Before they are allowed to enter the Wallowa Memorial Hospital’s walk-in ER entrance, patients will be evaluated for COVID-19 symptoms in the new yurt that has sprouted at the hospital’s parking area next to the ambulance entrance. Patients who use the walk-in entrance will use a phone in the vestibule between the first entry door and the inner door to contact a provider who will assist them.

More than 200 people have contracted coronavirus in Oregon and with the virus slowly making its way into Eastern Oregon a local case of the virus becomes a greater possibility. To date, 8 people have been tested for coronavirus. Only one test result has come back so far and it was negative for the virus.

The hospital hotline number for coronavirus and COVID-19 questions is 541-426-5475. If the messages on the hotline do not answer the caller’s questions, they can leave a message. A dedicated staff person will check the messages regularly and respond accordingly.

Wallowa Memorial Hospital, one of the top ranked critical access hospitals in the nation, has put nearly all its resources into preparing to combat a possible coronavirus outbreak. Brooke Pace, the hospital’s public affairs officer, explained the preparations made by the hospital and its clinic, Mountain View Medical Group. Winding Waters Community Health Center physicians are also a major part of hospital and community response in planning for COVID-19 response, said Nic Powers, director of Winding Waters.

One of the differences between the hospital three weeks ago and now is a “no visitor” policy with the exception of OB patients, end-of-life situations, etc. The cafeteria is also closed to the public.

Pace emphasized that the hospital and all the local medical clinics are working together to prevent, and/or treat an outbreak. Now, every person who enters the campus is screened for a potential health issue, which includes all patients of both the Winding Waters and Mountain View clinics, all patients coming to the hospital and visitors who qualify under the exceptions. Hospital staff are not exempted.

“Before entering this building, you will have your temperature taken and recorded,” Pace said. “Anyone with a 99.6 temperature or above will not be allowed into the building and be instructed to contact their primary care provider for further instructions. The thought process behind all of these changes is to continue to keep the hospital campus healthy and a safe place for people to be.” The ER has a similar procedure, and asked walk-in ER patients to be evaluated in a yurt set up outside the ER entrance.

While the virus has caused a number of people to be laid off from their jobs, hospital employees will not suffer the same fate. WMH Chief Executive Officer, Larry Davy, did not mince words on the subject, as he said that as long as the hospital has financial resources, no layoffs will occur.

“In a patient surge the hospital could be easily overwhelmed, and we’d need all hands on deck,” he said. “Departments that have reduced workloads will need to help those departments that are beyond staffing capabilities. A layoff would put our community at risk in accessing timely health care. Our primary focus will continue to be on what is best for the community.”

In order to allay virus concerns of the county’s citizens, the hospital is using every means of communication it can. This includes the Chieftain, the radio station and Facebook. The most encompassing outreach was an emergency meeting held by the Wallowa County Preparedness Committee that includes everyone who deals with the at-risk vulnerable population.

That includes all the primary care clinics, Adult Protective Services, the Center for Wellness, Senior Living, Joseph House, River House, Community Connection law enforcement and other government agencies. All the entities are working together to protect the community.

Pace responded positively when asked if the hospital, Mountain View Medical and Winding Waters staff are meeting regularly and getting extra training.

“Absolutely, we have an incident command set up right now where we are all meeting daily as a larger group and three times throughout the day addressing the current situation and doing staff planning reviewing where we are in terms of the policies that will guide us through the next stage of this pandemic,” she said. “This type of training is ongoing for us; we already had plans and policies in place, and now it’s making sure everyone is aware of where we’re at in that plan and what the next steps are.” She added the hospital has four levels of planning that include levels from no cases in Wallowa County to an over surge in the hospital.

Although the hospital is not offering training specifically aimed at home caregivers, Pace emphasized that the training for Covid-19 for this time is essentially the same as standard precautions for any infectious disease, which every home caregiver should be up to speed on. She also said that the Oregon Health Authority has a very thorough guideline for home caregivers to protect themselves and clients.

At this point, the hospital cannot do in-house testing for coronavirus; however they expect the kits to arrive in the near future. Pace cautioned they expect the in-house tests to be gobbled up quickly.

Despite rumors to the contrary, Wallowa County has tested eight patients for the virus. While seven are still awaiting results, one returned negative.

With TV news rife about the lack of personal protective equipment (PPE) Pace assured the Chieftain that the hospital is on top of the situation.

“That is certainly something we are monitoring very closely and continuing to stay ahead on,” she said. “At this point in time we feel very comfortable with the amount of our PPE.” She added that government mandates to large companies to focus production on PPE will help alleviate any upcoming shortages.

Lastly, Pace addressed the issue of the possible lack of beds if enough people came down with the virus. She said that the hospital had a plan to address such an event long before the coronavirus appeared on the scene.

“We have a plan called a surge plan, meaning a surge on the hospital that would utilize the entire campus in a way that will keep patients safe,” she said. “At full capacity, we have the ability to double the number of beds we traditionally have available.” She added the hospital also has a contingency plan that includes contracts with off-sight locations in case those 50 beds are filled.

