Local medical clinics on the front lines of COVID-19 outbreak

With social distancing the new normal due to a global pandemic, local health care professionals are turning more to technology in their patient care.

La Conner area medical clinics have employed secure video platforms to connect with patients anywhere at any time, while also regularly communicating with the public on how best to avoid COVID-19.

“For the past two weeks we have been fully telemedicine capable, completely morphing our practice of in-person visits overnight, managing patients in their home for common illnesses such as bronchitis, sinus infections and pneumonia, diverticulitis, and diarrhea as well as congestive heart failure, diabetes, high blood pressure and chronic kidney disease – all risk factors that if not treated can put someone in the hospital, possibly putting them closer to patients with COVID-19 infection and exposing them to risk,” said Dr. Charles Kotal, lead physician at La Conner Medical Center and its sister facility Island Internal Medicine in Anacortes.

Dr. Brianna Wilson of Thrive Direct Health Care in La Conner is also utilizing telemedicine technology.

“Currently,” she said, “I’m seeing lots of people through this method, which I’ve always done.”

Technology is likewise playing a vital role at Swinomish Medical Clinic, said Tribal Public Health Officer Sarah Wilborn.

“We have moved to a primarily telehealth system with same day access, keeping as many people out of the clinic at one time as possible,” Wilborn said.

She said keeping open lines of communication is also a key factor, especially given uncertainties related to the virus crisis.

“At Swinomish,” she said, “we are fortunate to have a communication system that allows us to send out regular updates and information that at this time includes (COVID-19) testing criteria.”

Wilborn lauded Swinomish leadership for having taken quick action at the front end of COVID-19.

Social distancing, while difficult, has been adhered to at Swinomish in the fight to curb the virus, Wilborn said.

“Swinomish people hold elders in the highest regard,” she explained. “Therefore, tribal members are particularly motivated to stay home in quarantine as much as possible.”

The local clinics are working in concert with area hospitals.

“At this time,” Kotal said, “we do not have COVID-19 testing on our premises as we are coordinating closely with the Skagit County Public Health Officer and the local hospitals to coordinate a system-wide response.

“When appropriate,” he added, “we are referring patients to their respective acute respiratory clinics set up specifically to respond to the COVID-19 pandemic.”

COVID-19 is a respiratory virus that attacks the lungs.

“The hospitals,” said Kotal, “have set up these clinics with staff trained in protocols and fully equipped with the necessary PPE (personal protective equipment) for testing.”

Resource management, as is the case elsewhere in the nation, remains a constant concern.

“Frustratingly for everyone,” Kotal said, “resources are limited, and testing patients exposes the health care workers to risk and takes away disposable and scarce PPE now from hospitals that will need it later to care for patients. We have to be judicious and not flood the respiratory centers with patients and use up those resources before they are truly needed.”

Wilson said Thrive offers free telephone screening to determine who needs to be tested and who should isolate at home.

“We can’t bombard the system by testing every person with symptoms,” she said, “but instead those at highest risk according to age and medical comorbidities.

“I have probably 30 nasal tests right now,” Wilson said, “and have tested two people.”

She reserves one hour daily, 3-4 p.m., for respiratory cases.

Wilborn said Swinomish Medical Clinic has access to COVID-19 test kits.

“But,” she said, “(we) have a limited supply. We are continuing to use the guidelines set by the CDC (Centers for Disease Control) and are only testing people who are symptomatic and are either in a high-risk group or have a known COVID-19 positive contact.

“We are doing fine in regard to PPE,” Wilborn added. “We are conserving PPE by grouping tests and having only select personnel have physical contact with patients. Like everyone else, securing PPE has been and will likely continue to be a challenge. We have several people and departments working together to secure PPE and are sharing among departments as needed.”

Wilson said Thrive is receiving an increased volume of calls requesting immune-boosting strategies to stay in front of COVID-19. She suggests adults undertake a daily vitamin regimen, including appropriate dosages of Vitamin C and Vitamin D3.

The bottom line, according to Wilborn, is that everyone is a stakeholder in the COVID-19 fight.

But it’s health care professionals who are on the front lines.

“This is a scary virus,” she said, “and we have our own families to take care of as well. But we have really pulled together and currently have a really good system in place. I think the employees of the clinic feel good about their work, in particular because the care is mutual.”

Her advice to the public is now as deeply ingrained as the time-honored prescription of eating an apple a day.

“Please stay home, stay safe and take care,” she said.