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Letter: COVID-19: A message from MCH

For The Madera Tribune

“Madera Community Hospital Emergency Department on the front lines of COVID-19 pandemic. The criteria may change in the next few hours — it has already changed at the national level,” said Sherrie Bakke of Madera Community Hospital. “I would simply reinforce Dr. McGovern’s quote, found in a media release: ‘In an effort to decrease patient visits to the emergency department, we have established a drive-up process where patients who have met criteria set by the health department can be COVID-19 tested directly from their cars,’ said Terrance McGovern, D.O., Medical Director Emergency Services.’”


Dear neighbors,

In this critical time of the COVID-19 (coronavirus) pandemic, we believe it is important to keep you informed and confident in Madera Community Hospital’s capabilities. With our advanced medical training, expertise and experience, it is our responsibility to openly share some important information to provide a better understanding of our current situation.

First, we believe it is important to provide you with some perspective on what a COVID-19 infection is and what it is not.

COVID-19 is the name of the disease and the name of the virus is SARS-CoV-2 (a member of the coronavirus family of viruses).

About 30 percent of all common colds are caused by viruses in the coronavirus family.

COVID-19 is a viral infection. It is spread by respiratory droplets produced when a patient coughs or sneezes. The virus can live in the environment for an extended time. You could be exposed by touching a surface where a patient has coughed or sneezed. It is thought that people can spread the virus before they show signs of sickness, but this is not thought to cause a high rate of new infections. Sicker patients seem to be more contagious.

The vast majority of patients will have a mild course of illness similar to a common cold. Common symptoms, based on almost 56,000 positive COVID-19 patients: Fever — almost 90 percent of patients

Dry cough — almost 68 percent of patients

Fatigue — 38 percent of patients

Uncommon symptoms: It is unlikely you have COVID-19 if you have any of these symptoms:

Nausea or vomiting — only 5 percent of patients

Runny nose — only 5 percent of patients

Diarrhea — only 4 percent of patients

If you have a positive influenza test or other documented viral infection, you have around a two percent chance of also having COVID-19. It is very unlikely you have COVID-19.

COVID-19 is indeed in Madera County. Madera Community Hospital was the first hospital in the region to care for a COVID-19 confirmed patient. The virus is circulating around our community — this is not surprising. Just as we see every year with the flu (influenza) and common cold, viruses can and do move quickly through populations.

What we need from you:

• Wash your hands often and use hand sanitizer often.

• Do not touch your face. This is more difficult than it sounds. The virus enters mucous membranes like the eyes, nose and mouth.

• Social distancing — Keep more than 6 feet away from others and do not gather in groups of more than 10.

• If you can stay home, stay home. If you are not being exposed, you can’t get the virus.

• Cover your nose and mouth when coughing or sneezing.

• Clean and disinfect frequently touched surfaces. Even those rarely disinfected; steering wheels, door handles, stair rails, handle bars, etc

• If you have unused personal protective supplies, masks, gloves and gowns, please donate them to the hospital.

We think it is important to acknowledge the virus has spread and its impact on our county will likely get worse before it gets better. COVID-19 isn’t an election year hoax, but the sky isn’t falling either. Reality is somewhere in the middle and the next few weeks will bring clarity to what we are really dealing with. It is for this reason that proper preparation is key.

We are not referring to toilet paper or water, but rather medical facilities and medical supplies. Your community hospital has been working tirelessly to ensure we are ready to help no matter how mild or severe the situation becomes. This is what we train for. As an integral part of this work, we have seen how agile a single, stand-alone hospital and an engaged community can be to implement strategies to protect and care for those who need our help.

Madera Community Hospital has mobilized resources to provide the following and much more:

• More than a month ago, our Medical Staff created a COVID-19 Task Force.

• We have an external screen and testing location for those who meet criteria for COVID-19 testing.

• The emergency department instituted an external triage and screening system (immediately isolating suspected patients)

• We have dedicated inpatient rooms and care teams for isolating suspected and/or confirmed patients.

• Daily, and in coordination with the Public Health Department, we ensured we have appropriate resources to care for potential patients.

• We have also worked closely with Camarena Health and their Chief Medical Director, Joel Ramirez, MD, Family Medicine, and with many of our community physicians, to help them prepare and respond to their patients and educate their staff. Physicians, nurses and other staff are on the front line and we are personally thankful to have such a qualified and amazing group of professionals caring for our County.

You have likely heard the catchphrase “flattening the curve.” Just to make sure everyone knows how impactful this process is, I wanted to take a moment to address it. The idea is actually simple — if everyone gets sick around the same time, the medical resources are quickly overwhelmed and the ability to care for the community is severely hampered. We need to make sure this doesn’t happen (the Italy experience is an example of this).

This underscores the importance of social distancing and the use of other countermeasures to slow transmission of the virus to a manageable rate.

We know most all patients will have a mild course of illness. We should also mention who is most at risk of being hospitalized from COVID-19. The following populations should take special care to stay home and away from people who may be sick:

• Those over 65 years of age.

• People with underlying medical conditions, such as chronic lung or heart conditions, diabetes, and

• People whose immune system isn’t as strong as it could be due to a disease process or perhaps a medication (think chemotherapy or steroids.)

Testing is a very important part of understanding who should be quarantined from others. However, tests are a limited resource throughout the United States. We are strictly adhering to the Centers for Disease Control (CDC) guidelines for testing. This is to ensure that every patient needing testing and meets criteria gets tested.

Our Emergency Department has been using an external triage system (patients are greeted outside the ED), where they are screened.

Those who may meet criteria enter our “drive through” testing station to expedite care.

This situation is constantly evolving, and we receive new information and guidelines almost daily as we gain more understanding of COVID-19 and how it affects populations. It is clear that the coming weeks will have many challenges. The financial impact of social distancing and quarantine is undeniable, but we are at an inflection point where those difficult decisions must be enforced. Our isolated elderly are in more need of our community’s support than ever. Your medical professionals are leaving their families to willfully step into battle on your behalf. Now is when we all must come together as a united front.

We are all on the same team. With rational, focused effort, we can and will navigate through this process to the absolute best of our collective abilities.

We are ready for the worst while hoping for best.

— Bakht Roshan, MD

Board Certified Infectious Disease Chairman, COVID-19 Task Force

— Terrance McGovern, D.O., MPH

Board Certified Emergency Medicine,

Medical Director Emergency Services

— Ali Rashidian, MD

Board Certified Internal Medicine

Board Certified Pulmonary Medicine

Board Certified Critical Care Medicine

Medical Director, Inpatient Services


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