On Tuesday, May 19, 2020, a panel of area healthcare experts met via teleconference to discuss their individual experiences since the quarantine began in late March. The leading topics discussed were testing, new approaches to mental healthcare and reopening of dental care. Roughly 80 individuals attended the teleconference and were able to ask specific questions of the panelists.
Tony Degina, who has recently joined Bayfront Health as their CEO reported that all procedures, including elective have resumed. Bayfront has instituted a streamlined process for patients undergoing elective procedures, modifying their pre-surgical testing procedures.
Bayfront is not testing its staff en masse, however is using screening procedures, such as temperature checks, and having employees self-monitor any symptoms.
Staff at Bayfront now have the opportunity to shower before returning home. Degina also emphasized that the hospital’s Employee Assistance Program (EAP) is available to support staff from an emotional perspective, and just to make sure they are comfortable and getting their questions answered if they have any.
Bayfront is also home to Enrichment Centers, which provide services for seniors such as meals and socialization. “Bringing seniors back into an indoor environment where they might have close contact or would have close contact to others is something that would have to be managed very very closely,” Degina said. The attendees of these programs will also undergo temperature screenings.
Degina, as well as the other panelists acknowledge that there are things that are not known about the virus that causes COVID-19. “We have a lot to learn about this virus, about how we’re going to manage it.”
The “New Normal” for everyone in healthcare right now is enhanced sanitization and infection control procedures.
While most of the attention has been focused on remaining physically healthy and avoiding the coronavirus, patient care in the mental health specialty has also noticeably changed. Sandra Marrero, Clinical Services Manager for Baycare Behavioral Health addressed the topic.
“Flying the plane as we're discovering new things is kind of how we're planning right now,” Marrero said, illustrating again that practitioners are rapidly finding new information, and adjusting their approaches frequently.
Marrero stressed the importance of communication with those requiring mental health services, as well as the providers. “We have to be careful with how we communicate and sort of balance the message,” she explained. It’s important that the healthcare team members feel supported and healthy as well as the consumers, because it’s important that they continue to receive necessary services.
Baycare Behavioral Health is using a telemedicine approach to remain in contact with those with substance abuse challenges and other mental health concerns. “As you can imagine, the need for services has not decreased during this time.”
Marrero calls the challenges faced by patients with substance abuse issues, “A perfect storm.” In these really trying times, overdoses are on the rise. She also reports an increase in the number of patients who do not show for scheduled appointments as high as 50%.
The number of people entering the system under the Baker Act has also increased.
“I don't see our services going away, but the need is definitely shifting.”
There are first aid classes available for lay people to learn how to assist in a mental health emergency. The classes have been on hold, but Marrero led a class in the past week with limited attendance. In these classes, attendees are taught how to identify a crisis, and learn how to help, whether it's a suicide prevention hotline or numbers for Baycare’s services.
Business leaders can assist their staff by offering an Employee Assistance Program. Marrero added, “try and create a culture of mental health literacy, so that it's safe for people to ask for help if they're in a crisis or just feeling really uneasy and need somebody to talk to.”
From the Florida Department of Health, Robin Napier reported that Hernando County has performed 2,742 tests, resulting in a 4% positivity rate. As of this writing, there are 109 total cases in the county. Of those 109 cases, 99 are now cleared of the virus.
“Those (99 individuals) have been clear from isolation. What that means is it's been at least ten days since their onset of symptoms and at least three days or 72 hours with no symptoms … just knowing that 99 of those have been cleared on gives us a little bit of relief that people are surviving and doing well after COVID-19.”
No residents of long-term care facilities in the county have tested positive.
Testing is now available to anyone, regardless of symptoms. However, when scheduling an appointment with the Health Department, there are designated times for those who are symptomatic. Symptomatic people can schedule from 8:00 AM - 10:00 AM, and asymptomatic people can schedule from 10:00 AM to 3:30 PM. Those who wish to be tested will need to bring a copy of your insurance card, and photo ID, but there is no cost for the test.
Going forward, as the quarantine lifts, Napier stressed the importance of continued diligence in handwashing and social distancing. “As we reopen in phase one ... we really need to continue to use those safeguarding measures that we've been practicing all along: good hygiene, staying home if you’re sick, and if you do go out, practice social distance. Maintaining that six foot distance is still so critical in stopping the spread of this disease.”
Following Napier, Joseph Resnick, CEO of Premier Community Healthcare reinforced the practices she mentioned. He also reminded the audience that the information that will continue to come out as the state reopens may be contradictory, and that the community as a whole is on the same “learning curve” as the practitioners.
Resnick reported that both of his facilities in Brooksville and Spring Hill are currently offering primary care, however dental care is only being offered in the Spring Hill facility at this time.
There are no immediate plans to deploy Premier’s Mobile Dental Care unit at this time.
Premier will also be offering testing for the presence of coronavirus beginning June 1.
Oak Hill Hospital’s CEO Mickey Smith reported that the hospital has begun drive-through testing for patients entering the facility.
Reiterating the cautiousness of his fellow panelists, Smith cited a case of an individual who was tested at Oak Hill. “We had a totally asymptomatic 30 year old patient come in and test positive. You never would have known it. So, it's the message that I'm trying to get to my staff right now -- this is probably the most dangerous time of this pandemic.”
Smith went on to say, “The state is starting to open back up and now is when we don't need to let our guard down. This is a mean, sneaky virus. There are lots of folks that are asymptomatic that are shedding the virus and so the universal masking the social distancing is even more critical.”
Dr. Husam Abu Zarad explained that the Crescent Community Clinic has been closed since the beginning of March, however his ‘dynamo’ staff have been keeping in close contact with patients. Dr. Zarad described the phone calls as a “warm touch,” to make sure that the usual visitors to the clinic have any prescriptions refilled, and also to provide the human factor of support.
The clinic also caters to the homeless population, and the staff have been conducting “field trips” to the homeless, to make sure that they have the necessary supplies. The staff has been providing masks, and educating the patients about the social distancing and enhanced hygiene.