By Kalin Krohe, Panhandle Post
A special COVID-19 announcement was added to the Alliance City Council agenda for the Nov. 17 meeting. Three Box Butte General Hospital staff members were in attendance to stress the importance of the community coming together to help slow the spread of the virus.
Alliance Mayor Mike Dafney had the COVID-19 announcement added to the agenda after a special meeting on Nov. 16 with Panhandle Public Health District, Mayors and County Commissioners throughout the panhandle, and hospital personnel.
"This is a dire pandemic," said Dafney. "As far as I heard we're just about at panic mode. There's a lot of things that people aren't understanding about this and consequences. We're kind of divided on just how serious it is. Just in the last 24 hours here in the United States we've had 156,000 cases. Some of the things that aren't being thought of, is our hospitals are filling up with COVID and we have other things going on like heart attacks. This makes it hard to get everything done. People aren't realizing that if you catch it, a loved one catches it...they're going to be in there by themselves. I've asked some of the medical people in the panhandle and the community to be here tonight to give us a recap of what they're faced with and what they're trying to deal with...and how important these masks are."
Box Butte General Hospital CEO Lori Mazanec stressed to the public that panhandle citizens need to come together to fight this pandemic.
"For the seventh week in a row, Nebraska set records for COVID-19 cases," said Mazanec. "The state also recorded a new weekly high for deaths related to the novel coronavirus. The deaths of 74 Nebraskans were reported during the seven-day period that ended Saturday. That was up from 55 deaths reported in each of the previous two weeks. The number of patients hospitalized with COVID-19 in Nebraska peaked at 918 on Friday, then dipped to 889 Saturday before rising to 914 on Sunday."
Mazanec said the panhandle reported 138 new cases today[Nov. 17], with 7 additional deaths.
"Box Butte County currently has 110 active cases and 2 related deaths," Mazanec stated. "The largest number of our positive cases is among the 20-49 age group, which is likely they are healthy enough to not be hospitalized, however we have no way to tell if they quarantined during their illness and maintained the isolation for the full recommended 14 days."
The State of Nebraska issued a new Directed Health Measure (DHM) effective statewide as of Monday, Nov. 16.
"This basically secured our decision early last week which temporarily halts elective surgeries requiring an overnight stay and that can wait four weeks or longer without substantially changing a patient’s outcome," Manzanec continued. "Of course, this impacts our financial viability, but also delays care for our patients.
"The Nebraska State COVID Transfer Center was established earlier this year out of the dire need for hospitals to help find acceptance to a higher level of care", said Mazanec. "The Transfer Center is a 24/7 service designed to mitigate the impact of hospitalization surges resulting from COVID-19. Hospitals seeking to transfer patients with COVID-19 or suspected to have COVID-19 are strongly encouraged to use the State Transfer Center. Clinical staff will seek placement at the nearest hospital with the capability and capacity to care for the patient. Due to the significant rise in COVID-19 and the corresponding impact on hospitals across the state, patient preference will not be a consideration in determining where the patient will transfer. If contacting a hospital through normal transfer processes, you may be redirected to the State COVID Transfer Center due to capacity constraints. There have also been many instances where patients are transferred out of state. The nearest facility having bed availability – St. Louis, MO, Iowa hospitals, and Salt Lake City, Utah are just a few instances of transfers from this area."
Box Butte General Hospital Covid hospitalizations over the past three weeks have ranged from 5 to 12 patients at a given time.
"This has been as high as 67% of our total staffed beds and continues to impact admissions overall", Mazanec said. "The care requires isolation protocols and focused on one to one care. BBGH has 25 beds, we have seen multiple days where we had 21 and 22 patients in beds at one time. This is when we see the stress not knowing when the next ambulance will bring an ill patient or some other family walks through the front door. We have seen the impact of not being able to transfer a patient out due to hospitals not accepting patients, Covid or otherwise."
"To illustrate the growth in cases, which has impacted overall hospitalizations, our daily case totals did: the first of September, Box Butte County had 32 total cases," Mazanec said. "By September 17, we had doubled our cases to 58. By October 1, showed 103 overall confirmed cases. By November 1, the total was 348, and now currently sit at 514 with 110 active cases. So that is a few of the statistics and facts. This doesn’t even compare to the emotional, mental, and physical fatigue and strain this is placing on our staff caring for these patients. Initially, 8 months ago, we saw the mental fatigue from all the planning and preparation for what seemed like nothing would come. Fast forward to now, and it has multiplied to the impact of exhaustion. Just last week, the difficult decision to allow one family member to be in the hospital as a loved one dies was made. Who wants to make that decision? I never thought I would be put in a position to weigh the risks of having a healthy person into an isolation room so they could hold the hand of their loved one. This is our reality right now. While it may not have impacted you yet, it will. I pray it only impacts you with the mild symptoms so many are fortunate to get. But we are now seeing it is not discriminating to anyone. Even the healthy are succumbing to this virus."
"We are asking for a unified stance from our community leaders to promote the essentials of keeping the virus from spreading faster", Mazanec added. "These things will slow the virus. I’ve always said we cannot stop it from spreading, however we can control the pace. We must have the community get behind and stand with us on: wearing a mask in public or places where there are other people; washing or sanitizing your hands frequently, and watching your distance with other people. Avoid large groups and even small groups of larger than 6-8 people."
