Gaelon Spradley, as CEO of the Valley View Health Center, I'm anxious to talk to you about your response to a potential local coronavirus outbreak. But first let's talk about Valley View. How many Valley View Health Centers are there and where are they located?
We have 13 clinics located in three counties. We serve Lewis County, Thurston County, and Pacific County.
Valley View is a nonprofit, federally qualified health center. What does that mean? And who do you serve?
Valley View is a nonprofit provider of health services, medical, dental and behavioral health. Our focus is serving rural communities and also low income and special needs individuals. Federally qualified health centers may also focus on other underserved groups, such as new citizens, immigrants or the homeless.
We qualify for federal healthcare subsidies. In the past communities have depended on doctors in private practice. These practices are disappearing in small towns and we are trying to fill that void.
Valley View's focus is on primary health care. Could you describe the types of care that entails?
Primary health care is the new name for what was called family medicine 30 years ago and general practice before that. Primary health care providers see newborns and the elderly and everyone in between. They handle acute medicine, which includes injuries like lacerations and infections such as the flu. They also help patients manage a full range of chronic illnesses, such as diabetes and hypertension. In urban settings a patient typically sees a primary care provider before going to a specialist. Rural communities rely on primary care providers to provide comprehensive services in the absence of specialists.
Are you coordinating with the Centralia General Hospital and the Lewis County Health Department?
We are working closely with the county health departments and also with the state Department of Health, who is under tremendous pressure from the national attention Washington is receiving, because of our status as the center of the country's largest and most severe coronavirus outbreak. We are working closely with hospitals in Lewis County.
Have the number of patient calls and clinic visits increased with the concerns about the coronavirus?
We are receiving more calls, but the number has not been overwhelming. In preparation for significantly more calls, we are developing more telephone triage resources.
What medical staff do you have in Lewis County? Do they have training to deal with a local outbreak?
In addition to our dental and behavioral health providers, we have four medical providers serving the Lewis County community. They are supported by our nurses, medical assistants, and medical receptionists.
We have developed protocols and are training our staff and providers to take care of patients in our community should there be a local outbreak. All patients are screened for symptoms of coronavirus and asked about their contact history when they call or come to the clinic. Our goal is to ensure patients get the care they need while preventing spread of the virus. Patients with flu-like symptoms including cough and fever are asked to stay home. But if they come to clinic they may be asked to wait in their car to be evaluated. If they arrive by public transportation or on foot, we immediately place them in a room to avoid contact with the people in the clinic waiting area.
If a patient with no underlying or chronic illnesses calls and describes covid-19 like symptoms, which are similar to the common cold or flu, what do you tell them? What do you tell someone with chronic health problems or an older patient?
We've worked with our staff to help them remain the voice of calm and reason when responding to worried patients. We remind people that it is still the flu season. It is much more likely that they are suffering from the flu, even if they've had a flu shot, than from covid-19. However, if a patient is experiencing severe coughing, shortness of breath or rapid breathing and a fever, we would encourage them to contact their primary care provider as soon as possible. If you do not have a high-risk condition and your symptoms are mild, you may not need to be tested for COVID-19; there currently are no medications to treat this illness. You may be asked to stay at home, and will be given advice about how to yourself from others while you are sick.
People who are over 60, are pregnant, or have underlying medical conditions - and certainly anyone with more severe symptoms including significant shortness of breath or respiratory distress - we would most likely direct them to go to an emergency room. Hospital emergency rooms are much better equipped to respond to respiratory distress than clinics. They are also able to isolate patients.
Do you have access to testing for the coronavirus? Have any of your patients been tested?
While we will soon have the capacity to test for COVID-19, our public health partners are still recommending that testing be coordinated through local emergency departments. If these recommendations change we will work with staff to implement the recommended updates. We have not yet taken any tests and we haven't seen any suspected covid-19 cases. It is also important to remember that it's not prudent to test everyone with flu like symptoms.
People are being bombarded with conflicting information on the coronavirus and there is no definitive guidance on how to respond. The health department is referring people to Facebook and several websites, which can also be confusing. Where are you getting your information?
The media tends to cover a single issue over and over again. Today's issue is the coronavirus. At Valley View we are following the recommendations of the CDC and receiving regular updates from our county health departments. The county health departments are our most reliable sources of information. They are monitoring the local and regional situation and talking to the state health officials. We also have to remember that there are still many unknowns, so there are questions that can't yet be answered.
Do you have anything else that you'd like to tell people in our community?
We need to remember that there have been no confirmed cases in the communities we live in. However, there is a possibility that we could see significant numbers of covid-19 cases over the next few weeks. For now, we are advising people to be cautious, follow the recommended best hygiene practices, including frequent hand washing, avoiding touching your face, keeping surfaces clean and staying home if you're sick. These practices are applicable to all types of disease prevention. Those of us with higher risks may want to avoid events with large crowds, traveling on planes, trains, buses and especially cruise ships with close contacts to other people.
The evidence regarding the coronavirus dictates caution, but not panic.
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