Health precautions lead to event cancellations

Saturday, March 14, 2020

Nursing home access restricted under new guidelines

The general response locally to the COVID-19 (coronavirus) changed this week, as the first major cancellation of an event took place in Monett.

Nursing homes and Cox Monett Hospital also implemented different protocols in response to a directive from the Greene County health care community, the Coronavirus Task Force and a detailed guide issued by the Centers for Medicare and Medicaid Services.

Health department overview

For the average person, seeing the run on toilet paper purchases at local Walmarts, the health scare may seem like a bigger issue than the actual number of cases justifies.

The first confirmed case of the COVID-19 virus in southwest Missouri was in Greene County, announced on Thursday. Up until then, there was only one confirmed case in St. Louis County, and 71 other tests had been found negative.

Roger Brock, administrator for the Barry County Health Department, said there were a limited number of the A and B flu strains still circulating during the last weeks of February. He noted cases of the flu often die out once the weather warms up.

“The state has set up a hotline, and the CDC (Centers for Disease Control) has good information on its website for guidance,” Brock said. “We’re not taking the approach of telling people to cancel gatherings. I know some have chosen to cancel. We will not make that call.

“If you have flu-like symptoms, it might be advantageous to your family and friends and the people you are visiting to wait. You might spread the flu. If you have flu-like conditions, contact your physician.”

The coronavirus, Brock observed, has similar symptoms to regular flu. He said it is a new strain, an animal virus that jumped to humans in China. Symptoms can range from very mild to severe respiratory problems.

“The at-risk population seems to be the older population at this point,” Brock said. “Younger ones are not showing as much effect, and they get through it pretty well if they do get it. Like any other respiratory infection or virus, there have been cases in all age groups around the world.”

It appears, according to the CDC, that transmission of droplets seems to spread the ailment. The CDC recommends separation from infected people as the main strategy.

“Healthy people don’t need to wear a mask,” Brock said. “If you wear a mask, it’s to not project contaminated droplets.”

As for the run on toilet paper, Brock said that did not appear connected to flu symptoms.

“I don’t know any answers to that,” Brock said. “The psychological effect of panic buying can correlate to the weatherman predicting four inches of ice. That’s the only thing I can figure.”

Transition Expo cancelled

The cancellation came from the 10th annual Transition and Resource Expo, slated for March 17 at the Scott Regional Technology Center. A large outreach to people with disabilities, both long and short term, the expo assembled around 45 vendors with services, new technology and networking opportunities. The event is underwritten by the Barry and Lawrence County tax boards for the developmentally disabled.

Geneva Blue, the work experience coordinator at Scott Tech, said organizers of the expo reluctantly decided to cancel the event due to concerns for the health of those who attend.

“Given the fact that vendors from all over the Midwest attend the expo, after consulting with health care providers, it seemed like too much exposure in light of so many of our attendees have health issues and are elderly. Flu is way up in our area. That was more of a concern from that angle than the coronavirus.

“In an abundance of caution, we set the next Transition Expo for March 23, 2021.”

New guidelines for nursing home access

On Monday, new guidelines were issued to health care facilities to combat the future spread of the coronavirus. The directive came from the Greene County health care community and the area Coronavirus Task Force. The guidelines were widely adopted, including in Monett.

According to a statement released by the Greene County health care leaders as a group, “The visitor restrictions are similar to those implemented during a tough flu season. Children ages 12 and under not seeking medical treatment will not be permitted to visit Greene County hospitals or other long-term care facilities until further notice,” beginning immediately.

“Additionally, those outside this age group who feel sick and are not seeking care are asked to avoid visiting hospitals or other health care facilities for the protection of patients, hospital staff and the broader community.”

“CoxHealth will be implementing these restrictions systemwide, including hospital facilities in Branson, Monett and Lamar,” a release from the hospital system said.

The Centers for Medicare and Medicaid Services (CMS) released a directive on Monday from its Center for clinical Standards and Quality/Quality, Safety and Oversight Group, giving more specific directions for nursing home operations. According to Mike Baldus, administrator for Lacoba Homes in Monett, the guidelines provided more specific directions for immediate implementation.

Visitors to facilities such as Lacoba and Oak Pointe Assisted Living and Memory Care are given hand sanitizer before signing in. They are asked to sign a form, specifying who they are visiting, recent travel history, and any possible health issues, specifically cough, shortness of breath and fever. Visitors have their temperatures measured. Anyone with a low fever higher than 99 degrees will be turned away. Those meeting the requirements are asked to wash their hands again before proceeding.

“The first thing people need to understand is the mortality rate for the elderly increases with the COVID-19 virus,” Baldus said. “We’re taking steps we’ve never taken before. The key to it is, this virus could enter the facility by any individual, especially the public. Individuals, as we understand it, may not even know they were sick. That doesn’t come till later. They could transfer the virus and be impossible to screen.”

Baldus said it is not yet clear how the COVID-19 virus is transmitted. It is thought that the virus is spread by touching a surface touched by someone with the virus, or coughed on. A person could be exposed through simple contact at a gasoline pump, for example. A person can become a carrier by touching the mouth, or eyes, thus allowing the virus enters the body.

“I’ve been doing this for 36 years,” Baldus said. “I’ve never seen a reaction of the public like this, or the public’s understanding, or the CMS going to this length. It’s pretty new on all of us.

