Carson Tahoe Health (CTH) is a regional medical center serving Carson City, Storey, Lyon, and Douglas counties, an area of more than 100,000 residents called the Quad County Region.
According to the State of Nevada Department of Health and Human Services Office of Analytics, as of this writing, there are 1,113 positive COVID-19 cases in the state with 17 associated deaths.
Of these statewide cases, the Carson City Health and Human Services Department (CCHHS) has reported 12 active COVID-19 cases with 5 in Carson City, 6 in Douglas County, and 1 in Lyon County. All are self-isolating at home.
“Should the (COVID-19) outbreak unfold, an intense one, we’re prepared to meet the needs of the community,” said Erin Meyering, spokesperson for Carson Tahoe Health.
Diane Rush, director of marketing and research said in an email that if a person exhibits COVID-19 symptoms, (fever, cough, and shortness of breath) they should first call the CCHHS hotline at (775) 283-4789. Both English and Spanish are available.
If they are showing significant symptoms and the hotline recommends they be seen by a doctor, the hospital asks that they use the drive-thru triage tent outside the Regional Medical Center Emergency Department to be assessed.
“We are doing these screenings via the tent to limit unnecessary traffic inside the hospital,” Rush said in an email. “If it is determined that symptoms are severe and the patient should be hospitalized, then they will be admitted to the hospital and appropriate precautions will be implemented.”
According to the US Centers for Disease Control, some 119,000 hospitalized patients had bloodstream staff infections in 2017, 20,000 died. A critical part of preventing the spread of diseases in a hospital, to include COVID-19, is cleanliness.
Juan Villanueva works in CTH’s Environmental Services.
“We are continually disinfecting, spraying each room, the whole facility before anyone gets into the room.
“The Carson Tahoe Hospital uses a system called ‘The Annihilzer.’ It methodically cleans, sanitizes, and disinfects all surfaces, including curtains. The machine creates a cleaning and sanitizing solution. The chemicals in the machine make the perfect mix to kill airborne pathogens,” Villanueva said.
When Nevada Governor Steve Sisolak closed all nonessential businesses in Nevada on March 20 of this year, he said a central goal of social distancing policies is to prevent the state’s healthcare system from being swamped.
“Statewide, we have fewer than 5,000 acute care beds. Of those 5,000 beds, fewer than 700 are intensive care unit beds that are better equipped to handle the severe cases of COVID-19. Right now, more than 80 percent of all those beds are occupied with a mix of COVID-19 and other patients,” the governor said in an online press conference on March 20. “That means, we have only 20 percent of beds available. We have similar limits when it comes to ventilators.”
Experience shows the difference between life and death from a serious COVID-19 infection is the availability of critical care. CTH is working to best muster critical care resources, but they’re hopeful the public’s adherence to social distancing will prevent a surge in life-threatening cases.
“CTH is still taking care of people unrelated to COVID-19. At this time there is not a clear consensus as to how fast the virus will spread in northern Nevada,” Rush wrote. “CTH is trying to create as much capacity as possible. This is why the stay at home order, social distancing, and handwashing is so important. We need to slow the spread of the virus so hospital capacities are not overwhelmed.”
Of the 12 cases in the Quad County region, all of them are convalescing at home. Not everyone who gets infected by COVID-19 needs to be hospitalized. If they do, Carson Tahoe Regional Medical Center has 159 licensed beds, and according to the hospital, they are modifying their emergency plans to increase capacity by at least 50 percent.
“It is not business as usual. We have triggered our emergency procedures which, among other things, cause key leaders to meet every day to assess the current situation, discuss various scenarios, and do planning for a future surge in COVID-19 patients,” Rush wrote in an email.
Worldwide experience has shown that human resources are the most important and potentially vulnerable element in treating those infected with COVID-19. In preparing for a surge in patients, CTH has looked forward to staffing needs.
“We have suspended non-essential operations so our normal volumes are much less than normal. The staff that provides those services remain employed which creates surge staff capacity for us. Staff are filling in where needed and are at the ready to address a surge in patients, should it be needed,” wrote Rush.
Testing is considered vital to get a clearer picture of the spread of the virus and to, “flatten the curve.”
The hospital can take samples but has to send them to a third party for testing.
“More testing capacity and faster testing times would be helpful. Currently, we are looking at a national shortage of test kits. Companies around the globe are working on this,” Rush wrote. “CTH will take its direction from the FDA and other state and federal guidelines regarding the availability and accuracy of testing. “We have some capabilities in-house that may soon be adapted for COVID-19 testing.”
A hospital ventilator is a medical device has proven to be a key piece of gear when saving the lives of critically sick COVID-19 suffers. A ventilator pushes air into the patient’s lungs to increase oxygen intake and dramatically increases the chances of recovery. The World Health Organization (WHO) estimates one-in-six coronavirus patients develop breathing difficulties and possible lung damage.
Does the hospital have a sufficient supply of ventilators?
“We have enough ventilators needed to care for our normal volume of patients,” Rush wrote. “The advent of COVID-19 has brought about a national shortage of ventilators so we are trying to get additional machines and developing other ways to care for these patients.
“Resources are being taxed so if we can say anything – Please stay home! If we can flatten the curve, the risk of overwhelming our healthcare system will be reduced.”
Meyering said the hospital has set up a centralized PPE (personal protection equipment) distribution center to most wisely deploy scarce protective equipment.
Members of the community are encouraged to donate N-95 masks, surgical gowns, gloves, and hand sanitizer to the hospital. Some Carson City residents have been sewing masks that patients are using while waiting for their lab results.
Both in biological and psychological ways, Villanueva’s work follows him home.
“I go to the garage, take off my uniform. I put on a gown, go into the house and take a shower right away. My wife made a special place in the garage for me to get dressed and undressed.
“I feel good working at the hospital because even with all the fear early on, everybody’s pitching in together. The first thing was the panic. Now, with the training we are getting, we’re doing way better, and I feel more comfortable using the equipment to protect ourselves.
“I don’t know the case in other hospitals, but we’ve been ready. We haven’t gotten any positive cases yet, but we’re ready, everybody’s ready.”
Joe McCarthy is a reporter for the Sierra Nevada Ally. In a past life, he’s been an arts administrator, local government public official, classroom teacher, and public education program director. He’s a proud member of the Education Writers Association and Solutions Journalism Network. With Brian Bahouth, he co-founded Carson City Community Radio, KNVC 95.1. He is now helping Brian build the Sierra Nevada Ally.
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