Across northwest Oklahoma and south central Kansas, hospitals are doing their best to prepare for COVID-19.

Fairview Regional Medical Center

Roger Knak, CEO of Fairview Regional Medical Center, doesn't beat about the bush. He can't afford to; he and his staff will be on the front lines of battling this new virus once it reaches this part of the state.

Or has it already?

“I would guess we likely have the virus in the area,” said Knak, “just from the fact that it's gradually spreading person-to-person from other parts of the country. I would venture to say it's probably in our area. I know that some people may thinl this is excessive hype and I hope they're right, but if we don't respond in a manner to get in front of it, then we're going to be in the position that our elderly” and others' with compromised health will die from it.

“The challenge is we're seeing that in the population over age 80 (the virus) is 17 percent lethal. There kind of seems to be a tipping line at age 70, and obviously any chemo or prior lung disease or immune suppressed – those are the patients having the worst outcomes.”

Like hospital administrators across the country, Knak finds himself having to implement an emergency plan that, even at this early stage, includes restrictions that some may find onerous.

Already, the hospital has suspended the physical therapy and cardiac therapy programs, because the people in those programs are at very high risk of catching COVID-19 and dying from it.

Other steps include restricting visitation, expanding telemedicine visits, and segregating the healthy from the sick in separate waiting rooms and treatments areas.

“We've implemented visitor restrictions for inpatients,” he said. Those people who can visit the hospital must enter through a single door “so there's fewer points of entry into the hospital, so we're better able to do eyes-on screening of any visitors.”

Fairview's hospital is also making telemedicine-style doctor visits available to people needing care. “We've implemented virtual doctor visits for patients,” Knak said. “When a patient calls to make an appointment, (depending on the patient's condition) we can instruct the patient to download a program and then they log in at the same time as the doctor does and they can have a virtual visit.”

The hospital has also set up separate waiting rooms and separate treatment rooms for people with illnesses, but it's all a very dynamic situation and things can change from one moment to the next, he said.

“We're meeting with our manager team daily because this is very fluid.”

Challenges in Oklahoma

One of the biggest challenges, Knak said, is the “extreme shortage of available testing. We have people presenting to the ER requesting testing, but with the state department of health protocols we have to prioritize patients with the highest need. We don't have any positive tests,” he said, “because we haven't been able to test much.”

Other challenges will likely be a shortage in intensive care unit beds and ventilators.

“We have one ventilator” and another similar machine for “short-term emergency use, but I know this is a conversation happening statewide in all medical facilities: how to utilize our resources best.” There has been talk around the world on this topic, obviously, with some countries saving scarce ventilators for those patients with the best chance of recovery.

Knak thought some urban patients might be sent out to rural hospitals when urban hospitals find their ICUs overrun. “That was the conversation yesterday,” he told the Newsgram Tuesday.

Knak is also worried about the elderly who don't come to the hospital.

“As we're socially isolating, my fear is that the elderly – is anybody checking to see if they have the things they need? And the social interaction – we need to be talking to them by phone so that this doesn't increase their depression, because with the social isolation – they can't even go to Sunday morning worship. We've now taken away everything” that supported the elderly in a social and emotional sense.

Knak urged everyone to work with their communities to keep everyone as healthy and happy as possible during what could turn into a difficult time.

Woodward's AllianceHealth Hospital

Doug Ross, AllianceHealth-Woodward's director of outreach, attempted to provide what information he could but wrote in an email that the information he's been given permission to distribute is “pretty limited at this point in time.” The hospital's parent company is not allowing the Woodward hospital staff to give interviews, he said. The hospital's parent company is the statewide AllianceHealth Oklahoma chain of medical centers.

Ross provided the following information about the hospital's efforts:

“Should any patients in our community be identified with COVID-19, we are prepared to provide clinical care as we do for any infectious disease. We are using the screening guidelines for symptoms and risk factors with all patients. If a physician determines a patient meets the risk criteria, they will coordinate testing and the patient’s ultimate disposition, consulting with the department of health, as necessary.”

Visitation has been restricted in the following ways:

• Two visitors per patient

• No visitors under 18 years old

• Visitors are not permitted in isolation patient rooms

• Delay your visits if you have any of the following: Fever, cough, or difficulty breathing, contact with someone infected with COVID-19, traveled to a high risk COVID-19 area.

All of the AllianceHealth hospitals had this advice on their websites:

“The Centers for Disease Control and Prevention advises: mildly ill patients should be encouraged to stay home and contact their healthcare provider by phone for guidance about clinical management. Patients who have severe symptoms, such as difficulty breathing, should seek care immediately. Older patients and individuals who have underlying medical conditions or are immuno-compromised should contact their physician early in the course of even mild illness.”

