COVID-19 Q&A: Summer Lakes residents asked to self-isolate upon return

Saturday, March 28, 2020

LRH tightens visitor restrictions

In the span of about 24 hours, Lakes Regional Healthcare and the Dickinson County Board of Health confirmed the first case of novel coronavirus (COVID-19) in the Iowa Great Lakes and began to tighten hospital access. During that time frame, the Dickinson County News submitted a series of questions in its effort to keep the public informed. Lakes Regional Healthcare's President and CEO, Jason Harrington and Vice President of Marketing and Retail Services, Jennifer Gustafson, reviewed the questions and Harrington responded Friday after consulting with the medical experts at his disposal.

Thursday — Dr. Zachary Boras, chairman of the Dickinson County Board of Health said the confirmed Dickinson County diagnosis involved a 61 to 80 year-old man. He is stable, currently in treatment and remains in isolation.

Friday — Lakes Regional Healthcare's next step was to further restrict in-person access to the hospital starting March 30.

Tuesday — The Iowa Department of Public Health (IDPH) confirmed a Clay County resident tested positive for COVID-19.

The diagnosis involves an 18- to 40-year-old adult female who is a resident of Clay County. Hospital officials in Spencer say she is recovering at home in isolation.

The Clay County adult was among 73 new cases reported Tuesday in Iowa. There have now been 497 positives cases recorded in the state. There have been a total of 6,888 negative tests to date, including testing reported by the State Hygienic Lab and other labs.

"With community spread of COVID-19 first confirmed in Iowa mid-March, we anticipated it was a matter of time before one or more cases would be confirmed in northwest Iowa," Spencer Hospital Medical Staff President Dr. Amanda Young said. "While this may be Clay County's first case, it may not be the last. And that's why it's critical to make prevention a priority – stay home if you are ill and everyone needs to practice social distancing to help prevent the spread of the virus."

Clay County Public Health Medical Director, Dr. David Keith, said testing is limited, so area citizens who are symptomatic should follow the CDC guidelines for self-isolation.

"With or without the test confirming infection of COVID-19, the care remains the same," Keith told Clay County residents. "There is no vaccine or antibiotic to treat COVID-19. For anyone with mild symptoms, stay home and isolate yourself as best as you can from others in your household. Treat symptoms with over-the-counter cough medicines and fever reducers such as Tylenol, but do not use anti-inflammatory medicines (ibuprofen) as they have been demonstrated to worsen the symptoms of COVID-19. If your symptoms become severe – meaning that you are having difficulty breathing, contact the clinic to be seen or, if necessary, the Spencer Hospital emergency department."

Looking ahead — The healthcare officials in Spirit Lake are trying to limit exposure to COVID-19. Lakes Regional Healthcare staff members are setting up virtual visitation. Family members are encouraged to connect with patients using phones, text, social media or video chat.

Harrington offered more detail about Dickinson County's first case, Monday's new regulations at LRH and shared the public health community's recommendations for Iowa Great Lakes residents who might be returning from their winter homes.

Q: Now that the first case of COVID-19 is confirmed in Dickinson County, what changes from the hospital's standpoint and from a public health standpoint?

A: We have been in preparation for our first confirmed case for some time, so we do not have to make many significant changes at this point. One change we will implement effective March 30 is a "no visitor" restriction. There are two exceptions: hospice patients, OB patients and those patients under age 18. In the case of hospice, we will allow two visitors at a time. In the case of OB, patients can have a coach/partner who can attend ultrasound visits and be present during the delivery process.

Since the COVID-19 pandemic was announced, we've been taking steps to decrease the number of people in our facility with the goal of limiting possible exposure and community spread. For example, we’ve limited the number of entrances people can use to enter the facility, and we've been screening every single person – employees, visitors, patients and vendors – that comes in to ensure they do not have COVID-19 symptoms and are not a risk to others.

We also have been caring for patients with similar COVID-19 symptoms in their cars. And if they absolutely must come in the facility to receive care, we provide them with protective gear, limit their exposure within the facility, and have our staff wear personal protective equipment around them.

Q: Were you able to determine if the Dickinson County case has a known origin or is it community spread?

A: The Iowa Department of Public Health informed us that the person who tested positive for COVID-19 traveled to another state within 14 days of their onset of symptoms and they also spent time in the community prior to becoming ill. Without a known exposure to a known case, they aren't able to determine whether it is travel associated or community spread.

