Young County leaders meet on COVID-19

City and county leaders met at Graham Regional Medical Center Monday in an effort to establish a combined effort in combating COVID-19 (coronavirus) before it appears in the area and spreads.

Representatives from the city of Graham, city of Olney, Graham Police Department, Young County Sheriff’s Office, Graham Regional Medical Center, Graham Medical Associates, Young County Courthouse and more came to Graham Regional Medical Center to listen to a presentation and ask questions.

Out of an abundance of precaution, members of GRMC were wearing masks during the meeting. GRMC CEO Shane Kernell said as of Monday, the county did not have a case of the virus.

“Right now, there are no confirmed cases in Young County that we know of,” Kernell said. “That could change at any moment, and I expect it to change. Right now, we are seeing an influx of people with flu. That is still going on. It seems like there is a second wind of it going on in Young County and across the nation, so it doesn’t help matters.”

Greg Coker, Young County Emergency Management Coordinator, confirmed there were also no cases within Region 9 as well, according to the communication he received as of Monday morning.

“I am in constant contact with Nortex (Regional Planning Commission),” Coker said. “Nortex controls the 11 counties in Region 9 of the state of Texas. I get updates at 6, noon, 18-hundred, or 6 p.m., and then sometimes, if anything is important, I get an email on it. So right now as of 0600 this morning there are no confirmed cases in 11 counties, so Region 9, and as I get information then it will go out through the chain.”

The physicians within Young County shared common concerns during the meeting about being proactive within the community in prevention and taking the appropriate measures now.

“My concern is that we have so many people that have different ideas and there are a lot of people in the community who do not see this seriously,” Dr. Steve Jones, with GMA, said. “I was at a meeting at our church with Dorman (Holub) on Saturday morning and was told that this was stupid and that I was stupid for saying that Eastside (Church of Christ) shouldn’t have church. And this is a gentleman who is educated and loves people and wants the best, but it just points out to me that not everybody gets it. Now I have lived through enough bad stuff in places like John Peter Smith and Bexar County hospitals to know that I don’t want to have to decide which of the people in this room who get sick from meeting here this morning get the ventilators.”

Jones spoke on an article he read about doctors in Italy having to make the choice of which of three 40-year-old men were going to get the last ventilator in the ICU, with the other choice being death. Jones said the community needs to look what could happen when making their decisions.

“The point that we need to take is community is the first two-thirds of that article. It is ‘my country thought this was a joke’. We kept going to school, we kept going to church, we kept congregating, we kept going to ballgames,” Jones said. “(…) I mean the NBA canceled their season, and we don’t want to cancel our church services tells me that we are not getting it. We are following a route that is already unstoppable. This is going to become a problem, it’s how big of a problem is it going to be and the point of the article that was referenced earlier is to flatten the curve.”

Dr. Ryan Easterling, with GMA Health, who has been releasing videos on Facebook about the virus, said the problem is running into a large number of cases all at once within the area.

“The reason that is such a big problem in Italy, is they didn’t act early. So, so many people got sick so quickly that there are not enough people to take care of them. There is not enough equipment to take care of them, there is not enough medicine to take care of them,” Easterling said. “So treatable people are dying because they don’t have the resources to take care of those people. So the point of flattening the curve is to slow the rate of infection. We might not even save any one specific person from getting sick, but if we can have those people get sick over two months instead of two weeks, we may have hospital space to take care of them.”

Dr. Pat Martin, with GMA, also said it was not a good idea to allow church services to go forward within the community. The group of physicians met with Young County Judge John Bullock on Monday and an emergency meeting of the commissioners court was called to appoint a Local Health Authority for Young County and possibly declare a state of emergency.

“That is the only thing we can do,” Dr. Easterling said. “You can wash your hands all day, good luck. Really, not meeting with people is the one thing you can do to keep Young County safe.”

Bullock said the emergency declaration is sent to the governor who has within 60 hours to approve it. Graham Mayor, Neal Blanton, said the doctors in the community should be spreading the word however they can.

“It is important that the doctors as a whole speak out,” Blanton said. “They are the most respected group in the community. They see this on an everyday basis and so it is really important that you get the word out to everybody that you can, either on your Facebook page or whatever, how important it is to mitigate this thing now versus what it is later.”

Kernell said the hospital is facing the same issue that is nationwide with the virus, which is the testing media.

“They have expanded who can do the testing to LabCorp and Quest (Diagnostics), those are two large national lab companies,” he said. “Still, the leading factor is the media to take the sample that is issued by the government and there are no test kits to really go out and take samples right now. We do have 10 on-site right now.”

Kernell said the hospital will not be releasing patient information due to federal laws, but will report a case of coronavirus to the state where the information will be released. GRMC limited visitors on Friday, March 13 to healthy individuals only that are ages 13 and older from the hours of 6 a.m. to 8 p.m. Kernell said testing is going to be a problem once it is more available for the community due to the restriction placed on those being tested.

