those N95s for the smoke from the fires last year. You can bring donations of such supplies to the hospital south entrance.
Since our hospital used to be a 40+ be facility, we are working on bringing in more beds to increase our current number from 25 up to about 45. We are also examining ways to dedicate areas of the hospital specifically for COVID-19 patients. We are ordering more ventilators, however, these are perhaps the one thing that is in least supply nationally. We do have the ability to increase our current ventilator capacity in a pinch if it comes to that.
In keeping with national recommendations from the CDC, we are limiting COVID-19 testing to patients that are being admitted to the hospital and to health care workers. This is to conserve the transport medium needed to run the test, which is in short supply. We are using Quest to run the test, which is a send out. The turnaround has been from 5-9 days so far. Two tests have now been approved by the FDA for hospitals to use in their own labs for COVID testing. One is the Bio-fire assay and we already have the analyzer machine to run that test. The other is the Cepheid test. We do not have the Cepheid machine, but they do over in Willits. Neither test is available yet and is not expected for several weeks, perhaps as much as 8 weeks out. When we have that test, we may be able to broaden the scope of who we can offer the test to.
Also, following CDC guidelines, we are restricting traffic into the hospital and we are checking the temperature of everyone who enters including doctors and nurses. We have also canceled all non-essential elective procedures so as to conserve limited resources. We appreciate your patience as we need to implement such measures.
All of us at Mendocino Coast District Hospital are working very hard and long hours to prepare for when we have our first patients here. We want you to be reassured that we are doing everything possible to get ready and to also continue to care for all of the other patients that we have.