Officials say Please Stay Home

Shelby County Hunkers Down. Residents settle in, prepare for possible coronavirus arrival here
Those who require hospitalization are usually those more significantly ill or with underlying conditions that put them at increased risk of severe illness. --Sarah Devine, MD, Chief Medical Officer

    COUNTY -- It’s apparent that Shelby Countians are taking the COVID-19 pandemic seriously, and are doing everything correctly to stop the spread of the coronavirus should it eventually show here locally.
    As of Thursday morning, there still are no confirmed cases of COVID-19 in Shelby County, according to Shelby County Public Health and Myrtue Medical Center.
    Statewide, that number jumped this week to 145 with Iowa recording its first COVID-19 related death this week.  (See accompanying article)
    While Iowa Gov. Kim Reynolds has not yet ordered a shelter-in-place directive, Shelby Countians are pretty much doing that on their own anyway as local officials advise residents to just stay home if at all possible.
    Local health officials want to praise the efforts of everyone so far, and are urging continued vigilance.

Myrtue Prepared
    Myrtue Medical Center continues to closely follow guidance from the Centers for Disease Control and Prevention and Iowa Department of Public Health (IDPH) with its response to COVID-19.
    “We have practiced emergency preparedness and response for many years, including pandemic response, and utilize best-practice incident command protocol with our local, regional and national partners,” said Myrtue Chief Executive Officer Barry Jacobsen.
    “We are keeping a close eye on medical supplies, including personal protective equipment, and currently have a good supply,” stated Jacobsen.  “The Iowa National Guard is delivering a shipment of supplies and personal protective equipment to Shelby County on March 25.  In general, Critical Access Hospitals have less than two ventilators.  Myrtue is fortunate to have three permanent ventilators.  We have also received an additional ventilator, and have the capability to provide respiratory support with the use of other machines and supplies on hand.”
    IDPH states about 80 percent of Iowans infected with COVID-19 will experience only mild to moderate illness.
    Like other hospitals in the state, Myrtue has suspended non-essential surgeries in an effort to preserve equipment, such as gowns and masks. The Iowa Department of Public Health also has asked businesses and organizations to consider donating personal protective equipment.
    Myrtue has received outreach from private business and organizations wanting to help, including those offering to make homemade masks.
    “We are exploring all options to meet the demand of personal protective equipment,” Jacobsen said.  “Many staff, including non-clinical, have been cross-training to other areas, and we are using our staffing resources to best manage the labor pool in this ever-changing environment.”

Can increase bed capacity
    Myrtue is a 25-bed facility, and plans are in place to increase bed capacity if needed. Average daily patient census in the hospital has been consistent at around 11 patients.
    “Patients will be treated and triaged at Myrtue, and protocols are in place to transfer to one of our referral facilities if appropriate and beds are available,” said Jacobsen.  “We continue to follow COVID-19 testing in accordance with state recommendations.
    “IDPH is guiding the testing, and our level of testing is consistent with what is being done statewide. Test kits from across the state are sent to the State Hygienic Lab, and testing is being performed by the State Lab only when certain criteria are met.”
    Jacobsen said the data changes daily, and as of Wednesday, March 25, IDPH reports 2,578 negative COVID-19 tests statewide reported by the State Hygienic Lab and other labs. Myrtue has done 18 tests to date, which aligns with state testing numbers per capita, considering the population of Shelby County.

Public will be notified
     If a COVID-19 case is confirmed in Shelby County, Myrtue’s Public Health Department will be advised, and the public will be notified, Jacobsen said.
    Myrtue’s response to a positive case will follow established protocols, and the public will be asked to maintain the practices set forth for social distancing, hand washing and staying home when ill.
    “We all must do our part to flatten the curve and eliminate the spread to protect everyone’s health and well-being,” Jacobsen said.

Mass testing not advised
    Sarah Devine, M.D., chief medical officer for Myrtue Medical Center, said Myrtue staff is committed to caring for all persons serviced in the county and region.  Like Jacobsen, she said Myrtue is following the guidelines set out for testing by the Iowa Department of Public Health.
    “It is important to understand that with limited testing available (not just the tests themselves but the personal protective equipment required for testing), mass testing isn’t advised,” Devine said.
    Symptoms may be mild and include fever, cough or loss of taste or smell.  These symptoms are similar to influenza or even allergies, if without fever.
    “Currently if you are ill and less than 60 years of age and without underlying medical problems, you may be asked to self-quarantine at home,” Devine said.  “This means that you may or may not have COVID-19, but if you are doing well and testing wouldn’t change your treatment, you may not be tested.”
    Those self-quarantining should monitor for worsening respiratory symptoms (cough, shortness of breath, wheezing), and call their provider immediately if these develop.  Worsening respiratory symptoms will be evaluated and may require testing as it may change treatment course.

Hospitalization means testing
    “All those requiring hospitalization and all those with an increased risk to others in the community will require testing,” Devine said.
    “Those who require hospitalization are usually those more significantly ill or with underlying conditions that put them at increased risk of severe illness,” she said.
    Testing also includes those who live in facilities where others may be exposed (for example nursing homes, assisted livings, residential facilities or correctional facilities) and those who care for those individuals (healthcare providers, fire and EMS, law enforcement and staff of residential facilities).
    “This is by no means all inclusive, but the goal of testing guidelines is to get testing to those at highest risk from having the disease and those at highest risk of transmitting it to that group,” Devine said.
    The basic guidelines are:  1)  Stay Home.  2)  Stay in touch with your provider.  3)  Wash your hands.  4)  Cover your coughs and sneezes.
    “If you have questions regarding if you should be tested, self-quarantine or if you should be evaluated, the state has set up a hotline for COVID-19,” Devine said. “Dial 211 for this hotline.  You may also get information through your provider.”


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