Experts prep for potential COVID-19 ‘surge’

Dr. Joe Adragna speaks during a virtual community update hosted by Montrose County Friday March 20, 2020. Representatives from Montrose County Public Health, Montrose Memorial Hospital, Montrose County Emergency Management and the City of Montrose delivered updates about public health, testing, and community efforts to mitigate the COVID-19 virus. 

The local health care community and public agencies are bracing for a “surge” in care needs, as the coronavirus-19 issue continues to grow and Montrose County works to ramp up testing.

Because the community has been proactive, steps are in place to mitigate any such surge in cases here that would require hospital care, officials said Friday, during a multi-agency briefing hosted by Montrose County. The briefing was aired on the county’s Facebook page and took place before the first positive result was confirmed in Montrose County.

“Our focus is on surge. We want to be prepared for our community,” said Larry Peters, chief medical officer for Montrose Memorial Hospital.

A “surge” refers to a situation in which cases of the virus, also called COVID-19, overwhelm existing health care infrastructure, such as hospital beds and medical equipment.

Montrose County on Friday afternoon reported 56 local tests for the virus, with five results returned at the time of the update, per Montrose County Emergency Preparedness Coordinator and Communicable Disease Specialist Lisa Gallegos.

Local governments had already been conducting business as though COVID-19 was present; the positive case confirmed later Friday underscored the importance of that strategy.

Among steps being taken to offset the impact of a COVID-driven surge in medical demand, the hospital is conserving supplies and personal protective equipment for mission-critical departments in the hospital.

To that end, and to help reserve resources for those most in need of care, non-urgent elective surgeries have been canceled, in accordance with state orders, although some elective surgeries that have a pressing medical reason behind them will still take place. The hospital will also be halting elective mammography appointments, Peters said.

He said the hospital has procured ventilators that are critical to saving the lives of people with severe symptoms from COVID-19, which causes upper respiratory distress. Montrose Memorial Hospital has 24 ventilators available and can expand its current six-bed intensive care unit by eight more beds. It would also open its same-day surgery unit to accommodate more COVID-19 patients, if necessary.

Additionally, the hospital is using the staff from departments whose work is dropping off in the wake of canceled procedures — they are being assigned to other tasks, such as lab work, requisitions, phones and security, Peters said.

“The collaboration is tremendous in our community,” he said, adding that MMH is in regular communication with area hospitals, as well as drawing lessons from what happened when COVID-19 hit Washington State.

In the event of extreme shortages, MMH also has extreme protocols it can enact, such as using a ventilator for more than one patient.

Dr. Joe Adragna of Peak Family Medicine is the medical adviser for Montrose County Public Health. He said the health care community is in constant communication with the hospital; medical directors and leadership of skilled nursing facilities and assisted living facilities. Experts have met with the surgical teams of MMH and Black Canyon Surgical Associates to assess capacity.

The county benefits from the teamwork of such professionals, Adragna said.

“Because of their efforts, our response is ahead of the curve, implemented before we (had) any (confirmed) cases in Montrose,” he said, also prior to the positive result having come back.

Additionally, rules have been relaxed to allow for more telemedicine access — from home, so that those most vulnerable to COVID-19 do not have to go to their provider in person.

“The medical community is strong, in good spirits, and dedicated to the oaths that we took,” Adragna said.

Montrose County will be getting help Monday from the Colorado National Guard, which is setting up at the Event Center to help administer tests to 100 prescreened individuals. (See related story.)

Officials Friday reiterated the limited availability of tests and that receiving one requires an assessment by individuals’ health care providers, a referral for a test and an order for one, based on set criteria.

Adragna said most people will not clear that criteria and if they are experiencing COVID-19 symptoms — broadly, fever, cough and shortness of breath — they should self-isolate until symptoms resolve.

Adragna reminded people that there is no COVI-19 vaccine and antibiotics do not work. The treatment is symptom control and isolation, to limit transmission.

But it’s not only the sick who need to be proactive, he said. Everyone needs to practice social distancing — staying home as much as possible, keeping far apart from others (to the extent possible) when out and about, and avoiding large groups of people.

“The young and healthy among us must be conscientious that even though they may have no symptoms or mild symptoms, they can pass it to someone (at risk),” Adragna said. “ … If you are sick, you should stay home.”

As well, do not go to the emergency room for mild illnesses or for testing, he said.

“We must all of us take responsibility to ensure our emergency department is reserved for the sickest,” said Adragna.

Officials are also aware that continued closure orders are hitting local business, City of Montrose Director of Business Innovation and Tourism Chelsea Rosty said. The city is working to promote local business, including by encouraging people to order takeout from restaurants here and post support on social media, and by asking businesses to patronize each other.

Rosty said Gov. Jared Polis has worked to line up disaster relief for small businesses, which can access more information at region10.net or choosecolorado.com.

There is a need to also promote positivity, Rosty said.

“Even the well are maybe suffering a bit with all this. There’s things in the community with regard to mental health we are thinking about as a team,” she said.

“ … We don’t know what’s coming, but we are pushing (local business).”

Montrose County Commissioner Sue Hansen said she and fellow Commissioners Roger Rash and Keith Caddy know the virus has people worried.

“It’s the time to remember that this community does come together in a very genuine way,” she said.

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.

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