Alva’s Share Medical Center

Share Medical Center has posted that they are restricting visitors within Share Medical Center, Share convalescent Home and the Homestead Retirement Center. All routine visiting is being suspended until the transmission of COVID-19 is no longer a threat to patients, staff and community.

Anyone needing services such as lab work, x-rays or to see medical staff must call first.

Efforts to reach Share Medical Center administration for more information were unsuccessful.

Kiowa District Hospital

Kiowa District Hospital CEO Janell Goodno said they are taking it day by day in this ever-changing world due to COVID-19. Following Kansas Department of Health and Environment (KDHE) guidelines, she said that if employees have been on a plane or ship, they are required to self-quarantine for 14 days.

“Our primary focus is on the manor,” Goodno said of the estimated 22 elderly residents there. Last week the only visitors at the manor could be residents' immediate family. Then not even immediate family members were allowed.

Monday afternoon Goodno said no visitors are allowed at the manor. At the hospital only immediate family is allowed and no one under age 18 unless they are a patient. Everyone, including employees, is screened before entering either building. KDH is a Critical Access Hospital with 10 beds.

“We are taking the highest precautionary measures to ensure that our residents, patients and staff are safe,” Goodno said. “KDH's Emergency Preparedness Team is meeting daily to ensure practices and protocols remain current with the CDC and KDHE.”

If someone wants to be tested for COVID-19, Goodno said KDH has the appropriate swabs to take a swipe and it will be sent in for accurate testing to determine if the person is positive or negative.

Medicine Lodge Memorial Hospital

Medicine Lodge Memorial Hospital CEO Kevin White said Monday they've had no cases of COVID-19. So at this point, the MLMH has not restricted visitors to the hospital, White said.

The MLMH is a 25-bed Critical Access Hospital facility. White said in preparedness of COVID-19 they are using only two entrances at the hospital and clinic. At those doors all employees and visitors are screened. They get a temperature check and answer a questionnaire. Some of those questions are if the person has been out-of-state or out of the U.S .; on a cruise; etc. White said there is an outbreak of this virus in four Colorado counties: Eagle, Summit, Pitkin and Gunnison.

If a person answered yes to any of those questions and believes they could have been exposed to the disease, White said they should self-quarantine for 14 days.

The MLMH has 14 nursing home residents housed inside the hospital in swingbed extended care. White said they are taking extra precautions for those elderly residents who are reportedly more susceptible to the virus.

Patterson Health Center

(Between Anthony and Harper, Kansas)

The Patterson Health Center, also known as Hospital District No. 6, is located just north of Chaparral High School between Anthony and Harper, Kansas. Patterson is a Critical Access Hospital with a 25-bed capacity.

When asked about their preparedness for COVID-19, Patterson's Director of Marketing Mitzi Bailey said, “We're staying very calm and we are prepared.” She said Patterson is following the guidelines of the Kansas Department of Health and Environment (KDHE) and the Center for Disease Control (CDC).

Dr. Petie Schwerdtfeger of Patterson Health Center said, “Patterson Health Center has a policy in place regarding patients with symptoms of Coronavirus. We are closely monitoring updates from the KDHE and CDC. We have not had any positive test but will continue to be vigilant with screening patients and testing them per the KDHE/CDC guidelines.”

When You Should Quarantine Yourself

The KDHE is recommending 14-day home quarantine for Kansans who have:

1. Traveled to a state with known widespread community transmission (currently, California, New York and Washington state)

2. Visited Eagle, Summit, Pitkin and Gunnison counties in Colorado within the past week.

3. Traveled on a cruise ship on or after March 15.

4. Traveled internationally on or after March 15.

5. Received notification from public health officials (local or state) that you are a close contact of a laboratory-confirmed case of COVID-19. (a close contact is defined as someone who has been closer than 6 feet for more than 10 minutes while the patient is symptomatic)

Home Quarantine Guidelines

Those who are under home quarantine should not attend school, work or any other setting where they are not able to maintain at about a 6 foot distance from other people.

If a person under quarantine develops symptoms of COVID-19 during their 14-day quarantine period, including a fever of 100.4 F or higher and lower respiratory symptoms like coughing or shortness of breath, they should contact their healthcare provider and tell them about their recent travel or other COVID 19 exposure.

Prevention

Currently there is no vaccine to prevent COVID-19. The best way to prevent illness is to avoid spreading the virus and to avoid being exposed to the virus. The virus is thought to spread between people who are within about 6 feet of each other for at least 10 minutes through droplets from coughing and sneezing.

To reduce the risk:

Wash hands often with soap and water for at least 20 seconds or use a hand sanitizer that contains at least 60% alcohol.

Avoid touching eyes, nose and mouth with unwashed hands.

Stay home if you are sick. Cover coughs and sneezes. Clean and disinfect surfaces daily.