Box Butte General Hospital PA-C – Emergency Department Steve Van Noy echoed what Mazanec spoke about.
"It's been very eye opening the last few months," Van Noy said. "It's frightening to have somebody suffocate in front of me. They asked me if they were going to die...and I knew what the answer was. It's frustrating when we don't see people wearing masks and then I see the same people in the ER. And then they test positive for COVID. They're some of the same people that put some of the odd arguments out as to why they don't need to wear [a mask], but it is a life saver. The panhandle of Nebraska is just out of control right now. I can't believe how many deaths there's been. I can't believe how many positive cases there's been."
Van Noy told all in attendance that his daughter got the virus and didn't do very well. She ended up in the ER four different times.
"It's frustrating. It's scary," Van Noy added. "It's making going to work not very much fun anymore. I see so many positive cases. Two weeks ago when I worked I couldn't ship anybody to Rapid City, Omaha, Cheyenne, Fort Collins, and Loveland. I finally called Denver Health and they had three beds. It was scary. I thought I wasn't going to get this patient out and this wasn't a COVID patient. We're getting killed by this and I feel like we can control it. We can do a better job at controlling it."
A lot of people are getting upset about wearing masks.
"I don't understand why," Van Noy added. "We have to wear a seat belt. I have to wear a helmet when I ride my motorcycle. So why not wear a mask, I don't understand it. We're all peaking out and tired. We've had more staff get sick than what I'd like to admit. That's just put us all in a bind. It just doesn't seem like things are getting any better. As Lori said the numbers are doubling every fourteen days. It's frightening...it's frightening. I can't look at any of you and tell you who's going to do well with it and who's going to get sick and die with it."
After Van Noy was done speaking, BBGH MD - Hospitalist Terri Myers came up to the podium.
"I take care of most, if not all of the patients who are admitted to the hospital for any reason," said Myers. "I have never experienced a patient load like we've had in the last three to four weeks. As Lori said we can hold up to 25 patients. In the last three or four weeks we've consistently had upwards of 18, 19, 20 patients. We're not seeing that outflux like we normally get. We are seeing COVID patients who aren't able to be dismissed in the normal 3 or 4 days. Are typical illnesses that we admit people for are chest pain to make sure they're not having a heart attack, pneumonia, heart failure...that kind of stuff...this is different, this is taking a hospitalization to the next level. These patients don't go home in 3 or 4 days. Most of them are there 5 to 10 days, if not more."
Myers said her nurses are taking care of COVID patients day after day. She said some days nurses aren't getting a lunch break
"We have excellent nurses. Our staff right now is just phenomenal," Myrers added. "I can't tell you enough about them. We're all here for the patients. That's our number one priority. Second to that, they're the ones that keep me coming everyday. I said if you guys can do this, I can do this. We work together very well as a team. I love my nurses and I wish I could do more to help them. I try to do as much as I can with patient care when I'm in the rooms because these patients are in isolation. Which means that every trip into a patients room needs an N95 face mask, a face shield, a gown and gloves. You do what you need to do with the patient...come back out...as you're coming out you take off the gown and gloves. The face shield and N95 mask can stay if you're going into another room. You wash your hands, you go put on a new gown and gloves and into the next room. It's just cumbersome to have to do that every time you go into take care of a patient. It's fatiguing to say the least for our nurses."
Myers said she thinks there is a disregard in the community from what hospital staff and public health officials are advising people to do with the virus.
"I went to a store in town two days ago on Sunday," said Myrers. "Myself and one other nurse that I ran into were the only ones in the store wearing masks including all of the employees. Maybe these people don't mean it to be this way, but I kind of take it as a disregard...you know that they don't feel like it's a big deal. When we try to tell people it's a big deal, they don't believe us. I think it would be a great thing to have the backing of our community leaders to say, 'hey Box Butte County this is a big deal...this is something we need to step up and get this under control."
Mayor Dafney replied by saying, "We're just going to have to keep pounding it and pounding it."
"It's doing exactly what it said it was going to do here," said Dafney. " They predicted it would start moving in and that's where we are at. I've been reluctant to even throw this out to council...on a mask mandate. We're so divided. The enforcement on something like that is hard. I hate putting things out there, but we do have the authority if we decide to...to mandate this town to mask up. I know that makes legal a little nervous because we're going to have those out there that protest it. When I requested that we mask up here [city council]...I no more go home and got a call from two to three people that were so upset. One of them was so upset that he'd never vote for me again. I could give a damn. That's asinine. But I'm putting that out there, council has the authority to do that if this thing gets too far away from us...we'll look at it."
Councilwoman Annora Bentley replied to Dafney's comments. She said her mother just passed away from the virus.
"I would like to beg everyone to wear a mask," said Bentley. "Because you don't want to have to go through what my family has just gone through. Not being able to see your Mother in the hospital. You should not have to depend upon a nurse to hold her hand while she's dying. Those nurses didn't sign up for that. I wish we would have a mask mandate. Thank you for all of the caring that you provided."