Sikeston, area medical providers prepared for COVID-19 outbreak

Thursday, March 12, 2020
Eric Slaughter, infection prevention/safety and emergency preparedness coordinator at Missouri Delta Medical Center, practices good hand-washing techniques Monday at the hospital in Sikeston. Washing your hands often with soap and water for at least 20 seconds is one of the easy steps to help prevent the spread of the coronavirus, or COVID-19, according to the Center for Disease Control and Prevention.
Leonna Heuring/Standard Democrat

SIKESTON — The first case of COVID-19, or the coronavirus disease 2019, in Missouri was confirmed over the weekend, but state and local health officials have been preparing for a possible outbreak for the past couple months.

“We are prepared for this outbreak, and even with the pandemic, we’ve been preparing since December for this,” said Eric Slaughter, infection prevention/safety and emergency preparedness coordinator for Missouri Delta Medical Center in Sikeston. “We have daily briefings with administrators at the hospital and our clinical leaders.”

The Sikeston hospital has been in contact with the Centers for Disease Control and Prevention every step of the way in regard to their guidelines and updates, Slaughter said.

“I’m researching every day, blasting out protocols, memos and updates, updating criteria and going around educating our front-line staff and our providers,” he said. ‘We’re working very closely with the Missouri Hospital Association, the CDC, World Health Organization and emergency agencies.”

Slaughter said he’s also in constant contact with the state epidemiologist at Missouri Department of Health and Senior Services.

“This is a very tight-knit group as far as everyone coming together cohesively in Missouri,” he said. “We’ve now organized bi-weekly meetings with the local ambulance/EMS directors, health departments as well, and our hospital is involved with that.”

On Wednesday, the World Health Organization officially ruled COVID-19 outbreak a pandemic, which is defined as sustained outbreaks in multiple regions of the world.

President Donald Trump also announced a ban to most Europeans from entering the United States or 30 days to try to slow down the spread of the coronavirus, effective at midnight Friday. The NBA suspended its season, and the NCAA tournament was canceled.

Slaughter said Sikeston and Southeast Missouri are prepared to handle a local outbreak.

“We’ve been reviewing all the personal protective equipment and the inventories we have on hand. Statewide, the Missouri Hospital Association is doing that as well. We keep a computerized query that every hospital in state of Missouri responds to make sure that everybody in the state has adequate supplies.”

Missouri Delta is equipped with the airborne isolation rooms — the negative air pressure rooms that are recommended by the CDC — to place these patients in if they test positive for COVID-19, he said.

Missouri Delta and its clinics also have the capabilities to test for the virus using “test kits” to collect specimen via a nose swab, throat swab or sputum.

“We’ve set a protocol. We have the supplies and we can test,” Slaughter said.

MDMC then sends the collections to the state lab, he said.

“The state of Missouri is now capable of running the COVID-19 test at the state lab so we would send test specimens to the state lab. They’re shooting for a one-day turnaround on the test at the state lab, which is a big improvement; the CDC was two to three days,” Slaughter said. “They’re hoping that private labs, starting this week, will be begin running the tests as well, and that will speed up the turnaround even faster.”

As of Thursday, Missouri Delta has not tested anyone for COVID-19.

“Even as early in January, we had people who had traveled to China or their co-workers that traveled to China report to us, and they had respiratory illness symptoms, but based on the ‘patient under investigation’ criteria that we follow and based on the guidance from our health department and our epidemiologist, none of those actually ended up meeting criteria (to be tested) at those times,” Slaughter said.

The CDC has a COVID-19 exposure grid for healthcare providers, which explains risk levels — from high to no-identifiable risk, Slaughter noted.

“It comes in handy, and we’ve been using that grid because calls have been coming since COVID-19 was confirmed in Missouri,” Slaughter said. “… To be considered high-risk for exposure, you need to be within 6 feet of the (infected) person for at least five minutes.”

According to the CDC, patients with COVID-19 have reportedly had mild to severe respiratory illness. Symptoms may appear 2-14 days after exposure and include fever, cough and shortness of breath.

