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MHP doctor warns diligence still needed to fully control COVID-19

The American way of life changed forever in March of 2020.

 

After months of following a new coronavirus strain that started in China and branched out worldwide, the United States was finally forced to deal with a pandemic – a first since the Spanish flu pandemic of 1918.

 

One long year later, the COVID-19 coronavirus has a vaccine in the administration process. Life may never return to the “normal” we knew, but life is moving on.

 

“We still have to consider it a marathon and although we can see the finish line we cannot afford to stumble now,” said Major Health Partners’ Chief Medical Officer Dr. Paula Gustafson. “We have to get across the finish line. We have to get people vaccinated. We still have to follow precautions. We still have a ways to go but we can see the finish line in sight.”

 

Jeff Brown photo

Wearing a mask proved to be a strong deterrent to contracting the novel coronavirus. An added positive effect to mask wearing is the low number of flu diagnoses currently in Shelby County, according to Dr. Paula Gustafson of Major Health Partners.

 

There is no end-all date for COVID-19, especially with virus mutations showing up worldwide.

 

“This virus is tricky,” admitted Gustafson. “Every time it moves person to person it has the opportunity to mutate. And then the mutations can again (put us) back to the drawing board as to what will work against this variant of the virus.

 

“The big race now is can we get enough people vaccinated and squelch this virus to the point we prevent transmission and don’t have to worry about these variants popping up here and there.”

 

Hospitals prepare for unique events like mass casualties and virus outbreaks but a real-life scenario quickly came to light last March which put the county’s only hospital into crisis mode.

 

“We were completely full at times,” said Gustafson. “We were looking for transfers. Other hospitals were looking for transfers. We were trying to find beds for people, trying to make sure we had enough medications on board.”

 

The pandemic put a tremendous amount of stress on hospital staff.

 

“I think one of the hardest things was when you have a lot of intensely ill people, the number of people required to care for them goes up,” said Gustafson. “Just to turn someone in a bed if they are on a ventilator can take up to six people. And having that staff available and everyone having to dress in what looked like hazmat suits to go in the room … it was very labor intensive.”

 

Like many hospitals, finding protective gear (PPE) for the staff was difficult.

 

“We tried to stay by the exact hospital standards and those standards are one N95 mask per (patient) encounter,” she said. “But suddenly N95 masks were as scarce as hen’s teeth. There were not any to be found. So we had to re-use them by putting them in for cleaning.

 

“That was scary because we had no idea how infectious or how deadly this was at the start of the pandemic. My hat goes off to all my colleagues who, even knowing there was a lot of personal risk and knowing that we didn’t exactly have every PPE we would have liked to have, made it through it.”

 

As the pandemic grew, the community rallied around its front line workers. Donations of various types of PPE started arriving at MHP. Local restaurants provided meals for the staff. And a “feel-good” event was organized in the hospital parking lot that brought people out to honk their car horns, wave at the hospital staff and show encouragement.

 

“I think it was welcome and it really did help to know the community was backing them and supporting them, even if it was giving meals or giving them a clap and saying, ‘Hey, thanks for all your work.’ It really did help a lot,” said Gustafson.

 

Jeff Brown photo

The term "social distancing" became standard lexicon in 2020 courtesy of the COVID-19 pandemic.

 

As of March 19, Shelby County is listed by the Indiana State Department of Health as having 4,683 positive cases of COVID-19 and 93 deaths attributed to the virus.

 

This past year has taken a toll on Shelby County Health Department director Robert Lewis. What started with meeting after meeting led to a full court press of educational messages about hand washing, wearing masks and social distancing.

 

“It has been wearing on all of us,” admitted Lewis.

 

The process of teaching the community that wearing a mask is important and then the follow up work of contact tracing after a person is diagnosed with COVID-19 left many frustrated.

 

“It was a lot of phone calls and education last March and April,” said Lewis. “You can’t get people to wear masks and we are the bad guys for trying to educate people. Then you have spikes (in cases) and we are the bad guys all over again.”

 

Shelby County’s nearly 5,000 positive cases landed in the middle of its surrounding counties.

 

Decatur (2,736) and Rush (1,666) had fewer cases while Hancock (7,574), Bartholomew (7,596) and Johnson (16,737) were higher.

 

The data breakdown for those in Shelby County contracting COVID-19 is fairly balanced. Only 14% of those affected were age 70 or older. Of the six remaining age groups: 0-19, 20-29, 30-39, 40-49, 50-59, and 60-69, the contraction rate was between 12-15% in each age group.

 

Fifty-four percent of Shelby County’s positive cases were female.

 

The positive cases reported early were low because testing was limited. As testing expanded, Shelby County saw many more positive cases.

 

On Dec. 8, 77 positive cases were reported – the most for a single day in the last 12 months. On Nov. 25, there were 76 cases and three more days had at least 70.

 

Nineteen were reported on Christmas day and 43 more were added to the list on New Year’s Eve.

There were never more than three COVID-related deaths listed on any given day in Shelby County. That happened three times – Oct. 25, Nov. 18 and Jan. 2.

 

“Was it bad? Yes,” said Gustafson. “I do reflect back and say we are very fortunate. It could have been a lot worse.”

 

With more data, the knowledge base increased with regard to how COVID-19 works. And that data will help hospitals should a future situation arise.

 

“I think we have a better handle on how infectious it is,” said Gustafson. “We know how to protect ourselves against it with PPE and hand washing. We know how effective it is that wearing a mask and social distancing drops numbers very quickly.”

 

Major Health Partners opened its facility at Intelliplex Park in January of 2017, leaving its outdated facility near downtown Shelbyville. That move helped the community tremendously in fighting the virus.

 

“I don’t know if we could have social distanced in the other (hospital),” said Gustafson. “It would have been really hard.

 

“We have a vaccine clinic that runs now six days a week. We couldn’t do that in our old facility. There was no room for that. Being able to provide that service to this community is phenomenal. It would have been much more difficult had the pandemic hit five years ago.”

 

The virus has been fought from the national level all the way down to small communities. Local hospitals banded together to keep communication channels open to share information.

 

“We’ve learned you can’t do it in isolation,” said Gustafson. “You need your community. You need to be on board with everybody in the community and with all your neighboring hospitals. You have to have links opened up and you have to be willing to work with each other and share. You can’t hoard.

 

“If you have somebody who has expertise in an area then you lend it to a hospital. We had nurses going different places. The key thing is it’s a big team effort from everybody. You just can’t do it in isolation.”

 

Jeff Brown photo

COVID-19 forced the Strand Theatre in Shelbyville to shut down for much of 2020. While the pandemic is weakening, there are not yet any scheduled events for 2021. 

 

So when will it all be over? There is no date on a calendar where life will be declared normal again.

 

“I think they talk about we won’t be feeling really comfortable until we get herd immunity,” said Gustafson. “That is somewhere around 70% of the population in the United States. The (Centers for Disease Control) is tracking that very closely. That’s what we do with other infectious diseases. We make sure we have herd immunity. I don’t know that date but we are hoping we can get every adult that wants a vaccine vaccinated by May. And that is a possibility.”

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