“Testing, I know that is going to be a big frustration. I can already anticipate it getting hit with a lot of patients at once. People are going to want to be tested,” Kernell said. “I am sorry, the capacity is very limited right now for various reasons. Right now, it is the (transport) media. And we can’t just indiscriminately test anyone that shows up at once to be tested.”

Dana Price, GRMC Infection Control Nurse, said the Texas Department of Health and Human Services testing requirements can be found online on the department’s website. Those requirements are limited to those with fever, cough, shortness of breath, in addition to having close contact with a confirmed case, having traveled to a location with an ongoing transmission of COVID-19, having risk factors for getting ill from COVID-19 or are hospitalized with COVID-19 symptoms, even if you do not have any risk factors.

“It boils down to symptoms,” Dr. Jones said. “‘I think I have corona.’ Well how sick are you? That is what I need to know as your doctor. How sick are you? If you are running a high fever and can’t breath, you need to get to the emergency room, if you are running a good fever and are coughing a lot, you need to get to the clinic, if you feel kind of bad and have the snuffles, you need to stay and home and call your doctor and report your symptoms and get advice over the phone.”

A representative of Olney Hamilton Hospital said they are following the same steps and adhering to the same criteria for COVID-19 with one respirator for transport and one at the hospital.

GRMC said they will limit the transfer of patients to those with ICU-type conditions which they will not be able to handle.

“ (We will) let those larger facilities take care of those ventilator patients and patients like that,” Sharon Hillard, CNO of GRMC, said. “And by the way, we do have two ventilators here in our hospital. We see ventilator patients frequently, so our staff is all trained.”

Coker asked what plan GRMC had in place in case Young County has a case, or a number of cases, of COVID-19.

“What we have got at our hospital, is we have one reverse-isolation room, one negative pressure room, and we are prepared to put in a patient, if we need to,” Kernell said. “Above and beyond that, we can designate an entire wing as a sick wing and empty out the hospital, of course, of our inpatient elective surgeries which has been done, and if need to we can expand from there. We have got multiple points in the hospital we can do that.”

Kernell said the max capacity would be 30 patients at the hospital and that all elective procedures, outside of a few surgeries which will not require an inpatient stay at the hospital, have been canceled.

“Anything that requires an inpatient stay after surgery, has been canceled, so total joints is primarily what we do that result in inpatient stay orthopedic-wise, those have been canceled.” Kernell said.

The city of Graham released a statement Monday about how they are approaching the virus. Mayor Neal Blanton said Monday at GRMC that the city will not be restricting meetings.

“We are not going to tell anybody right now that they can’t meet,” Blanton said. “We are not going to tell Dorman that he can’t have church, but we are going to emphasize the importance of what the governor says and what the CDC says about groups and how it is transmitted and the importance of separating yourself from other individuals. We are going to take a proactive role in that. We think that everybody needs to speak with one voice. That’s the hospital, that’s the county, that’s everybody (to say) that this is a serious situation that we need take it seriously, but we don’t need to panic.”

City Manager Brandon Anderson said if locally the medical professionals wanted to establish a group to give advice on what steps the city could take, they would adhere to their advice as health professionals.

“I believe we need to weigh heavily on our medical professionals, and that’s where the information needs to come,” Anderson said.  “And what we need to do as leaders and as respected individuals within our community is when that comes across, we need to share it. The other thing I have talked to about our city staff is how you handle and how you outwardly show your emotion during this as well. We need to show confidence as a leader, but there needs to be a level of balance within our emergency feelings, but not to create the panic side.”

Young County Sheriff Travis Babcock ceased visitations to the Young County Jail on Friday, March 13 and said during the meeting Monday that there were no inmates or staff with flu-like symptoms.

“Everybody is getting checked for temperature once they come in to work and they are going to get checked when they leave,” Babcock said. “And I understand that that doesn’t mean a whole lot, but it does to me.”

Babcock said by the end of the day Monday, Young County dispatch would have a way of screening potential calls to 911. Young County EMS Paramedic, TJ Ward, said they will attempt to limit exposure to calls that could potentially be COVID-19 cases. Dr. Jones said the key is to act now in making sure the area is safe before a case does come to the county.

“A week ago today I started realizing the impact of it and Saturday I was praying for our lunch and I started crying with our family because I don’t want to happen here what has happened other places and just to make sure that we are being wise about the things that we are deciding,” Jones said. “If you haven’t been in a situation where you had to make life and death situations between two people, I don’t know that you are going to fully comprehend what this is like. We’ve been there as physicians because of the places that we have trained and the things we were put through, and there are other people the room that have as well.”