SELMA – After hearing about local COVID-19 developments from the Fresno County Department of Public Health Director David Pomaville, the Selma Health Care District unanimously decided to make $50,000 available from its budget in case there is a local outbreak of the disease.
“We have a lot of scenarios that we don’t have exact answers for,” Pomaville said. “Our perspective is evolving every week and things are moving pretty fast.”
At a special meeting called on March 10, Board Vice Chairman Anthony Herrera said he knows from working professionally as a nurse that local hospitals are already typically full and rooms that can safely hold patients with COVID-19 are few.
“We have one room that’s a negative airflow room. It wasn’t being used for that, so I had to move a patient out [so we could] rule out COVID 19. We only have a limited amount of rooms of that type.”
He added that since a vaccine may not be developed for another year to 18 months, any who do develop the disease will likely be at home on self-quarantine and in need of help.
“That’s why we were thinking, what can we do for people are locked in for 14 days?”
The board approved taking $25,000 from its reserve and another $25,000 from their general fund to make $50,000 available for COVID-19 related needs such as food, medicine and public information.
Health Care Board President Rose Robertson said she’d want to get input from the Selma Fire Department, City officials and local nonprofits as to what emergency supplies would be needed if a local emergency called. Also, since California Gov. Gavin Newsom on March 16 secured $1.1 billion in emergency funds for the state’s fight against the rapidly spreading coronavirus, Robertson said their board would hope to get some of these funds paid back by the State.
“Let’s hope that we get reimbursed. I’m going to all be about getting reimbursed by that Gavin Newsome that allocates some of that money,” she said.
The board set up an ad hoc committee of Robertson and Herrera to determine which nonprofits could receive financial contributions to help residents who are on quarantine because of COVID-19.
During his informational presentation, County Health Director Pomaville did not mince words when it came to whether more patients would be diagnosed with COVID-19.
“Some people think that we’re 10 days behind Italy. It could be. I don’t know that we’ll go that far, that fast, but I think nationwide, we have about 600 cases. California’s got 109 plus the cruise ship folks. That’s about 145. So, I’m not quite on that spectrum, but I will tell you as we do more testing, we’re going to find it more.”
Pomaville said their department first started monitoring the COVID-19 developments in China back in January and described the rate at which the infections have spread around the globe as “alarming.”
Since there are different types of coronaviruses, there has been confusion over what the disease is, who is susceptible and how best to prevent it.
“The ones we know about, like MERS and SARS, are two that were very similar in a lot of characteristics to COVID-19,” he said. Confusion arises because medical professionals aren’t exactly sure how strong, resilient and lethal such diseases are going to be when they first emerge.
As concern rose, travel restrictions were imposed at the federal level. Travelers were quarantined and in California, Pomaville said about 130 people who’d traveled to China have been monitored.
“Now you seeing things change where it’s South Korea, Japan, Iran, Italy. So you’re seeing a lot more spread of the disease in those countries. We’re ratcheting our own response as we saw it ratcheting up in other parts of the world.”
A Fresno County Health Department operations center was started about two weeks ago. Pomaville said he’s been meeting with EMTs, safety personnel, law enforcement, city leaders, special districts, schools and the medical community to inform them of developing events.
Locally, there have been some unexplained pneumonia cases in the community where doctors are first “doing a really good job of ruling out everything before they assume it might be COVID-19.”
Pomaville said before ordering COVID testing, doctors do rule-out testing to find out if an ill person has traveled to an already affected area or were around somebody that’s had COVID.
“There’s got to be a good correlation to an exposure.”
Currently, only the CDC can test for the new coronavirus. California is getting 1,200 more test kits, however those kits go to laboratories. Patients have to be tested by their clinicians, hospitals or health department and then the swab specimen is sent to labs.
“It’s literally changing every day, but testing capacity is going up,” he said. “We’re up to 15 labs in California that can do testing.”
The problem is, those labs are already backed up, he said.
“We’ve gotten more kits to do the testing, but we still haven’t gotten enough. There were 20,000 or so that we’re getting and they’re coming in chunks.”
Pomaville said he thinks that even if a person contracts COVID-19, they will likely only be sick for a few days. However, his epidemiologists’ statistics show the elderly are more likely to get sick and die, especially if they already have health issues.
“This is definitely a disease that discriminates towards older populations. They’re the ones that are most vulnerable for those respiratory diseases. So we’re trying to get that testing network up in place.
“The course of treatment is to go home, get well and stay out of public spaces. If you have confirmed cases, you’ll probably be quarantined legally.”
Patients who are considered low risk will be told to self-isolate, he said. They’ll be monitored and given specific instructions about how to check themself to make sure they’re not developing a fever or cough, he said.
This has already happened in Selma.
“Someone in Selma this weekend was at a medical facility and was escalating the concern. We were running a bunch of tests and then COVID comes up. It was best for them to stay home until we got the test results back so the [parent] and three kids say fine, we’ll go home.”
Pomaville said his staff called to check on how they were faring and the patient revealed they could not get prescribed medication and comply with the self-quarantine. Calls were made to social workers to help the patient not only get that medicine, but needed groceries for their family.
“I had one of my social workers help to solve the problem. We got her her meds and got her lined up. She had the resources; she just didn’t know how to get to them.”
This patient did not have COVID, but Pomaville said this scenario would likely be repeated where a patient has to wait it out at home in isolation and await test results.
Pomaville said the next big concern will be if someone contracts the virus without having traveled or been exposed to another who has COVID-19.
“The next couple of benchmarks will be the first time we have community transmission. We need to talk about it as a community. That’s what we call community transmission - when we don’t know how or where that exposure occurred. That’s a remarkable milestone for us [as it] will trigger more concern. There’ll be more restrictions on mass gatherings. And then, of course, if we have a death associated with COVID.”
The question was raised about those who have diabetes or asthma and other respiratory conditions and whether they are more susceptible to contracting COVID – 19.
Pomaville was frank when he said respiratory illness such as asthma and pneumonia “don’t ever go well together. That’s the general conclusion. I don’t know the answer whether or not you’re more vulnerable if you have asthma. I just don’t know the answer to that question and I should have that answer.
“We have heard that discussion and I thought about it the other day about our risk factors here. I need to find that out. Underlying issues, anything that compromises your immune system, those are the ones that give the disease the opportunity to get embedded in your lungs.”
The reporter can be reached at 583-2427 or email@example.com.
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