Vale ambulance member Wally Whitaker displays one of the masks emergency providers would provide a patient suspected of a COVID-19 infection. (The Enterprise/Pat Caldwell)
ONTARIO – The Malheur County Health Department said Monday area residents should prepare for the possibility of local cases of COVID-19, a new coronavirus that first appeared in China two months ago.
Across the nation, the American health care system is scrambling as new cases of the virus continue to rise.
Monday afternoon, a third presumptive case was announced in Oregon, in the tiny hamlet of Weston in Umatilla County, as Washington state announced four deaths linked to the virus.
The Umatilla County man, a casino worker at the Wildhorse Resort & Casino outside of Pendleton, was taken to a Walla Walla, Washington, hospital after attending a middle school basketball game Saturday.
The local health care system will react to potential cases of COVID-19 through a multi-tiered system that includes the health department, local health care providers, hospitals, clinics, the Oregon Department of Education, the Oregon Health Authority, and emergency service providers.
The federal Centers for Disease Control and Prevention is leading the COVID-19 response, said Sarah Poe, director of the Malheur County Health Department.
“They (the CDC) are doing all the secondary testing. We work with health care providers who would collect a specimen and send it to the Oregon Health Lab,” said Poe.
She said her agency sent notices to anyone with a medical license to practice in Malheur County about the COVID-19 evaluation criteria and instructions for testing.
Poe, who was home sick with a cold, said Monday it was important for residents not to overreact if they become ill. Minor cold and flu symptoms should not motivate people to rush to local clinic or doctor’s offices, she said.
“I have all these different symptoms going on but I find I am able to manage my symptoms. But if my symptoms exasperated and I have trouble breathing and have a high fever, then I would call my health care provider,” said Poe.
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Poe said a call to a health care provider or a local clinic would allow medical personnel to evaluate the symptoms and, if need be, prepare for the patient to be evaluated in person.
Otherwise, Poe recommended individuals with cold or flu-like symptoms stay home.
If a resident has a high fever, trouble breathing or other underlying health conditions, they should call their doctor, said Poe.
If a person does develop serious symptoms that appear to be related to COVID-19, they would be screened and questioned, said Poe.
“Have you traveled to a country that has COVID-19? Or had contact with someone with COVID-19? For most of Malheur County that will be no,” said Poe.
Poe said patients would be tested for “other respiratory illness,” including flu.
“Then, once, they’ve ruled those things out and if you are hospitalized they put a request out that you are under investigation and contact the health department,” said Poe.
Poe said the health department would then enter the data on the patient into a statewide electronic health data base.
Testing for the virus will be done either by a primary health care provider or by a hospital. The specimen is then sent to the state health lab to determine whether an individual is infected, said Poe.
“And they can only say it is presumptive. The CDC has to confirm it,” said Poe.
Meanwhile that person is monitored and quarantined.
“If we did have a positive case we’d tell the press and other entities that would help us screen who had contact with that person,” said Poe.
Katy Dudley, safety officer for the Saint Alphonsus Health System, said proper identification of a potential patient with COVID-19 is the critical first step.
“The criteria for testing is still a combination of symptoms or respiratory illness, fever, cough and travel history,” said Dudley.
Dudley said the travel history criteria continues to “evolve.”
“I know last week they updated it to include South Korea, Iran, Japan, Italy and China,” said Dudley.
As for when to seek medical attention, Dudley said residents should be vigilant.
“They should proceed with getting an evaluation as they would any other health care condition. We are following CDC guidance to say if it is not urgent, call your health care provider but if it is urgent you should seek care and be prepared to provide a travel history,” said Dudley.
Irene Winters, chief nursing officer for Valley Family Health Care, said medical staff at the organization’s clinics are prepared for COVID-19 cases.
“We are making sure all of our clinics have the equipment they need – masks, gowns – and we are making sure all of our providers and staff are getting the education they need on how to respond to patients with symptoms,” said Winters.
Winters echoed Poe’s advice.
“We don’t want people in the hospital unless they are critically ill. We’d advise them to go home and isolate themselves as much as possible along with Tylenol and Motrin,” said Winters.
Lee Hensley, a former local resident, said last week as he came through Vale that he was surprised by the lack of concern coronavirus after he touched down at Los Angeles International Airport on a trip back from China.
He said he was shocked to see that people disembarking from a flight from Italy weren’t wearing masks.
