Fearing a critical shortage of surgical masks for health care workers caring for people with the coronavirus, Gov. Kate Brown ordered hospitals in Oregon to cease nonemergency procedures to conserve medical supplies.
The order applies to hospitals, outpatient clinics and other health care providers, such as dentists and veterinarians. Health care experts are worried about potential shortages of masks, gowns and gloves in a virus outbreak.
“It is critical that we preserve every piece of personal protective equipment we have in Oregon so that our health care workers can keep themselves safe while treating COVID-19 patients,” Brown said in a statement Wednesday. “If we do not take immediate action, the surge in demand in our hospitals for masks, gowns and gloves will quickly outstrip the limited supplies they have available.
“We cannot let that happen. I want to thank the health care providers —including dentists, veterinarians and others — who have already preserved and donated their critical supplies.”
Washington Gov. Jay Inslee also moved to restrict nonemergency medical and dental procedures to conserve protective equipment for health care workers.
Brown’s order also limits visits to hospitals to help protect health care workers and patients.
Columbia Memorial Hospital in Astoria and Providence Seaside Hospital are the most impacted on the North Coast.
Columbia Memorial stopped all nonessential surgeries on Tuesday. “Personal protective equipment is obviously a great concern to all of us as we work to keep our community healthy,” Nancee Long, the director of communications at the hospital, said in a text message.
Earlier Wednesday, in a message to patients and the community, Columbia Memorial had pledged that any changes to care, such as office visits and elective surgeries, would be communicated directly by caregivers or providers. The hospital has 25 beds but has plans to expand to handle additional patients if necessary.
“We are facing uncertain times in health care,” the hospital said. “Things are changing so rapidly that in some circumstances, yesterday’s decisions are being amended today.”
Mike Antrim, a spokesman for Providence Seaside, said the 25-bed hospital is adding 16 beds. Camp Rilea personnel with the Oregon Military Department also worked with state and Providence Seaside maintenance crews in putting up tents outside the hospital.
The tents will be used for testing and triaging people who get sick from COVID-19.
Elective surgeries are medically necessary but can be delayed, according to David Northfield, a spokesman for the Oregon Association of Hospitals and Health Systems. Examples are knee or hip replacements, cataracts or a deviated septum.
Testing is difficult
The message this week from local public health officials on testing for the coronavirus was dire: Act like everyone around you could have the virus, but don’t expect a test for it soon unless you’re suffering from pneumonia-like symptoms.
“The health care community is just as frustrated with the inability to test as the public is,” said Ellen Heinitz, a naturopathic physician and Clatsop County’s community health project manager. “We would love to do that in a heartbeat if we could. It’s just the roadblocks to that are not something we have control over.”
State labs and the federal Centers for Disease Control and Prevention are limited in how many sample kits they can give out or process, Heinitz said.
To be considered for a test, a person needs to be in need of hospitalization and show symptoms of a lower respiratory infection, severe shortness of breath and other pneumonia-like symptoms. They also have to first test negative for the flu, which was already in season prior to the spread of the coronavirus, along with a host of other illnesses.
Heinitz and other health officials have preached the basics: Wash hands with hot soap and water for at least 20 seconds; keep a distance from other people; regularly clean and disinfect surfaces; get a flu vaccine; and stay home if sick.
“If they have something mild, stay at home, quarantine yourself for 14 days or until you have no symptoms for three days — whichever is longer,” Heinitz said.
Scott Docherty, a local photographer and web designer, was among the few tested by a local health care provider.
Docherty said he immediately quarantined himself in his house after falling ill around a week-and-a-half ago. He went into his medical provider Tuesday with coughing fits, a stuffy nose and a high fever, fearing pneumonia. The provider confirmed he didn’t have pneumonia before testing him for COVID-19, he said.
“They weren’t sure they were going to test me,” he said. “Their criteria is pretty strict for testing people right now.”
He and his wife, Mary, were told to quarantine themselves for at least another two weeks, he said, although he doesn’t expect his test results for coronavirus back until Monday.
The Oregon Health Authority reported that 2,550 people had been tested for coronavirus in Oregon as of Friday morning, with 114 positive. Clatsop County hasn’t recorded a positive case, but officials said they don’t know how many people have been tested locally.
“The negative tests are great news,” said Michael McNickle, the county’s public health director. “That just shows the number of tests we’re taking are all negative. That’s actually good news. We’re really geared up for the positive test, if it ever happens.”
Some states have set up drive-thru testing sites. The county has a plan in place to set one up, but it wouldn’t be very useful without enough testing kits or the capacity to process them, McNickle said.
Providence Health & Services announced that tests for COVID-19 would be processed in their regional lab. The lab will process tests collected in eight Providence hospitals in Oregon, including Providence Seaside.
Limits on hospitals
The limits on visits to hospitals follow state restrictions on Oregon long-term care facilities intended to protect the elderly and the disabled, who are at greater risk from the virus.
Only essential medical and emergency personnel and visitors to residents who are at the end of life are allowed at nursing homes, assisting living facilities, residential care facilities, adult foster homes and group homes for people with intellectual and developmental disabilities.
Oregon is erecting a 250-bed temporary hospital at the state fairgrounds in Salem to free up other hospital beds around the state for coronavirus patients.
The Oregon Medical Station is a mobile emergency hospital that the state purchased several years ago in case of a health crisis.
The state’s overriding goal is to slow the progression of COVID-19, so as not to overwhelm Oregon’s health care system. Brown and other state officials said that is why restaurants, bars, schools and all large events have been closed or canceled.
“All the things we’ve been trying to do, as grievously hard as they are for the economy, are single-mindedly aimed at the notion of making sure we don’t run out of hospital capacity,” Pat Allen, the director of the Oregon Health Authority, told the state Legislature’s Joint Special Committee on Coronavirus Response on Wednesday.
“This is a situation that will not last for weeks. This will last for months and potentially a lot of months,” Allen said.
Along with setting up the temporary hospital in Salem, officials want hospitals to create 1,000 temporary beds statewide. Officials also are exploring whether hotel, college dorm rooms or other places could be used.
“Are there facilities we can literally stand up in parking lots?” Allen said.
These would be so-called “step down” facilities, requiring fewer traditional medical staff. Allen said they could serve patients who normally would be released from hospitals into nursing homes and other care facilities, which now have been closed to the public; less-sick patients who otherwise would be sent to regular hospitals; and homeless people and others who no longer require hospitalization but cannot continue their recovery at home.
Retired health professionals and others with medical training could be tapped to help staff these facilities.
“The idea is to basically within the next three to four weeks stand up as much of that kind of collection of care as we possibly can,” Allen said.