Coronavirus Regional Response Update

15 Mar Coronavirus Regional Response Update

Representatives from multiple local and regional agencies just met for continued strategic planning for the likely arrival of coronavirus (COVID-19) to San Miguel County. For further information, go here. For the latest from the Telluride Med Center, go here.

Dr. Sharon Grundy

Efforts are focused on infection prevention and control measures, including frequent hand-washing, staying home when sick and cleaning surfaces.

If and when the virus arrives in our county, local agencies are prepared to initiate containment strategies which include infection control and mitigation. Colorado State Health Officials late Wednesday issued new guidelines to healthcare and EMS providers for the use of “personal protection equipment” (PPE).

Please do not be alarmed if you see providers wearing PPE such as masks, goggles and gowns. There are a limited number of healthcare and EMS providers and want to keep them safe to help continue to help provide care to you.

While there is a lot of information health officials do not know about this coronavirus. What is known, however, is that for most people, symptoms are mild and will not produce more than typical respiratory-illness symptoms such as fever and cough.

Currently no state in the U.S. is considered by health officials to have widespread virus activity, and there are just over 100 cases in Colorado. State officials caution however, that they expect that to change in coming days and weeks.

A reminder, it is not too late to get your flu vaccine. While the vaccine offers no protection against the coronavirus, it does offer some protection against the flu, which is a lot more widespread locally and nationally.

Our county recognizes the public concern and is working hard to keep you informed in a timely manner with transparency. As always, your public health and safety is of paramount importance.

Coronavirus (COVID-19) Testing Update

San Miguel County medical centers including the Telluride Regional Medical Center and the Uncompahgre Medical Center now have the equipment needed to perform coronavirus (COVID-19) testing and are working on safety procedures to perform the tests and keep staff safe.

At present, there are no confirmed cases of coronaviruses in San Miguel County or Colorado.

Please note: Testing is not necessary if you simply have a cough or have travelled to a country or region on the CDC’s list of affected geographic areas.

Testing may be recommended by your physician based on CDC and Colorado Department of Public Health & Environment protocols which require one of the following scenarios:

a) Fever or respiratory symptoms and recent close contact with a confirmed COVID-19 patient.

b) Fever or respiratory symptoms, without alternative explanatory diagnosis and a history of recent travel to the CDC’s list of affected geographic areas.

c) Patient is hospitalized with respiratory illness, e.g., pneumonia, acute respiratory distress syndrome (ARDS), and without alternative explanatory diagnosis.

Telluride Medical Center Prepares for Coronavirus/Telluride:

As the nation braces for what could be the first pandemic since the 2009 H1N1 outbreak, local health workers at the Telluride Regional Medical Center are preparing for novel coronavirus COVID-19 by solidifying protocols, compiling preparedness public service announcements, expanding telehealth capabilities and above all urging the community to use common sense hygiene practices.

Dr. Diana Koelliker

“At this point there’s no immediate risk, but to ensure we’re ready, should the situation change, we’re holding regular meetings to determine the best ways to offer care to those suspected of exposure,” said Dr. Diana Koelliker, director of trauma and emergency services.

Recently the World Health Organization said that while it is too early to call the COVID-19 outbreak a pandemic, countries should be “in a phase of preparedness.”

“What we do know is that more than 80 percent of the cases reported are not severe and the symptoms look a lot like Influenza, which at this point is a far greater threat to our population,” said Dr. Koelliker. “We don’t want the community to worry so much as we want them to be prepared.”

In addition to what the CDC recommends for preparedness — stocking up on food, hydrating drinks and both prescription and over the counter meds — local doctors caution there are additional considerations for those living at altitude.

“We’d like every household in this community to own a thermometer and a pulse oximeter,” said Dr. Grundy.

An oximeter attaches to a finger to measure oxygen saturation levels, or the oxygen levels in blood. These devices are inexpensive but can be instrumental in determining someone’s pulmonary health at elevation.

