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Letter: COVID-19: A Message from Madera Community Hospital, its physicians, and staff

Dear Neighbors,

During the past month, our community and hospital have made significant changes in how we work.

For us, this is the first time in our careers when we are caring for patients without the patient’s friends and family physically visiting to provide emotional and spiritual support. We understand families are missing out on celebrating the first hours of a new life.

Others are leaving this life, in the hospital, without the physical presence of those who care about them the most. We are doing everything we can to keep patients, families and our workforce healthy, yet, the ‘greater good’ is tough on us too.

Regardless, now is not the time to abandon the guidelines to avoid COVID-19. Everyone must continue to stay home, diligently wash your hands (we are even washing our hands more than normal) when you have to go out, follow social distancing rules and wear a covering over your nose and mouth.

The common COVID-19 media topics include shortages of COVID-19 testing kits, critical personal protective equipment, the influx of patients needing hospitalization and clinical trials for treatment.

As of today, Madera Community Hospital and our clinics in Chowchilla and Madera have testing supplies. We are adhering to testing guidelines issued by the Centers for Disease Control, California Department of Public Health and Madera County Public Health. The screening criteria prior to being tested has been consistent for several weeks and involves the following:

• Fever of 100.4 or greater.

• New or worsening cough.

• New or worsening shortness of breath.

• Within the last 14 days has been in physical proximity to someone diagnosed with COVID-19 or someone who is under investigation for COVID-19.

• Within the last 14 days, attended any large gatherings

• Within the last 14 days, traveled outside of the Central Valley.

Madera Community Hospital continues to use all resources to assure we have adequate Personal Protective Equipment. Our community has rallied around our need for PPE. We are grateful for the donations of goggles, face coverings, masks, gloves, disinfectant, hand sanitizer, surgical gowns, face shields and more.

Thank you to all who are personally participating in ensuring our workforce has the equipment we need to keep all of us safe, including the many patients who do not have COVID-19 and need our hospital for unexpected healthcare.

Those who have donated are publicly recognized .

We want to publicly commend the continual rigor of the Medical Staff COVID-19 Taskforce. Collectively, physicians as well as nurse leaders and our CEO, have implemented strict PPE standards of use, and rolled out ‘just in time’ training to those who provide direct patient care services in the hospital and clinics. Earlier this week, based on the most current science, universal masking was implemented throughout the hospital and clinics. We also began documenting everyone who enters a patient’s room. We have implemented this process for all patients, not just those patients on isolation. These efforts, along with a conscientious and compliant workforce will continue to keep our team safe.

At this point, Madera County has a disproportionately low level of confirmed COVID-19 cases. However, in late March, the California Hospital Association projected the need and asked us to increase our surge plan by an additional 40 percent — and we have.

All hospitals have surge capacity plans. These plans are submitted to the California Department of Public Health. The surge capacity plan establishes guidelines and priorities for inpatient bed utilization and management of an influx of patients in need of hospitalization or emergency care.

Madera Community Hospital is an Adult General Acute Care Hospital, licensed for 106 beds. Our surge capacity is 147 beds. Today, in preparation for the COVID-19 Pandemic, our surge capacity is 205 beds. We have purchased additional ventilators, rented additional beds and are ready to provide this level of care.

Hospital CEO, Karen Paolinelli, is in weekly conversation with leadership from the Fresno hospitals and the Hospital Council. These meetings have developed a collaborative commitment addressing staffing, resources and supplies, should any of our hospitals experience an influx of patients.

The addition of Vituity Healthcare and Medical Staffing as our Emergency Department physician group has also strengthen our position. Vituity staffs the emergency departments in Clovis, Saint Agnes, Hanford, Visalia and Los Banos. Vituity’s local Board Certified Emergency Medicine Physicians are networked with national colleagues who are assisting with our preparedness should we experience an emergency response. A company with a national footprint and local relations in neighboring hospitals puts us in an unprecedented position for cross county healthcare delivery.

Last week, Fresno County established a regional alternative care site. The Fresno Convention Center site with 200 cots, was constructed by the National Guard from State supplied resources. The regional resource, if needed will care for non-COVID-19 patients needing minimal convalescence. We are working with the Emergency Medical Services alternative care site team on establishing discharge criteria, transportation and activation rehearsal.

We know people are waiting for a guaranteed COVID-19 treatment and a vaccination. The benefit of having a Board Certified Infectious Disease Doctor on staff is the ability to discern media reports from science. We are pleased to announce, Madera Community Hospital applied for expanded access to Remdesivir, an anti-viral drug showing promise in improving outcomes from a COVID-19 diagnosis. We also procured an additional supply of Hydroxychloroquine for the treatment of confirmed COVID-19 hospitalized patients with moderate to severe disease.

You, our community, have been the true driving force in subduing COVID-19 and we cannot thank you enough! While Madera Community Hospital Administration and front line healthcare workforce continue to be set in the ready position, please remain vigilant about social distancing and continue all virus preventing measures.

We will get through this together.

— Bakht Roshan, MD,

Board Certified Infectious Disease,

Chairman, COVID-19 Task Force

— Terrance McGovern, DO, 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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