During the past month our community and hospital have made significant changes in how we work. For us, this is the first time in our careers when we are caring for patients without the patient’s friends and family physically visiting to provide emotional and spiritual support. We understand families are missing out on celebrating the first hours of a new life. Others are leaving this life, in the hospital, without the physical presence of those who care about them the most.
We are doing everything we can to keep patients, families and our workforce healthy yet, the ‘greater good’ is tough on us too. Regardless, now is not the time to abandon the guidelines to avoid COVID-19. Everyone must continue to stay home, diligently wash your hands (we are even washing our hands more than normal) when you have to go out, follow social distancing rules and wear a covering over your nose and mouth.
The common COVID-19 media topics include shortages of COVID-19 testing kits, critical personal protective equipment (PPE) and the influx of patients needing hospitalization. As of today, Madera Community Hospital and our Rural Health Clinics in Chowchilla and Madera, as well as Camarena Health, are not short of testing supplies. Having supplies does not provide access for asymptomatic individuals to be tested.
We are adhering to testing guidelines issued by the Centers for Disease Control (CDC), California Department of Public Health (CDPH) and Madera County Public Health. The screening criteria prior to being tested has been consistent for several weeks and involves the following:
- Fever of 100.4 or greater.
- New or worsening cough.
- New or worsening shortness of breath.
- Within the last 14 been in physical proximity to someone diagnosed with COVID-19 or someone who is under investigation for COVID-19.
- Within the last 14 days, traveled outside of the United States.
- Within the last 14 days, traveled outside of the Central Valley.
Regarding Personal Protective Equipment (PPE): Last Tuesday morning we received our order of 12,000 hospital grade surgical masks. We feel somewhat relieved and are persistent in using these masks only for patient care.
Our community has rallied around our need for PPE. We are grateful for the donations of goggles, face coverings, masks, gloves, disinfectant, hand sanitizer, surgical gowns, face shields and more. Thank you to all who are personally participating in ensuring our workforce has the equipment we need to keep all of us safe, including the many patients who do not have COVID-19 and need our hospital for unexpected healthcare.
Those who have donated are publicly recognized at www.MaderaHospital.org/Howyoucanhelp.
We want to publicly commend the continual rigor of the Medical Staff COVID-19 Taskforce. Collectively, physicians as well as nurse leaders, have implemented strict PPE standards of use, and rolled out ‘just in time’ training to those who provide direct patient care services in the hospital and clinics. We also began documenting everyone who enters a patient’s room. We have implemented this process for all patients, not just those patients on isolation. These efforts, along with a conscientious and compliant workforce will continue to keep our team virus free.
At this point, Madera County has a disproportionately low level of confirmed COVID-19 cases. However, in late March, the California Hospital Association projected the need and asked us to increase our surge plan by an additional 40% – and we have.
All hospitals have surge capacity plans. These plans are submitted to the California Department of Public Health. The surge capacity plan establishes guidelines and priorities for inpatient bed utilization and management of an influx of patients in need of hospitalization or emergency care.
Madera Community Hospital is an Adult General Acute Care Hospital, licensed for 106 beds. Our surge capacity is 147 beds. Today, in preparation for the COVID-19 Pandemic, our surge capacity is 205 beds. Yes, it will be tight, but it will also be safe. We have purchased additional ventilators, rented additional beds and are ready to provide this level of care.
Last week, Fresno County established a regional alternative care site. The Fresno Convention Center site with 200 cots, was constructed by the National Guard from State supplied resources. The regional resource, if needed will care for non-COVID-19 patients needing minimal convalescence. We are working with the Emergency Medical Services (EMS) alternative care site team on establishing discharge criteria, transportation and activation rehearsal.
While Madera Community Hospital Administration and front line healthcare workforce continue to be set in the ready position, we need you to stay positioned at home, with your hands clean.
Bakht Roshan, MD
Board Certified Infectious Disease
Chairman COVID-19 Task Force
Terrance McGovern, DO, MPH
Board Certified Emergency Medicine
Medical Director Emergency Services
Ali Rashidian, MD
Board Certified Internal Medicine
Board Certified Pulmonary Medicine
Board Certified Critical Care Medicine
Medical Director, Inpatient Services