“At altitudes like that of Telluride’s, normal oxygen saturation levels stay between 90 and 93 percent, when oxygen levels drop below 88 we know it’s time to see the patient possibly for a chest x-ray or to be monitored,” said Dr. Grundy.

Having a community that is prepared and informed can make a big difference.

The doctors do report there has been an uptick in calls this week from patients who want to know if they should still take their off-season vacation.

“We can’t stress this enough, the CDC is going to be the best resource for everyone — including us,” said Dr. Grundy. (Visit CDC.gov)

Additionally, Colorado Department of Public Health and Environment has a hotline for coronavirus questions: 303-389-1687.

Another question the Med Center is hearing: Is there a coronavirus test patients could take?

“There is absolutely no ‘rapid coronavirus test’ at our clinic,” stressed Dr. Koelliker.

In fact, according to Dr. Koelliker, there is an extensive CDC protocol with multiple qualifying factors that must be met to even warrant a test.

“The availability of the rapid test is likely to improve over the coming weeks, the Colorado Department of Public Health now has the test available, but we will not have the test in San Miguel county for the foreseeable future because of our limited lab capabilities.”

If you think you could have been exposed to coronavirus — as in you’ve recently traveled to a place where outbreaks have been reported, or have had close contact with someone else who has — and now have a fever, cough, and shortness of breath, the medical center would like to hear from you.

“By phone,” said Dr. Grundy.

Should the virus spread to the region, one tactic the medical center may utilize is telehealth visits.

“There are a great number of patients who can be adequately cared for via telehealth visits,” she said. “If the novel coronavirus spread escalates, our telehealth portal will allow us to safely reach out to patients.”

Established patients of the Medical Center need only a smartphone or computer, a connection to the internet and have signed a consent form to participate in a telehealth visit.

“Our biggest challenge, as a small isolated clinic, will be our capacity and limited resources,” said Dr. Grundy.

Ultimately, it’s conventional wisdom that the doctors want to drive home: If you are sick, stay home from work or school. Stay away from others that are sick or coughing.

“Wash your hands. Wash your hands. Wash your hands,” said Dr. Koelliker.

Also, cover your mouth when you cough or sneeze, but with your elbow, not your hands.

“And then go wash your hands again,” added Dr. Koelliker.

Working within and outside a small facility:

At the Telluride Regional Medical Center teams have begun assessing stable patients with respiratory symptoms in patients’ cars, in temporary structures (in the parking area behind the medical center) and in the San Miguel County Sheriff’s Command Trailer.

“It’s a matter of architectural limitations — we have only three entrances, which make mindful infectious disease prevention challenging, nevertheless, we’re able to minimize contamination risks within the facility” Dr. Grundy said.

In fact, according to Dr. Grundy, every patient is assessed over the phone for coronavirus risk, before entering the building.

“It’s working in part because of community support. We have tents brought to us by Viking Rentals; a mobile unit on loan from Sheriff Bill Masters and extra security to allow for patient privacy provided by Master’s team.”

Dr. Grundy and Dr. Koelliker also acknowledged the community’s patience and are asking for extra sensitivity regarding patient privacy.

“If you happen by the medical center and see your neighbors and community members being evaluated, that does not mean they have coronavirus, or even that they are being tested for the virus,” said Dr. Grundy.

Community asked not to gather in groups greater than 75:

In her capacity as San Miguel County Medical Officer, Dr. Grundy made a formal request, based on new guidance from federal and state health officials, for the community to avoid attending large events or gatherings (greater than 75 people) and for event planners and venues to voluntarily cancel such events. These guidelines are effective immediately and for the next 30 days.

Dr. Grundy’s statement went on to advise the public to practice “social-distancing” which is the practice of staying at least 6 feet away from others in social settings to help prevent the spread of coronavirus.

“This is not a time to panic, but rather a time to be reasonable, prepared at home and at work and diligent with good hygienic practices,” said Dr. Grundy.

“This doesn’t mean you have to shelter in place and avoid your favorite restaurant or bar,” said Dr. Koelliker. “Social distancing and good hygiene can be practiced in these settings.”