Hensley said emergency medical technicians met passengers disembarking from international flights but asked only if anyone felt sick or had been to the city in China where the outbreak is profound.
Hensley said he lived in the southwestern city of Chongqing, China, for 10 years. Local health officials said Hensley had been tested negative twice for the virus and spent 14 days in isolation.
Across the county, schools are ramping up efforts to keep parents informed. Following district policies, superintendents are tasked with implementing the state’s communicable disease plan.
Superintendents are taking direction from the Oregon Department of Education. In a memo sent out Monday – the third message to district leaders since Feb. 27 – the state asked schools to defer to local public health authorities to determine whether students should stay home.
The Nyssa School District published recommendations from the World Health Organization and the Malheur County Health Department on its website. Nyssa also passed along information to parents and students through an app the district uses to share information.
Darren Johnson, Nyssa superintendent, said custodians are cleaning door knobs and other frequently-touched surfaces to minimize contamination.
Johnson said the district will be in touch with local health officials to decide if and when a school closure would be necessary.
In Vale, Superintendent Alisha McBride sent out letters to parents and teachers on Monday.
In her email to parents, she reminded them of Oregon Health Authority recommendations to prevent the spread of the disease. The recommendations urge people to cover their coughs and sneezes and wash their hands with soap for up to 20 seconds.
McBride said all district employees learn of the Vale School District’s communicable disease policies at the beginning of the school year through the staff handbook. Staff were provided links to the policies and administrative regulations again Monday via email.
McBride advised teachers to use wipes to ensure all tables and desk surfaces are disinfected each day.
She added that each classroom should be equipped with a container of disinfecting wipes and that janitors will be monitoring soap and hand sanitizer dispensers in addition to disinfecting frequently-touched surfaces daily.
McBride also advised teachers to be mindful of bullying and to practice confidentiality.
“It is important to ensure that individuals are not discriminated against if they are ill,” she wrote to staff.
Both McBride and Johnson said they haven’t seen any noticeable difference in attendance in recent days.
“If the spread of the virus continues, Vale School District will work collaboratively with the local health department to determine whether a school closure is necessary,” McBride wrote in an email.
In their communications to parents, some districts are encouraging parents to keep sick children at home.
In Adrian, superintendent Kevin Purnell said his staff annually participates in Safe Schools training and are reminded of proper respiratory hygiene.
Nicole Albisu, Ontario School District superintendent sent a letter to parents Monday detailing steps to prevent contracting the virus, including increased hand washing, coughing and sneezing etiquette, and avoiding touching the eyes, nose and mouth with dirty hands.
Albisu told parents that the district is monitoring the situation, and is maintaining frequent communications with public health authorities.
She also told the Enterprise it’s critical as a school community “to ground ourselves in the facts.”
“While the spread of novel coronavirus is troubling, we must remind ourselves that fear, rumors, and stigma do nothing to stop the further spread of the disease,” Albisu said. “Viruses do not discriminate. Facts and science, proven public health measures and common-sense precautions in our personal lives are the best measures we can take to protect the people we serve.”
Saint Alphonsus Medical Center Ontario is ready if coronavirus appears.
“We have signage across the system, at all of our entrances, that asks anyone coming into our facility, if they have been to China or exposed to anyone with the novel coronavirus to don a mask immediately and get them out of the waiting room,” said Jill Grandi, registered nurse and infection preventionist at the Ontario hospital.
Dudley said Saint Alphonsus began to prepare for coronavirus in mid-January, after reports of the malady began in China.
“With any kind of communicable disease, the world is a small place and we felt it was important to be proactive. We’ve been working with emergency medical services, public health and other hospital systems to coordinate,” said Dudley.
Grandi said the Ontario hospital conducts annual training on personal protection equipment that would be used to treat a patient with the virus.
“Right now, we are also doing additional rehearsals, practicing putting on the gown and gloves and eye protection. We are working with our clinical educators to rehearse and practice with some extra protective equipment,” said Grandi.
Grandi said a recent remodel at the hospital also included the construction of five airborne isolation units.
Dudley said it’s hard to say how severe the coronavirus outbreak could become.
“But I think we are well positioned to react to changes that come.”
Claudia Weathermon Tester, marketing, communications and foundation director at Saint Alphonsus, said the local hospital is prepared.
“We see it coming and we are ready,” said Weathermon Tester.
News tip? Contact reporter Pat Caldwell: [email protected] or 541-473-3377.
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