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IFHS Staff Discuss COVID-19 and City Preparedness

KUCB

There are still many unknowns about the coronavirus. According to officials, it seems to spread a lot like the flu.

 

A U.S. government-led study showed that the virus can remain on surfaces for up to three days. It's also possible that it can linger in the air.  

 

Still, the vast majority of cases are either asymptomatic, or have very light symptoms. But in China, about 15 percent required hospitalization and 5 percent ended up in critical care.

 

As the coronavirus spreads throughout the United States, health workers are on the front lines of resistance.

 

KUCB's Caroline Lester sat down with Iliuliuk Family and Health Services director Melanee Tiura, and clinic doctors Megan Sarnecki and Murray Buttner.

 

Listen to their conversation below. 

 

TRANSCRIPT:

KUCB: So one of the questions I had is how you guys are thinking about triaging, like quarantining, telling people to self isolate vs. coming into the clinic, like what kinds of decisions are you making about that and what would that look like?

MEGAN SARNECKI: So we haven't done it yet, except for this one patient, but we're following the CDC guidance. To get a test, first of all, we have to talk to the state of Alaska, at this point, which is good because they can then also give us recommendations on, okay, yep, we agree that person needs to be tested. They should be put in self-quarantine with daily temperature reports or whatever for the next 14 days and we'll check in with them, etc., etc. I think this is going to rapidly develop over time.

MURRAY BUTTNER: So I think the self quarantining-there's the industry side and the community side. So the industry is preparing an entire bunkhouse to put people in and their safety team would be involved in making sure people weren't breaking the quarantine and they were getting fed and taken care of. And on the community side, hopefully most individuals will be with their family helping take care of them. But those that are not, the social services folks, APIA, and USAFV and stuff, the churches are stepping up to try to figure out how to take care of people who are being asked to quarantine at home. And the public health nurses have these logs and protocols, and conceivably the clinic or people up in Anchorage would actually be calling on people and checking on them every day, just like they do on the TV patients. Quarantining people isn't new and so the way we'd handle that. The phone triage thing, I picture normally you try to give people reassuring advice how to take care of themselves. But when you have things you can treat usually you're like, "Oh, why don't you come to the clinic?" So that's how we usually handle things. In this case, since there isn't that kind of treatment, we would be talking to people over the phone to reassure them, figure out if they're just this much sick or this much sick, give them good advice. If the testing is an issue, figuring out, OK, could you come at 7 o'clock when the clinic's closed, we'll meet you in the back, then we'll only have one or two workers exposed. We'll test you, we'll send you back to quarantine. And then also figuring it out on the phone, OK, this one's going to need the full enchilada. So you can do a ton of that over the phone. And that's those three groups: like not really sick, sick but should stay home and we'll figure out what next, and wow, why don't you come in.

KUCB: Hmm, so there are three ventilators on the island, correct? Do you feel like that's enough?

BUTTNER: It's probably more than we'd ever be able to handle.

SARNECKI: If we had more more than three people on a ventilator, again we only have two nurses on the island. So we have a paramedic, and an EMT-3, and then there's lots of folks over at EMS who are amazing and could come help us, and if Lifemed was on the island, there's some variability there. But could we get overwhelmed? Yeah. That's why the mitigation. Any hospital can get overwhelmed. We only have 4500 people on this island, so we have three ventilators. I don't know what the typical ventilator-to-population ratio is, but I suspect ours is probably not significantly worse than other places. If all of Anchorage, and all of Alaska ships to Anchorage, and too many people need ventilators, Anchorage is going to run out, too.

KUCB: Melanie, this is a question for you. Have you felt supported by industry?

MELANEE TIURA: IFHS has been well supported by industry for many, many years. They have been wonderful with donations and helping us in a variety of ways, including their safety teams. We collaborate with them on a regular basis. So, yes, industry has been very helpful. They have coordinated this Fisheries Infectious Disease Work Group, and it's Seattle as well as all of Alaska. And that's been very helpful for us to be able to exchange information. They have, again, offered a lot of support: how can we help? How can we help to manage flow? How can we, how can we help our employees to be to be seen at your facility in an efficient way? They've implemented the Anchorage-based screening site as well. For that reason, they are trying to help to keep our community safe. They also have done a lot with sanitation, education for their staff. They're doing a really good job.