The CDC said individuals who think they are sick or are getting sick should not report to work. Individuals should monitor for cough, shortness of breath, and fever and should practice social distancing to avoid the spread of any illness they may have.

“I would encourage people if they’re running a fever and have respiratory illness symptoms to see their doctor (call in advance),” Slaughter said. “So far, the data shows in many people this is somewhat of a mild virus in the first week, and then there’s often a clinical deterioration in the second week, and they can come down with pneumonia or another very serious illness, and those people often require hospitalization that come down with those severe second-week illnesses.”

If someone is sick, it would be very wise to be seen by their provider so they can rule out basic respiratory illness very quickly with their testing, he said.

“If they still don’t have a rationale for why you’re sick, we probably need to be talking to the health department and probably testing for COVID-19,” he said.

Individuals experiencing the described symptoms and have had contact with a confirmed case of COVID-19 should contact their health care provider or emergency room by phone first.

“If they let our staff know ahead of time, we can streamline even better them coming in immediately masking and being taken to a private room. We don’t want people to come and sit in a waiting room, coughing all over everyone,” Slaughter said.

“When you come to us and you present with a respiratory-type symptoms, we are immediately putting a mask on you, placing you in a private room and screening in you at the point,” Slaughter said. “We still want to know if you have been to any of these high-risk countries or if you’ve been around any confirmed or suspected cases yourself.

He continued: “If you meet those criteria, those medical professionals are to immediately call me, whether it’s at our clinics or hospital. Then, I get involved and we further evaluate that patient.”

There’s a two-page “patient under investigation” form released by CDC, and it asks all the questions the epidemiologists need to know, Slaughter said.

“Once we complete that form, we contact the state lab, the epidemiologist and they give us guidance based on all the information we’ve obtained,” he said. ‘If we meet that criteria, then they’ll want to test for COVID-19 – but before we test them for that, typically, we’re going to run our standard respiratory pathogen panel. We’ll test them for the flu, for all the common viral and bacterial infections that can cause very similar symptoms.”

With the virus being community-acquired now – the concern isn’t context so much as symptoms, Slaughter said.

“If we can identify a reason why you have a respiratory illness, then we know that is most likely your problem, not coronavirus,” he said.

It is at the guidance of the state epidemiologist, Slaughter said, that if someone who tests positive is ill enough to require hospitalization, Missouri Delta would keep them and they would be placed in the airborne isolation.

“If they are well enough to go home, typically, people have been told to self-quarantine until those results are known,” he said.

The COVID-19 situation continues to evolve, Slaughter said. Missouri Delta officials have been in ongoing meetings, and updates to the hospital’s procedures will be dispersed to the public as they are made, he said.

The pandemic status does not change what people should still be doing: cleaning their hands often, cleaning high-touch surfaces daily, staying home when sick and monitoring symptoms, Slaughter said.

Currently, the CDC frowns upon people who are low-risk wearing the face masks, especially if they’re not trained to wear them, Slaughter said.

“The typical person would put that mask on, and they’re going to wear that around and reach up and touch their face, adjust the mask. They’re touching the environment and bringing bacteria viruses right to that mask on their faces,” Slaughter explained.

Also, if the general public takes all the masks, then the ambulance crews and emergency staff — the people who are at high risk in close procedures — wouldn’t have them, he said. The supply really needs to be reserved for the medical providers, he added.

“If you have the symptoms, wear the mask – not necessarily wear the mask to not catch it,” he said.

Something that will help is for the people who must self-quarantine to honor that, Slaughter said.

“The CDC’s COVID-19 public page is updated daily. There really is information there for all questions,” Slaughter said.

The CDC update is at cdc.gov/covid19. The state Department of Health and Senior Services said residents and medical providers needing advice on the virus can call the newly opened toll-free hotline, 877-435-8411, at any time on any day.

Communication is key here – whether it’s the public or healthcare providers, Slaughter said.

“People need to do the common-sense practices, such as washing their hands, covering their coughs and sneezes – the same things we tell you during flu season every year,” he said. “If they would do those things, their chances drastically are reduced for having to worry about contracting this virus.”

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