NIHD continues to monitor, prepare for COVID-19

Terrance Vestal
Managing Editor

While as of Wednesday there have been no confirmed cases of COVID-19 in Inyo or Mono counties, staff at the Northern Inyo Healthcare District continue to monitor and prepare for what could be an impending outbreak.
Dr. Stacey Brown, Family Medicine physician and director of NIHD’s Rural Health Clinic, said the hospital has incident command meetings on Mondays to try to get a good handle on what’s happening.
“The hospital and the health care district continue to function at full capacity so there’s no service lines that are being limited at this point,” Brown said. “We still have good supply lines or we’re holding on to what we have.”
Brown said the district will be looking at the outpatient clinic arena by recommending that patients postpone some of their annual wellness visits. He said the hospital will be reaching out to some patients to reschedule those appointments “so that we can free up time to do the other things that we need to do for the sick folks.”
While a COVID-19 drive-through test site has been established at the Rural Health Clinic, Brown wanted to stress that this is a testing mechanism for the district to conduct tests in a safe manner for both patients as well as staff.
“It is not a free-for-all, drive-in clinic,” Brown said. “It’s a scheduled process, just like the Same Day Service line is where we do a pretty rigorous screening telephone triage, to see if somebody does qualify or need to be tested, and then make an efficient workflow to have them tested.”
The testing site is located in the outpatient parking lot of the hospital. The district had 70 test kits earlier this week.
Now that a testing site is in place, Brown said the challenge is trying to figure out where the hospital can send the testing swabs for the quickest turnaround time.
Currently the district’s laboratory sends them to Burlington, North Carolina.
“We were hoping two to three days if we were testing locally in the region, but it looks like they have such a backlog that we may end up seeing test results out as long as five to seven days,” Brown said.
He said the district is hoping that through triage, screening and testing, the hospital doesn’t see a sudden surge of patients that would strap the district’s resources.
Tracy Aspel, NIHD chief nursing officer, said the hospital is licensed for 25 inpatient beds. However, NIHD can work with California Department of Public Health to receive what are called “flex waivers” to expand services if needed.
“What’s really exciting is that we have an amazingly committed team that is working really hard on brainstorming and problem solving and coming up with the best ideas to take care of patients for our community,” Aspel said. “And so we’re really working ahead of the curve before we have any problems.”
Robin Christensen, NIHD infection preventionist, said ultimately the goal for the district is to have more test kits coming from the California Department of Public Health and the federal government to make sure there’s enough testing equipment and supplies to meet the needs of the community.
Christensen said she also has been in contact with the Bishop Care Center infection preventionist and said that facility has stopped all visitors coming in.
“And that was a mandate from CMS (Centers for Medicare and Medicaid Services), an agency of the federal government,” Christensen said.
She said the Bishop Care Center is closely monitoring its patients and if any patients were to show any symptoms, those patients are going to be receiving the same type of testing for other suspected cases.
“We’ll be ruling out flu, strep, they’ll be checking to see if the patient has any pneumonia and then moving forward after that,” Christensen said. “So we’re in close contact with Bishop Care Center and Toiyabe’s infection preventionist as well.”

Toiyabe Indian Health Project
Dr. Kori Novak, CEO of Toiyabe Indian Health Project, stated in a memo that the facility has been preparing to meet this crisis with the resources it has, including constant communication with federal Indian Health Services, California Rural Indian Health Board, and state of California officials, as well as local county officials. For the safety of staff and patients, Toiyabe is working with essential personnel only in its facilities.

Photo caption: The Rural Health Clinic’s drive-in testing service is operational during normal clinic hours, 8 a.m. to 7 p.m., Monday through Friday, and 8 a.m., to 6 p.m. Saturday. Patients are asked to call the clinic first to be screened and arrange for a time to be seen. Shown here, moments after swabbing a patient for flu-like symptoms, are Medical Assistant Tiffany Cruz, Physician Assistant Tammy O’Neill, and Medical Assistant Emily Smith. Each caregiver is wearing the one-time use personal protective equipment most Northern Inyo Healthcare District staff would be wearing when handling high-risk cases.
Photo by Barbara Laughon/Northern Inyo Healthcare District