“We have a lot of protocols on the flu. At this point, we don’t know if they’ve found anything that would kill the coronavirus. So we’re in uncharted territory. We don’t know.”

Those who are given access go directly to the room of the patient and visit there only. Baldus said patients are being told to stay six feet away from visitors, with no handshakes or hugs.

“The first thing we did was explained to the residents what this is and what they’re hearing on TV,” Baldus said. “We said we need their help. It’s not a good time to visit unless there’s an emergency situation.

“There are other ways people can visit. We’re telling them to use cellphones and FaceTime. We can help with those things to find other ways to visit. We’re just discouraging visiting at this point.”

Baldus noted that while federal government has urged nursing homes to conserve on their supplies, as well as screening anyone with symptoms of respiratory infection, such as “fever, cough, shortness of breath or a sore throat,” officials are also urging steps like taking the temperature of visitors, representing “a double edged sword.” The CMS guidelines indicated state and federal surveyors would not cite facilities for a shortage of supplies such as gowns, respirators, surgical masks and alcohol-based hand rub.

The CMS also advises limiting physical contact with residents and others while in the facility. Health care providers with signs and symptoms of respiratory infection are advised not to report to work, to put on a facemask and self-isolate at home.

“We still don’t know how the virus is being transmitted,” Baldus said. “We think the virus may be spread by a cough and touch, either through ingestion or other contact. We want people to understand we are trying to protect our residents. People don’t realize they are the problem.”

Access to all seven Missouri Veterans Homes has been summarily restricted, as of March 8, according to a statement issued by the Missouri Veterans Commission.

According to Jamie Melchert, communications director with the Missouri Veterans Commission, all families, vendors and volunteers would be restricted from access until further notice. Staff would work with families to continue contact through video methods such as FaceTime.

Melchert said staff were being assessed daily upon arrival. Anyone showing signs of illness will be sent home.

Absentee voting for April promoted

In light of health concerns, Lawrence County Clerk Tammy Riebe issued a statement Friday offering absentee voting to all people, not just those who will be out of town on election day April 7.

“Voters with a compromised immune system or who are in a high risk age group for the coronavirus have the option of voting absentee in the April election,” Riebe said. “To avoid crowds at polling places, [voters] may vote absentee at [the clerk’s] office in the courthouse from now through Monday, April 6. Hours are 8 a.m. to 4 p.m. Monday through Friday. There will be Saturday hours from 8 a.m. to noon April 4.”

Those wishing to request an absentee ballot by mail should make that request by March 25, Riebe added.

YMCA action

The Monett Area YMCA, which has many surfaces that come into contact with patrons, has heightened its strategies for keeping people safe, Dove Henry, executive director, said.

“We are striving to provide the safest environment possible while still keeping our doors open to the community,” Haney said. “With the flu and coronavirus so much in the news, we have an even greater responsibility to our patrons. We have always asked members to wipe down equipment with disinfectant after use. We have posted an abundance of signs requesting that they do so before as well as after use to help protect themselves.

“Our staff has been asked to increase common area sanitizing. Door handles, counter tops, coffee areas, etc. will get extra attention multiple times each day, hourly if possible. In addition, all our equipment will be sprayed down and allowed to air dry with disinfectant each night, focusing on commonly touched surfaces.”

Haney nonetheless offered caution to older patrons.

“Knowing that our senior population is one of the most vulnerable, we are recommending that those with a weakened immune system should avoid large groups, use social distancing (6 feet), and don’t hug or shake hands,” Haney continued. “We have suspended our monthly potluck but will continue to offer senior classes until it is deemed not safe to do so. We have discussed the health benefits for our active older adult class attendance and acknowledge that each person should make a decision knowing the responsibility they have to keep themselves safe. All hand weights, chairs, balls and stretch bands are cleaned immediately after every use. Our Kids Zone area adheres to a very strict cleaning regiment.

“We are taking additional precautions with our competitive adult basketball participants. All players are asked to only play if healthy, wash hands before games and are also provided mandatory hand sanitizer before play. The basketballs are also being cleaned on a regular basis.”

A multi-page memo was issued Thursday night by the YUSA’s national office detailing how branches are to respond to the virus issues. Haney said the local YMCA is following strategies under the guidance of its national organization.

“As things progress, we may change our policies to adapt to the needs of the community and we are following all guidelines and mandates set by YUSA as well as the direction and leadership of the Ozarks Regional YMCA,” she added.

Monett school district steps

The Monett school district sent a flier home with students on Thursday about infectious diseases, and officials posted it on the district’s Facebook page.

The information sheet reminded parents that students would not be penalized for staying home when sick. Parents were urged to keep ill children at home.

Plans call for placing more disinfectant in schools and on buses.

“Currently, we have increased our cleaning and sanitizing procedures and are emphasizing the importance of good hand hygiene at school,” the flier stated. “Although we hope that our school will not need to close, we are looking at ways to support student learning in the event of a prolonged closure.”

According to the statement, the district plans to follow recommendations by public health authorities about closing schools. The superintendent and school board would make further decisions in case not enough healthy staff members were available for work. The possibility was left open that in specific circumstances, some campuses may be closed while others remained open.

“We are tracking student and staff illnesses in our schools on an ongoing basis,” the flier concluded.

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