Over at Winding Waters Clinic, spokesman Nic Powers said that the staff is busier in a different way than three weeks ago. Thanks to the coronavirus, curbside visits have ramped up dramatically.

“We’re taking care of people with symptoms of infectious diseases whether it’s flu or RSV (Respiratory Syncytial Virus) or maybe Covid out in their cars at the curb,” he said. “We are taking the temperatures of all patients coming into the building. If they have a fever, we’re asking them to go into the back for the curbside visit, so they’re not accidentally exposing staff or other patients to an infectious virus.” He added the clinic has taken staff temperatures for well over a week to make sure they are healthy or they go home if they display symptoms.

Powers said that testing capacity is extremely limited. Although the clinic has sent off tests, they’ve gotten no coronavirus confirmations back.

“”We’re adapting,” he said. “We’re now only basically open for urgent or emergency care – anything we need to do in person, medical or dental.”

The clinic is also making great use of telehealth services, so that anyone who wants to speak with a provider can do so.

“People can at least get advice that way, and if there’s anything to show us in a video image, we can see how they look and decide how to help them.

Home visits are something else the clinic offers for their most vulnerable people who are homebound and are advised not to leave their home because of age or medical condition. The clinic has a provider who daily goes out on these home visits.

The Winding Waters staff wishes that it could be open for more routine care, but the clinic is following the latest state guidelines, which is discouraging physical interaction as much as possible to lessen the possibility of spreading germs.

“We’re still here and still open for people that need us and very much part of the planning and response in association with Wallowa Memorial Hospital, Mountain View Medical and other providers in the community,” he said. “There’s definitely a coming together of the medical and health care community in the county.”

Winding Waters has yet to lay off any employees and hopes it doesn’t happen. Powers said that the clinic plans to keep everyone useful and busy. Some of this is done by repurposing some employees from their normal duties. He said that although cash flow has taken a hit, he’s also hopeful of getting some emergency funding from the federal or state government that will help the clinic get through this rough patch and keep people employed and taking care of patients.

Like the hospital, the clinic is getting plenty of calls, most seeking advice and some with concerns that the county already has a case. The clinic makes an effort to keep a unified voice with the hospital and other clinics.

Powers suggested that those with a temperature of 99.6 or higher should quarantine themselves to see if the fever moves up or down in coordination with their health care provider. He advised citizens who live in remote areas with spotty internet to call either their primary care physician or pick one of the clinics to find one.

Other advice included home caregivers wash their hands often and find a replacement if they themselves exhibit symptoms.

“Our most vulnerable folks are those over 60, especially those with other conditions, especially respiratory conditions like COPD, asthma or emphysema,” Powers said. He added those with auto-immune disorders are also at risk.

He noted that Dr. Elizabeth Powers from the clinic, along with Jenni Word, the hospital’s chief nursing officer, are working in tandem on public outreach, including the Chieftain, radio, Facebook and the the phone.

Although the clinic has some concern about running low on personal protective equipment, he noted that the hospital is the health care emergency manager, and they advocate for all county providers to get PPE supplies and distributing the supplies depending on need. He added that he had heard that morning (March 19), that because the county has no confirmed cases, it has a lower priority for the state response.

“I know we have enough to last the next couple of weeks,” he said. “Beyond that, who knows?”

Over at the Olive Branch Family Health Inc. clinic, Theresa Russell, a Family Nurse Practitioner and the clinic’s owner, said things have been busy since the outbreak.

In the last three weeks the group is taking universal health care precautions with everyone who comes into the clinic.

“It reminds me back in the day of AIDS, back in the ‘80s when it first came out,” she said. “We came out with these universal precautions and everyone was real careful. This is reminiscent of that although it’s a totally different disease, of course.”

The clinic is taking special care with their immune-compromised clients and the elderly. Health care providers are setting up more home visits and being and are being careful to preserve personal protective equipment, such as face masks, gloves and gowns.

“We are keeping up on supplies, but we haven’t had an epidemic,” she said. “That’s the key: We’re using good judgment, but we’re not going to know until and unless — hopefully we won’t have an epidemic here.”

Olive Branch personnel have not experienced any layoffs, but it is a possibility if the clinic experiences many low-volume days.

Russell said that those things are something many don’t think a lot about. The clinic is making an effort to provide the care their patients need within a safer environment and in safer ways. She advised everyone to get a flu shot and to practice regular hand-washing. Russell also suggested people check the CDC web page or a trusted medical professional rather than Facebook for Coronavirus information.

“There’s so much misinformation out there that it makes me want to scream,” she said. “We welcome those phone calls because we’d rather inform our patients of the truth.”

The clinic is flooded with phone calls that last week, kept a nurse busy for two full days. The most common phone questions ask if the clinic is open; if the county has a case of Coronavirus and asking how they can get seen. The clinic is also part of the health-care provider group that meets to discuss responses to the virus.

The clinic has tested for flus, but not for Coronavirus. Russell explained that the clinic has to get permission to test for the virus, which includes a two-page online CDC form. From there, the state’s lab will decide if the patient warrants testing.

“We need to test more people,” Russell said. “We need to test everyone with an upper or lower tract respiratory infection. Until that happens, we aren’t even going to know how this is going.”

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