Dear Reader,

I’ve been blogging for FresYes.com since June of 2014 and the overwhelming majority of my posts have featured fun, family-friendly things to do, delicious places to eat, or locally owned stores to shop. Today’s article will be different than any other I’ve written, and I hope that whether you’ve read my posts in the past or never have before, that you will read this one and share it widely. Thank you.

-Natali C.

I had the privilege of hearing from four frontline care providers who spoke with FresYes about COVID19, how it is being handled locally, what they are seeing so far, what they’re hoping the public will do and how this pandemic is affecting their lives as healthcare providers. Here’s what they wanted you to know.

Note: The providers consist of a Nursing Supervisor “Amy”, an LVN “Kelsey” and two Physicians “John” and “Jane”, all of which work for Community Regional Medical Center in Fresno, however their individual identities will not be shared, by request.

FresYes: What are you seeing currently, in Fresno? What is testing like and how has patient care been affected?

Amy: I have loved my job since the first day, through all the growing pains and fear. I’ve been in the room of so many people who have died, and in every area of our hospital throughout the years. I have coded people I knew was a futile effort, I have coded people desperate to save them and I have held the hand of those who have made the brave choice that this is the end and accepted it with love and grace. We (healthcare providers) are SO STRONG. We will run headfirst into the fire, it’s instinctive. I am in awe of my coworkers; of the many teams I have worked with over the years. I have never seen fear or panic in their eyes, I do now. For the first time, I’ve heard people refusing assignments.

Why are we scared? The death rate (of COVID19) is currently only 1% according to the CDC today. The flu has been near these rates before and we grab our mask and don’t think twice about our flu positive patient.  Sometimes the next day we show symptoms and know where we got it… oh well, a couple days on the mend and we go right back.

This time, symptoms don’t show up for about a week. We have no idea that we were exposed, infected and continuing to work and go home to our families. A week later we show symptoms. We go to get a mask to take care of these patients, there aren’t enough. We are reusing our PPE (Personal Protective Equipment) that has been engrained into us it MUST be only used once.

Kelsey: At work, we separate patients who have symptoms of COVID-19, from the general population and we have been screening patients for symptoms as soon as they walk into the emergency room. We have a triage trailer for those who are stable, yet present symptoms of COVID19.

John: Currently, we are able to test patients who exhibit symptoms (fever, cough, shortness of breath) and those that have severe enough symptoms to be admitted stay at the hospital, and those that are experiencing milder symptoms are sent home to quarantine. Those who arrive at the hospital that don’t exhibit symptoms but just want to be tested, we’re not able to test – we simply don’t have enough tests at this point. Results are coming slowly. The fastest we’ve seen is 4 days, more typically, we’re waiting 7-9 days, even if patients are in severe enough condition that they’re in the ICU.

Jane: COVID19 isn’t just affecting COVID19 positive (or potentially positive) patients – it’s affecting all aspects of patient care in the hospital. For example, patients are not able to have visitors at this time due to the risk of exposure to COVID19, since visitors may have no idea they’re carrying the virus. As of now, mothers in labor can only have one support person, and if the cases of COVID19 rise sharply here as they have in New York, we may not be able to allow them to have anyone with them for their protection.

I have a patient who I’ve cared for for an extended period of time, as she has been battling cancer. She recently reached the end of her fight and was unable to say goodbye to many members of her immediate family or be comforted by them in her final days as even end of life visits are limited to two people.

Not being able to have family members present is incredibly difficult for patients, stressful for family members, and at times very difficult decisions must be made and explained over the phone vs. in person. As grave as it sounds, I can’t stress enough the importance of ensuring your family members fully understand your wishes if you find yourself needing to go to the hospital during this period of time.

FresYes: We are hearing a lot about the shortages of PPE facing healthcare providers. What types of PPE items are you using, and do you have what you need? How can the public help you in this area?

Kelsey: I wear a special mask, goggles, a gown, and gloves to protect myself. I am also self-quarantining when not at work and practicing good hygiene, as well as social distancing.

John: So far, we have enough PPE to last us about two weeks at the current rate at which we’re using them. And, we are only issued one mask a day, so we’re re-using them.

What’s tough is we have a lot of patients who may have other legitimate reasons for having respiratory issues, but we can’t be sure they don’t have COVID19 because the tests are taking so long to come back, so we’re having to use and dispose of PPE after caring for them, when really – it wasn’t necessary to be quite so cautious. Faster test results will help us preserve more of our PPE for when we really need them. Also, if we end up having a spike in cases like they’re seeing in New York, we will go through our PPE faster, and we may run out before we get more. That’s definitely a concern.

Jane: Currently, we are having to go to the medical office and request a mask, and we’re issued one per shift. The reason they are being so tightly rationed, and that we’re so short is that people who aren’t in healthcare have been hoarding them, and a lot of people have been unfortunately stealing masks and gloves from the hospital and doctor’s offices. We ask that anyone who has amassed a supply of masks due to fear, please surrender them (no questions asked!) to the County Health Department so we can use them to care for patients. Also, PLEASE don’t steal them. We recently received a big donation of masks from Harbor Freight here in town – we are incredibly grateful to them – they deserve a big shout out!

FresYes: Talk to us about what we need to do as a community, to truly flatten the curve and slow the spread of COVID19.

Amy: What can you do? How can you help us? STAY HOME!!! Just because you do not feel sick and neither do your friends, does not mean you have not been exposed. Meeting at a house party or the park to hang out is NOT OK even though you all feel healthy.

