Subject: Timberlake Alert - Message from Dr. Tom Faber, Zuni Indian Health Serv ice Hospital Clinical Director

Draft PSA Script for COVID-19 (March 16, 2020)-

Hello- this is Dr. Tom Faber, the Clinical Director of the Zuni Indian Health Service Hospital.  I am speaking with you today, Tuesday, March 17th 2020 on behalf of the Zuni Hospital because we want to provide you with the most recent information about the Coronavirus.  We also want to inform you about what we’re doing at the hospital to prepare for this public health emergency.    

Since we last updated you, the Coronavirus, or the illness it creates called COVID-19, has spread across much of the world, including the United States.  Recently, cases were reported in New Mexico, and given what we know about how easily COVID-19 spreads, we need to be prepared for the virus here in Zuni. 

Because this is a rapidly evolving situation, the information we discuss today, Tuesday, March 17th, can change.  For the latest information, we recommend checking the Centers for Disease Control (CDC) website at www.CDC/coronavirus.gov or just google CDC coronavirus.  You can also call the NM Department of Health Coronavirus Hotline at 1-855-600-3453. 

I wanted to begin by describing some of the actions that we at the hospital are taking to provide the best care possible while also doing everything we can to prevent the spread of this virus.  Starting Wednesday, March 18th, you will notice several changes- all meant to improve your safety. 

First, we are changing the way people enter and exit the hospital in order to separate those who might be sick with COVID-19 from those who don’t have any symptoms.  We have designated two separate entrances: The main or north hospital entrance by the dialysis unit will be for anyone who has a cough or fever. This entrance will be color coded RED.  The north east entrance by administration will be for those people who do not have any symptoms.  This entrance will be color coded Green.  

Secondly, when you enter the hospital during regular business hours, you will be greeted by a medical screener who will confirm whether or not you have a cough or fever and redirect you to the correct entrance if needed.  If you don’t have any symptoms of cough or fever, you will be given a green paper indicating that you have been screened and can proceed to your planned destination, such as the lab or your clinic appointment.  For patients with symptoms, we will ask you to sanitize your hands, put on a mask to cover your cough, and we will then escort you to a waiting area specially designed to prevent the spread of virus outside of the room.  Patients will be instructed to wear the mask for the entire time they are in the hospital.  Obviously, patients with concerning symptoms such as shortness of breath or chest pain will be assessed right away.  When leaving the hospital, we ask you to exit from the same door in which you came in. 

 

During this time, our laboratory will open one hour later than usual and will be open for your pre-visit lab draws from 8:00 am to 5:00 pm Monday through Friday.

Thirdly, we are limiting the number non-urgent appointments to decrease the number of people coming into the hospital and potentially becoming infected with COVID-19.  Many scheduled appointments are still happening, but whenever possible, we will be contacting our patients to convert these clinic visits to telephone visits.  It’s still very helpful for you to get your labs done before your medical telephone visit.  This way, you and your doctor can talk over the phone about your medical needs without any risk of you getting infected with COVID-19 during the appointment.  Some appointments, especially those with the dentist, eye doctor or physical therapist will need to be rescheduled until the risk of COVID-19 is lower. 

Of course, patients with any urgent or emergency health concerns, can always be seen, and we remain open 24 hours per day, 7 days per week to care for you. 

Fourth, we are making changes to our medication refill process to better accommodate your needs at this time.   Starting Tuesday, March 17th, Patients will be given 90 day refills, rather than the typical 30 day supply.  In addition, you can pick up your refills from the hospital parking lot, and you don’t even need to enter the building.  Just check-in with the pharmacy staff located in the Mobile Dental Van in the east parking lot, and they will bring your medication refills to you.  Nothing will change with the process for calling in to request refills, and you will still receive a text message when your refills are ready.  During this time, refills will only be dispensed between the hours of 8:00 am and 6:00 pm Monday- Friday. 

If you are picking up new medications following a clinic or urgent care visit, you will continue to pick them up at the pharmacy window as before. 

As I mentioned in the beginning, this is a quickly evolving public health emergency.  Over the coming days and weeks, we will probably be instituting additional measures to meet the needs of our community.  We will be sure to update this message often to keep you informed along the way.  All of us at the hospital greatly appreciate your understanding during this time, and we want you to know that by staying away from others if you are sick, by washing your hands and covering your coughs, you can play an important role in protecting our Zuni community from COVID-19.

In addition to the current measures we are taking at the hospital, we also wanted to provide the latest update on the COVID-19 virus itself and how you can keep yourself healthy.  

Here are answers to some of the most common questions people are asking:

What is the Coronavirus or COVID-19?  In December 2019, a new virus was found in China.  Viruses are germs that spread to people and make them sick.  Viruses are very common, and we have all been infected by them – probably within the last year.  The common cold is a virus that gives you a runny nose and a sore throat.  Influenza is another virus, which causes a fever, body aches, cough and has infected a lot of people in Zuni this year.  Here at the hospital, we see people with respiratory viruses every day.  The Coronavirus is just a new virus similar to the flu.  Like the Flu it is called a respiratory virus because it lives in the mouth, nose, and lungs and is spread by coughing, sneezing, and touching your mouth or nose and then touching a surface or another person- like with a handshake. 