Q: What would you like the public to know as they try to process this information?

A: Dickinson County residents have been doing a great job of social distancing and self-isolating. At this point we have no reason to assume there is broad spread in the community. However, it may not be the last COVID-19 case here, so it's important to continue to make prevention a priority by:

• Washing hands frequently with soap and water for at least 20 seconds each time

• Covering coughs and sneezes with a tissue or elbow/upper arm

• Staying home when ill

• Practicing social distancing, staying at least 6 feet away from others whenever possible

Q: What expectation do you see with the numbers now that a case is confirmed in the Iowa Great Lakes?

A: Even though we don't have a reason to assume there is broad spread in the community, we expect that we will have more cases in the future. We expect and hope the pandemic will be nearing its end as summer approaches.

Q: This is also the time of year when people return to the Lakes from their winter homes in more-populated areas. Are there recommendations for them regarding whether or not they should reconsider the timing of their return?

A: We don't have recommendations regarding whether or not they should reconsider the timing of their return, but we do definitely encourage those who are returning to the Lakes to self-isolate for 14 days. COVID-19 takes up to 14 days to manifest and during this time people who have been elsewhere could be infectious. Self-isolation means to stay home and not go to school, public areas or attend gatherings.

All non-essential medical appointments should also be postponed. If you must go to an essential medical appointment, it's important to call Lakes Regional Healthcare’s COVID-19 Call Center at 712-336-6696 to plan how to attend your appointment without possibly exposing others to the virus. Self-isolation also means staying in a specific room away from others in your home and using a separate bathroom, if possible.

During the 14 days of self-isolation we would also want people to watch for a developing cough or difficulty breathing and to take their temperature twice a day to watch for a fever.

Q: Avera in Sioux Falls just got approval for COVID testing in South Dakota. Is that where the first positive Dickinson County test went? And if so, is better testing going to lead to an uptick in results locally – simply because more tests can now be processed?

A: Lakes Regional Healthcare actually sends tests to both the Iowa Department of Public Health and to Avera in Sioux Falls. We've been using both tests for the last week. Although there are more testing facilities, the criteria for testing is very narrow and most people will not be tested unless they are hospitalized with COVID-type symptoms. Unless you are sick enough to be hospitalized, you will be directed to go home for 14 days and self-isolate.

If your symptoms worsen, you should notify the clinic via the COVID-19 Call Center at 712-336-6696.

Q: Is there anything else you'd like people to know?

A: Please continue practicing social distancing and self-isolation whenever possible. Also, be very careful about the sources that you are relying on for information about COVID-19. We currently utilize the Centers for Disease Control and Prevention and the Iowa Department of Public Health as our sources of credible information. In addition, having a single case in the community is not a reason for panic, but just a reminder to continue to do the things you are doing to keep yourself healthy and safe.


DOCTORS' NOTES

Medical professionals throughout northwest Iowa also are taking steps to limit exposure to the novel coronavirus through in-person access restrictions:

• Avera Medical Group Lakes Family Practice and Avera Medical Group Spirit Lake Medical Center are asking patients not to bring guests to appointments except in certain cases, such as when the patient is a minor or an OB patient who is having an ultrasound.

Lakes Regional Healthcare officials are directing medical records requests to 712-336-1230 (option 4) and bill payment requests to 336-8700 (ext. 1129). Lakes Regional Healthcare has a bill-paying option on its website and payments can also be mailed to Lakes Regional Healthcare, PO Box AB, Spirit Lake, Iowa 51360.

• For the safety of patients and healthcare workers, new visitor restrictions are in place at three local clinics — Milford Family Care, Avera Medical Group Spencer and Sioux Rapids Family Care.

Adult patients are not be allowed to bring guests into the clinic unless clinic staff deems there is a clinical reason for that guest (such as patient safety). Until the time that COVID-19 no longer poses a public health threat, all patients and guests will be screened. Patients with symptoms of fever over 100 degrees, cough or shortness of breath will be asked to leave the clinic and call the appropriate clinic. No guests will be allowed with these symptoms.

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  • Informative BUT should have started immediately. It makes no sense to me that it's not effective until Monday.

    -- Posted by MARY LOU AYRES on Sat, Mar 28, 2020, at 2:14 PM
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