Guest Column

The state of COVID-19 in our community

By Dr. Sarah Durney
Posted 11/12/20

As many of you are aware, SARS CoV2 viral transmission rates in our area have increased significantly over the past month. Wastewater testing has projected approximately 6.5% shedding rate in Cody …

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Guest Column

The state of COVID-19 in our community

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As many of you are aware, SARS CoV2 viral transmission rates in our area have increased significantly over the past month. Wastewater testing has projected approximately 6.5% shedding rate in Cody and 2.5% in Powell. There are 172 active cases in Park County as of Nov. 8. It appears we are experiencing the beginning of the “surge” we were told would come much earlier this year. Over the past month at PVHC, we have consistently cared for three to five COVID-positive patients per day. This, in addition to our regular patients and, as a whole, we are running a significantly higher inpatient census compared to previous years.

Administration, providers and staff are working diligently to meet our community needs and have been doing a fantastic job caring for our loved ones. However, we are seeing challenges as we look to the larger hospitals in Billings for transfers, and anticipate they may not be able to consistently accommodate transfers in the near future.  Currently, both Billings hospitals are running over 100% capacity and are facing staffing shortages. Casper hospitals are running near capacity and South Dakota has been looking to offload patients to Casper. In addition, we are seeing antiviral shortage from the State of Wyoming for remdesivir. Public health has become overwhelmed by contact tracing and will be passing responsibility of contacting exposures to the patients diagnosed with COVID. We will now be relying on individuals and businesses to perform much of their own contact tracing. 

As a small rural community with limited resources, these trends raise significant concern and should cause all of us to take note as we strategize how best to proceed. What can we collectively and individually do to help our friends and neighbors as we face this challenge? What tools are at our disposal?

For us to be successful, we will need to regroup our efforts with social distancing, improved sanitary practices, and renewed vigor with mask wearing. Social distancing means trying to avoid situations where individuals are within 6 feet of each other without masks and avoiding large groups of people. Basic sanitary practices should include staying home when sick, using hand sanitizer after going to the store/restroom/group event/restaurant etc., and trying to avoid touching our faces (so hard to do for some of us!).

Masks are one of our most effective tools to limit viral spread, and I will cautiously speak to this issue. Though “masking” has seemingly become very political, I implore each of us to step back and look at our community situation without the lens of political affiliation. As a physician practicing pre-COVID, I requested my patients presenting with viral respiratory symptoms to wear a mask during their time in the waiting room and in the exam room. In addition, I met them wearing my own mask and “reading glasses”; I did not want to contract a virus and potentially take it home to my family. The same is true today — we are facing a respiratory virus spread through the droplets in our mouth/nose, and both evidence and logic speak to the fact that masks do slow SARS CoV2 spread.

The biggest difference we are seeing with this novel virus is the capacity for asymptomatic spread. We believe patients may be spreading virus two days before coming down with more prominent symptoms like cough, headache, and fever.  This virus is tricky. It’s novel.   

With Thanksgiving and Christmas only weeks away, we should consider modifying our plans and being creative with how we celebrate to minimize viral spread while the hospitals are struggling. Imagine if one person’s sacrifice leads to another’s blessing, and how this is magnified as we all work together.   

Individually, we should evaluate our own health and make a plan to bolster our immune systems. There are many simple ways to give the immune system a boost:

• Get enough high quality rest (avoid phones one hour before bed, sleep seven to eight hours per night);

• Eat right (lots of veggies, lean proteins, avoiding sugars and processed foods as much as possible);

• Decrease stress (turn off the news sometimes, nurture forgiveness, make time for prayer and meditation, don’t overcommit, plan ahead, play music, practice gratitude);

• Increase physical activity and sunshine as much as possible;

• Consider some basic immune boosting supplements (daily vitamin C 250-500mg and vitamin D 2000IU);

• Have a “sick day” supplement stock at home (vitamin C 1,000-2,000mg two times a day as the stomach tolerates, zinc 10-25mg daily, vitamin D 10,000IU daily, and some warm tea to soothe a sore throat);

• Be willing to stay home and away from others when ill (sometimes having a collection of humorous books or movies for sick days makes the downtime a little more tolerable).

At Powell Valley Healthcare, we are working diligently to meet the needs of our community in a variety of ways. We have expanded our capacity in the respiratory clinic — and will continue to expand as demand increases. We are offering remote visits through telehealth — which is surprisingly easy for even our older patients; you can request a telehealth appointment when you schedule. By utilizing nurse triage for more involved over-the-phone questions, we are able to help patients at home and avoid unnecessary visits if indicated.

Our community paramedicine team is busy with home outreach and they work in conjunction with our chronic care management services. We continue to screen all patients to avoid COVID spread to those with chronic conditions.

Our new oncology and cardiology programs are growing quickly and we hope to offer a variety of these services locally, which is timely as the Billings hospitals struggle with capacity. We continue to provide excellent primary care for patients with chronic diseases and acute/same day needs.

We are taking advantage of our relationship with Billings Clinic’s provider education opportunities in regard to COVID management for outpatient and inpatient care. We are networking with public health, the schools and local businesses to combat local COVID spread.

Our staff have been amazing, working extra hours, forgoing personal time, sacrificing their own needs in order to care for our community. I am so proud of all of our great employees who face this thing every day and do so with a genuine smile. Please thank our healthcare workers when you see them; they are our frontline.

As I reflect on our upcoming Thanksgiving, I am reminded of so many blessings and am humbled to have the opportunity to live here and serve our neighbors. This is a special place full of hard working, God-fearing, talented individuals who value each other and unite in adversity.

We have so much to be thankful for during these times.

(Dr. Sarah Durney is the medical director of the Powell Valley Clinic.)

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