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Scott Webb: The Salinas Valley Memorial Healthcare System podcast on COVID-19 was recorded on March 13th, 2020. Though it's easier said than done. The Coronavirus COVID-19 is not a reason to panic. It's a time to educate and prepare ourselves to deal with this situation. And joining me today to help us all understand COVID-19 and how medical professionals in Monterey County are dealing with this pandemic is Carla Spencer, Director of Emergency Services at Salinas Valley Memorial Healthcare System. I'm Scott Webb and Carla, thanks so much for joining me. I know you're busy. To get things started. What is a Coronavirus?

Carla Spencer: So the Coronavirus is a respiratory disease caused by the novel Coronavirus and it was first detected in China back in, you know, the beginning of the year, sort of December and January. So that's essentially high level what the virus is.

Host: Okay. So we've got novel Coronavirus, Coronavirus, and now really the pandemic is as a result of this strain, the COVID-19. So what exactly is COVID-19? How did we get here?

Carla Spencer: COVID-19 is just an abbreviation for Coronavirus disease. And basically the 19 is just because it started in 2019 actually in China. So COVID-19 is just the abbreviation for Coronavirus disease 2019.

Host: How is the test administered? I think that that's what a lot of people want to know. How do they know that they, that they have this Corona virus? How is the test administered? Where can they go? What are you doing locally there in Monterey County? Let's cover that.

Carla Spencer: So testing, you know, we are really guided by the CDC and the Monterey County Health Department in terms of testing. So the actual test that's done to determine whether a person has COVID-19 is two different swabs and the swabs are like, we would test somebody for flu. So there's a swab that goes deep into the nose and then a swab that goes deep into the throat. So the throat swab is almost like, if you've ever been tested for strep throat, same sort of thing. So it's not a blood test. It's really these two swabs that would diagnose the virus in terms of, you know, Monterey County. Essentially what we're doing here is that we are going by the CDC guidance and by the guidance of the Monterey County Health Department. So every patient that shows up, you know, to the emergency department, and this is consistent throughout the County is screened for a couple of different things.

Number one, what are their symptoms? Do they have cough, are they short of breath, do they have a fever? Number two is the travel history. So the CDC has identified the five main countries, which is a China, South Korea, Japan, Italy, and Iran. And then also we have the added of if have you been on a cruise ship recently? So if the patients, you know, any one of those could be high risk. The third piece of information that we look for is whether a person has had any exposure to somebody who has been positive for Coronavirus or COVID-19. So in terms of the screening, that is what we're putting patients through as they come into the emergency department. If they have met any one of those screening criteria. Then we phone the Health Department and then collectively with the Health Department, the hospitals and the CDC, we will determine whether we're going to test the patient or not.

So it's important to know that at this point because of the limited testing capability that at this point somebody can't just come to the emergency department say I want to be tested for COVID-19. And so we, you know, take that in terms of right now because we are trying to conserve the limited test kits for the patients who we really need to test. Now will we see that change in in the coming weeks? Probably. I think as labs work to develop different tests and the Health Departments look to develop their own past, I think we will see that change where we will be able to test more people. At this point though, we want to again conserve the test for the people that are really high risk. What we want to urge people is to not the flood, the emergency department. The emergency department is used to treat patients who need emergency care. Kind of one of those times to really be cognizant of that. If you're sick and you don't require emergency care, that you just stay home, you stay home and you wash your hands very well, you cover your cough, you know all of the things that the CDC that you've, you know, has put out all of the things that you're seeing on the news. That really is a big message to take home, come to the emergency department if you're sick and you require emergency care.

Host: Some of this stuff just seems like great advice anytime you aren't feeling well, which is, you know, stay home, take care of yourself, don't go to the emergency department every single time. You don't feel well because they're just not designed for that. It's too much stress on the system. So I think these are obvious, but how can we protect ourselves? There seems to be a lot of discussion, especially in social media and I've seen people post things like, weren't we always supposed to wash our hands? You know, why is this a revelation to some people? So take us through that Carla. How can we best protect ourselves?