Here is what we know so far:

What are the symptoms? 

People with COVID-19 usually have fever and cough, and some even have trouble breathing. Other symptoms can include runny nose, headache, sore throat, and a general feeling of being unwell.

How is COVID-19 spread?  COVID-19 seems to spread very easily from person to person.   Just like the cold or flu, COVID-19 lives in saliva, mucus, and tears, so when we cough, sneeze, or touch our eyes/ nose/ mouth, the virus is ready to spread.  COVID-19 moves from one person to another by being carried on little water droplets after a cough or sneeze, on the surface of a table or counter, or through direct contact like kissing or even a handshake- if you then touch your eyes, nose, or mouth without washing your hands first.  Right now, the CDC is saying that the virus can travel on water droplets as far as 6 feet, so someone could be infected by a person coughing 6 feet away. 

How can I protect myself and my family from getting COVID-19?  There is no vaccine against COVID-19, so the best way to prevent illness is to avoid being exposed to the virus.  How can you do this? 

 Number 1, avoid contact with people who are sick.  This means that if you are sick, stay home from work and even do your best to stay away from friends and family.  If you are not feeling sick, do your best to avoid being around others with cough and fever.  This is the reason why so many schools have closed across the country and why public gatherings have been banned in most communities.  Here at the hospital, we would also ask patients to not come into urgent care if you are have a mild cough or fever.  Unless you feel as though you need urgent medical care for difficulty breathing or other serious symptom, it is best for you to stay home, rest, and prevent spreading the infection.

Number 2, cover your cough or sneeze with a tissue, then throw the tissue in the trash.  If no tissue is available, cough into your elbow.  Wash or sanitize your hands after throwing the tissue in the trash.

Number 3, clean and disinfect frequently touched objects and surfaces often using a regular household cleaning spray or wipes.

Number 4, wash your hands often with soap and water for at least 20 seconds (that’s singing the happy birthday song twice), especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.  If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Number 6, if possible use a face mask over your nose and mouth if you are coughing or sneezing.  If you have a cough and are entering the hospital we will also give you a mask to put on right away to prevent spread of the virus.  When you leave the hospital, discard your mask in the trash at the exit and sanitize your hands. Avoid touching door handles or door bars as you exit.

Don’t forget about all the other ways you can remain healthy too, such as: drink lots of water, eat healthy, keep stress levels down, get plenty of sleep, and make sure to get your flu shot and if eligible the pneumonia shot.

 How dangerous is the COVID-19?  Right now, it appears that at least 80% of people infected with the Coronavirus have very mild symptoms, such as slight cough, fever, and runny nose.  Some people have no symptoms at all.  Others, however, can develop an infection in their lungs, which can cause shortness of breath and low oxygen levels.  These are the people that need to come to the hospital for care.  1-2% of patients may even die from COVID-19.  This is why we are remaining so careful to do everything we can to prevent the spread of this infection. 

Who is at highest Risk: People at highest risk seem to be elders and people who have severe chronic medical conditions like heart, lung or kidney disease.

Advice for people at higher risk of severe disease includes: Stay at home as much as possible; When you go out in public, keep away from others who are sick, limit close contact and wash your hands often; Avoid crowds.

 Is there a test for COVID-19?   Yes there is, but our current ability to test for COVID-19 here in Zuni is very limited.  We at the hospital are working with state and federal agencies to quickly increase our ability to test for COVID-19.  Right now, however, we are not able to provide routine testing.  

How is Coronavirus Treated?  There is no medication that kills the Coronavirus. Right now, the best medical treatment is to rest, stay hydrated, and treat your symptoms with medications if needed.  For example, if a patient has a fever, taking Tylenol is appropriate to lower the fever and help you feel better. 

For the vast majority of people, this treatment plan of rest will be enough for your own immune system to kill the Coronavirus and allow you to return to normal.  For a very small number of people, severe symptoms such as difficulty breathing will occur, and for those people, oxygen and other treatments may be necessary. 

This is the reason why we are asking: if you have mild cough and fever, the best thing you can do is to stay home, avoid contact with other people, and rest.  This way the hospital can be better prepared to care for the patients who do need to come in for shortness of breath or severe illness. 

If you do come in for care, please try to limit the number of healthy people that come with you.  We don’t want your relatives catching the Coronavirus or a cold while they are here with you. 

We understand that it can be a very scary situation to hear about COVID-19 in the news.  It’s important to remember that there are things you can do to prevent infection- good hand washing, covering your coughs, cleaning high touch surfaces like door handles and counter tops, and separating yourself from other people if you have a cough or feel feverish.  People with severe or concerning symptoms- mainly difficulty breathing- need to seek medical care, but those with mild symptoms are actually better off staying at home with rest and preventing contact with others.  Together we will get through this public health emergency.  We will be providing updated information as it becomes available.  Thank you for your attention.