Liz Powers

Elizabeth Powers, M.D.

The COVID-19 pandemic has suddenly and drastically impacted most aspects of our daily lives, even here in Wallowa County. As much as we might want to cut ourselves off from the rest of the world, it is likely that we will soon have COVID-19 in our community. Your entire healthcare team – from those answering the phones, to those helping you during clinic and hospital visits, cooking meals, and keeping things cleaner than ever – everyone is committed to caring for you, now, as always, even as they run the greatest risk of exposure.

Despite the focus on COVID-19, there is still much we don’t know about the virus, and that uncertainty makes it harder for us to know how to respond and how best to protect our community. In particular, we still don’t know how infectious this coronavirus is (likely about twice as infectious as the seasonal flu), or how many people are “silent carriers” with no symptoms. Information to date suggests that COVID-19 is less deadly than prior novel coronavirus infections (SARS, MERS) and has a mortality rate closer to that of the 1918 flu pandemic. While the vast majority of COVID-19 infections are not serious, some infections are serious enough that patients require life support. And some, often with prior complications, have died.

What we do know is that healthcare systems in our country and around the world are being overwhelmed by the number of patients needing care during a surge. A surge is when a large number of people get infected at the same time. Most of them don’t require medical care, but when those who do all need care at the same time, it can overwhelm existing healthcare systems.

With that in mind, our Wallowa County healthcare community has made extensive preparations for a possible surge. We have an Incident Command Team, led by Stacey Karvoski, which is already organizing and actuating our surge plan. We have systems and structures in place (including a tent in the ED parking lot) that will help us take care of different types of medical emergencies. For example, if you are having a heart attack, you’ll likely find yourself in the “usual” emergency room, whereas if you fall and cut your arm, you might find yourself getting stitched up in your primary care clinic (during business hours), or in outpatient therapy (in the evenings). If you have symptoms of coronavirus infection, you will likely be examined in your car (yes – curbside service at the Emergency Department) or in the tent. At our hospital, we do not routinely keep patients on life support (these patients usually transfer to an ICU in a bigger hospital); however, we do have the skills and equipment available when needed.

As this pandemic continues to evolve, so does our planning. Our incident command team meets two to three times daily, continuing to optimize our local response. Equally important, our community providers meet daily to coordinate care and to review any new clinical evidence related to COVID-19. In this way, our care for acute and chronic health conditions is consistent across all local clinics, and we collectively stay current on the ever-expanding data related to diagnosis and care for COVID-infected persons.

Some epidemiologists project that resource use at the hospital will peak near the end of April. While we plan for the worst, we continue to actively encourage steps that will set us up for a “best case” scenario. The actions we take collectively over the next three to four weeks will dictate whether or not we’ll be able to “flatten the curve” and avoid a surge in very ill patients. These actions include our “no visitors” policy on the medical campus (including the hospital and clinics), our screening of all patients and employees prior to entering all healthcare facilities, and our advocacy for strict adherence to social isolation strategies. Following these recommendations will help protect our most vulnerable community members, and all of our healthcare providers and staff.

We greatly appreciate all the ways you are demonstrating that you’re are here for us and for each other. We have been moved by the overwhelming outpouring of support for our healthcare team and for our vulnerable friends and neighbors – the offerings of food, transportation and supplies (including those of you donating and making masks) have been greatly appreciated. Thank you for your generosity and kindness. Your Wallowa County healthcare team is prepared. We have planned and trained for an event like this, and we are here for you. I am confident that we will get through this together.

Mountain Medicine is edited by Ron Polk with contributions from Wallowa County medical practitioners.

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