Carla Spencer: The best mode of protection right now is good Hand-Washing, good hand hygiene. When you know you're out in public places before you're going to eat or before you're going to touch your face or anything like that because that's how a virus spreads, right? This is very similar like to the flu virus. So before you're going to do anything like that, that you just ensure that you wash your hands, try to kind of not touch any of your mucus membranes like your mouth or your eyes, cause that's how a virus could spread. So you just want to be really cognizant of that. Make sure that you have good hand washing. Make sure that when you're sick you stay home because really it's about mitigating spreads. I think it's pretty simple in those few things that you could do to protect yourself.

Host: Yeah, no doubt. And I've been talking to my kids about this, you know, my, my daughter's 12 and it's just a germ factory, you know, really in these schools I'm like, just wash your hands baby. Just before you eat lunch, wash your hands when you come over from school, wash your hands. So let's just say you're diagnosed with COVID-19 what does that mean exactly? Obviously it's going to have a more serious effects for some than others. So how long is the recovery period? What do they need to do, that sort of thing.

Carla Spencer: What I can tell you is that you're absolutely right in the sense that some elderly patients that have a lot of medical problems and things will react to the virus a lot worse than others. About 80% of people who are diagnosed with Coronavirus have very minor symptoms. So that's something to keep in mind is that the majority of the patients who are diagnosed have minor symptoms. But then you have, you know, your elderly population that have other medical problems that, you know, same thing with the flu virus when they get the flu. It's definitely just a, you know, a compounded effect. So in terms of the recovery you know, there's a lot of things out there that people recover within a few days. When we talk about how long should you stay away from people, that magic number that's floating out there is 14 days.

Will they find out more in the future? Probably, I would say cause they're, they're finding new things about the virus every day. But for right now the important thing is that if you're diagnosed that the patients would be quarantined at home if you're well enough to be home if you're in, if you're admitted to the hospital, then we have isolation procedures in the hospital that we would abide by. In terms of the hospital staff, and the mitigation of exposure. So for people who get diagnosed and that have minor symptoms, which is the majority of the people, then it would be just really home, you know, self quarantine at home, supportive care because there is no treatment at this point for the virus. It's just surrounded, you know, with supportive care. So fluids and you know, taking care of yourself, keeping your fever under control, you know, things like that.

Host: So I know that folks are seeing some tents there and there seems to be a little bit of confusion about what those tents are for. Are those quarantine tents? What's going on there Carla?

Carla Spencer: You know, early on when the Coronavirus was advancing and we seeing cases early on in the United States, the Monterey County Health Department decided that we would start to have collaborative meetings amongst the County Health Department with all four hospitals in the County, Memorial Community Hospital, the Monterey Peninsula, Natividad Medical Center and Salinas Valley Memorial. So we've been doing that weekly. And so essentially the decision to put up the tents was that, so we can have a mechanism to separate, you know, your respiratory patients or possible COVID patients from the rest of the population that goes into the emergency department. So the tents, and I've heard things that are these tents, testing centers and things like that. And they are not, what the tents are going to be used for is essentially, like I said, to separate. So patients will be screened outside the ER for the screening criteria that I talked about at the beginning.

And then if the patients are respiratory related patients, we would utilize the tent to cohort those patients together. And then the patients that did not have respiratory symptoms and things like that or didn't need critical care would then proceed up to the actual emergency department. And so the really the tents are a proactive measure to mitigate spread into the hospital. And so it's important to kind of, for people to understand. I'm really proud of Monterey County. I'm really proud of the collaboration that all four hospitals are having. It's really brought us closer together. And so we are doing things in a unified manner together as a County. And so that the community know that we're ready, we're prepared and you know, we can deal with these situations as they come if they happen to get worse.

Host: Yeah, that's really great. And I know that as you said, things are changing. This is fluid. And what everybody needs to do is stay up to date with this information, do what they can do, things like washing your hands, not flooding the emergency departments if you don't have to. Everybody just needs to do their part. And this you know, really trying time and it sounds like you guys there at Salinas Valley and the other hospitals in Monterey County, everybody's definitely doing that. Thanks so much, Carla. I really appreciate your time today. For more information on COVID-19 and services offered by Salinas Valley Memorial Healthcare System, visit svmh.com. I'm Scott Webb. Thanks for listening.