BUTTNER: They've reached out a ton, asking great questions. I went down to Alyeska and talked to them last night. One of the questions that came up on the call-in show: I know that they are trying to turn down the spigot and only bring up new essential employees. They're not trying to bring in new rafts of people. They're trying to get by with what they've got because they don't want new people here. They're hoping this thing will be over by B season. But that's unknowable. So they're incredibly invested in this because it's really bottom line stuff for them.

KUCB: What does screening mean when you see them for just a blip and what's looking like a 14 day incubation period?

TIURA: That's a really good question, and patients keep asking about it. They think screening means testing, and that is not the same thing.

SARNECKI: Right. Again right now we don't have the ability to do testing. And you're right, screening is a moment in time. So in my mind, the most useful place for screening is as people move from place to place. So as one industry is bringing people up from Seattle or beyond, that is a good time to say, "Where have you been? Who have your contacts been? What are your symptoms?" And check in with people. Again, there's asymptomatic people, so we're basing it on travel history, temperatures, and personal histories of symptoms. But you're right, coming in for someone who's been on this island and hasn't left, there's no such thing as a good screening test. Maybe we'd pick up a fever in somebody who hadn't noticed, but that's unlikely. Most adults, when they have a fever-as opposed to my children who feel fine at 102-we feel horrible. So, exactly, screening is fraught with, it's never going to be perfect. Up to 50 percent of people with this virus are probably going to be asymptomatic. We're talking not even a cold. And so that's never going to be a perfect thing. Does that mean we shouldn't do it as people are moving like at the airport, or if we're moving large groups of people for industry, or whatever reason? Or maybe even communities bringing up this idea of people coming back from spring break, again, that airport screening that multiple entities are working on. I think it's still worthwhile, even though it won't be perfect.

KUCB: Are there things that people should stock up on, like medical supplies to prepare for self-quarantining?

SARNECKI: The recommendations from the CDC are actually to stock up on your own medicines. So a three month's supply, which most people out here already get because they get them through mail out. We don't have a pharmacy on the island. So most people are already doing mail out. But if you haven't been on top of that, which many of us slack and don't get our medicines ordered on time, this is the time to do it. As well as the things that we really think you should stock up on, which can be challenging to get right now, like hand sanitizer, just basic soap. Washing your hands for 20 minutes works. Buy some regular soap-20 seconds, 20 seconds, thank you-cleaning wipes, and you can just buy plain bleach. And there are guidelines on the CDC website. You can Google like what percentage bleach you have and how to mix it with water to make a sanitizing and disinfecting solution. So I think those basics are the things that people should stock up on. We don't have any reason to think from what's happened so far that anyone is going to run out of toilet paper or that the barges will quit coming. We have talked briefly about, could we run out of food? So with the death rates that this has shown in other countries, again, it's not like 40 percent of the world is going to die and the barges are going to quit coming. So anything could happen, but there's a lot of food on this island and there's a lot of frozen fish. From what we've seen so far, there's no reason to think that you should stock up on anything other than, if you were asked to be put in self-quarantine, you probably don't want to have to go out and go to the pharmacy or whatever. And clinics are going to be overwhelmed. So that's part of the other reason for let's get a three month supply of your medications now, because if the clinics and hospitals are overwhelmed with coronavirus sick people, they might not get to your high blood pressure pill refill within 48 hours.

TIURA: And I think it's important for people to have what they need, but not to have what other people might need. So going to the store and stocking up on all of the Lysol that you can possibly carry-don't do that. If you have a stockpile that you're not going to get to until 2023 and your neighbor doesn't have any, you're not protecting yourself or the community. So we need to share what's there.

Caroline reported for KUCB in 2020.
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