If you have signs and symptoms, stay home and get better!!  You don’t come to the hospital for the flu, only when the flu symptoms are so bad, they need treatment. We cannot fix you, we can only treat the symptoms. If you just need rest and fluids and ice packs, stay home. Come to the hospital when this feels like a medical emergency, just like you would do with any other virus or disease process.

Kelsey: Even if you are young and healthy, you should self-quarantine to protect those around you from this virus. You should also practice good handwashing techniques and social distancing if you must be in public.

John: If you are feeling ill, but not so ill that you need to go to the hospital, self-quarantine and rest. We have a very limited number of negative pressure rooms at the hospital [rooms where the air in the room doesn’t circulate into other rooms] and we need to reserve those for the sickest patients.

Jane: A number of our local cases are in younger people, ages 18-49. For MANY of these patients, their symptoms are very mild. This is why it’s so important that we maintain social distance and continue self-quarantining.

FresYes: So Jane, are you saying several of the younger patients have symptoms mild enough that could be mistaken for allergies or a mild cold?

Jane: YES! And some are completely asymptomatic! So, if you think because you feel fine you can just visit with one other family or one small group of friends at this time, you’re wrong. We NEED everyone’s help to flatten the curve – please stay home and continue practicing social (physical) distance.

FresYes: If someone thinks they might have COVID19, how do they know when/if they need to go to the hospital?

John: The main thing we’re concerned about is the lungs being compromised. And, we don’t want people to wait until their breathing is so bad, that they are going to be at a point of dire emergency by the time they arrive at the hospital, because that adds to the chaos and makes care more difficult for everyone involved.

Jane: If you think you have COVID19 (or have been tested and know you do) and are resting at home, you want to keep an eye on your shortness of breath. If its worsening, even while just sitting, getting up from a chair or trying to walk across the room, it’s time to get additional medical attention. If you’re with someone who has already been exposed, they can drive you to the hospital, otherwise, call 911. Be sure to give them the heads up that you believe you have [or know you have] COVID19 so they can come prepared with proper PPE.

Amy: Please remember that this virus is not the zombie apocalypse though, keep some perspective, keep your head on straight and just stay home and stop the spread.  It is a virus like the flu is, this one just looks and acts differently. Most of us would probably recover in less than a month, and it may only feel like a tough cold and cough that is hard to shake. But for others it can become serious quickly.

FresYes: I know this whole situation is really difficult, but is there any chance you have some good news for us? What can we be hopeful about right now?

Jane: It is absolutely not too late to flatten the curve in the Fresno area. We can absolutely still make a difference by staying home, practicing good handwashing and social distancing. The summer months can be tough in the Valley, as Valley Fever and asthma issues both increase with the heat – and right now we have the chance to flatten the curve before those health issues arise – and that gives us a fighting chance of being able to help those that need help in a medical system that isn’t over capacity.

John: The good thing about Fresno is our population density is nothing like New York, Los Angeles or San Francisco. The fact that we have more space between our homes, businesses and properties here definitely works in our advantage as far as spread of a virus goes. If we use this advantage in combination with social distancing and staying home, I’m optimistic we can really slow down the spread of COVID19. There’s a lot of talk of additional testing rolling out, and faster result times promised, and that will make a positive impact on our local situation as well. We’re also hearing that the virus isn’t mutating very fast, which is a good thing as far as making it possible to create an effective vaccine.

Amy: At this time, there are fewer than 20 positive (known) cases of COVID19 in Fresno, and many of these cases are actively recovering. [Editor’s note: this was accurate at the time of the interview March 26th, 2020. Since then this number has risen and community spread has now occurred in Fresno County, making social distancing more important than ever. Community spread is when someone catches the virus, but the source can not be traced to travel or any known person-to-person exposure.]

FresYes: Any final words you’d like to share with our readers?

Jane: Don’t forget to take care of your mental health at this time. Make sure you keep in touch with friends and family via phone or using technology – stay connected. Go outside when you are able (maintain social distance at all times) and get fresh air. Turn off the news from time to time. Meditate, exercise, do what you normally do to take care of your health from home.

Since my husband and I both work in healthcare, we had to send our daughter to stay with family during this time. This was incredibly hard – as we’ve had to do this for short periods in the past, but we’ve always been able to tell her when we’d be back to pick her up. This time was so very hard – we don’t know how long we’ll have to be separated as a family.

This is what I signed up for. I want to help, and I want to be there for people during the darkest times – but we need everyone’s help to flatten the curve right now. From what I’m seeing so far, Fresno is doing a better job than many other cities, and I’m encouraged.

Amy: We can’t save everyone this time, but YOU can. If you stay home, you can potentially save hundreds to thousands of lives. This is the truth. My kids are bored and missing their friends desperately just like yours are. Explain to them that they are potentially saving their friends lives by staying away from them, this isn’t a punishment – it’s to keep them healthy and strong.

If you’re able to be at home, take advantage of this time that we always say we want and play board games, bake cookies, ask your kids to interview you and ask any question they want — you’ll find out what they are thinking and feeling and connect on a deeper level. Spend time doing what they want — I have never watched so many TikToks in my life (on my days off)!

John: Two things: 1. Follow the rules issued by our local leaders so this pandemic can keep from getting worse or at least slow in our area. 2. Support your friends and neighbors, especially those who have lost work during this time. Find out their needs and either help financially if you’re able or provide items they need when you can – on their porch.

Amy: Be kind, show love, trust God, pray for each other. This is how we recover from this, united as a city, as a nation, as humanity.

Editors note: The views and opinions expressed by the four interviewees are their personal views and experiences and do not reflect the views of Community Regional Medical Center.