NSHC Situation Report Update

March 20, 2020

to the Norton Sound Health Corporation community

There are no cases of COVID-19 in the Norton Sound/Bering Strait Region. There are 12 confirmed cases of COVID-19 in Alaska.

The latest news from Alaska Department of Health and Social Services, including the latest health mandates and alerts, can be found here.

Service and Program Updates:

CHANGE IN SERVICES: Starting Monday, March 23, NSHC will be taking more of an urgent and emergent care approach to services. NSHC will be scaling back its focus to health care matters that cannot wait for more than 30 days, which will be determined on a case-by-case basis. NSHC will keep its departments operational, but staffing and services may be limited.

DAY SHELTER: The NSHC Day Shelter will be moving from its downtown location to the Nome Recreation Center, starting Monday, March 23. It will be extending its hours to 8:30 a.m.-8:30 p.m. The Nome Emergency Shelter Team (NEST) will operate out of the same location, also with extended hours, from 8:30 p.m.-8:30 a.m. This arrangement through the partnership of the City of Nome, NSHC and the Nome Community Center will help ensure everyone's safety during this crisis. The Rec Center phone number is 443-6645.

WOMEN, INFANTS AND CHILDREN (WIC): NSHC WIC Participants in Nome are discouraged from visiting the Nome WIC office located in the hospital and will be issued benefits remotely. Clients are still able to come in for certifications to avoid lapses in benefits. Please call to check if your certification is due to avoid unnecessary visits. Clients who are due a new set of benefits are encouraged to visit www.wichealth.org or call the WIC office at 907-443-3299 to complete their quarterly nutrition education.

exempt from the need for height, weight and blood work. WIC will still need all forms and signatures completed and returned to the WIC office, either in-person, by postal mail, or email to [email protected] . WIC does accept pictures of applications sent via phone. Applications can be found online at the NSHC WIC website .

DENTAL: The NSHC Dental Clinic will only be treating patients with urgent needs. For now, the American Dental Association and Indian Health Service recommend that elective dental procedures be curtailed. Here is what this means to you:

EMERGENCY MEDICAL SERVICES: EMS is postponing all American Heart Association classes. The AHA is recommending considering extensions of AHA provider cards beyond their renewal dates for up to 60 days, at this time. Over the next 60 days, for providers whose cards have expired due to inability to complete training during the COVID-19 outbreak, the AHA will allow the instructor to provide remediation during update courses.

Medicaid/Medical Travel: The Alaska Medicaid program is limiting Medicaid travel to only those services that cannot be postponed for three months (e.g. facility discharges, emergency ambulance transports, acute psychiatric events, urgent surgery). This decision follows the Alaska State Chief Medical Officer's advisory requesting that providers postpone non-urgent and elective services.

Effective immediately, all travel authorization requests must include written documentation explaining why the service for which the recipient needs to travel cannot be postponed for up to three months.

At NSHC, these same standards will start being applied to all medical travel.

Visitor Guidelines: Visitation is restricted at NSHC - both at the Norton Sound Regional Hospital and in village clinics. NSRH now closes to the public at 7 p.m. Visitors are not allowed in Quyanna Care Center or Acute Care, unless they have the special permission of the nursing manager. The Patient Hostel/Pre-Maternal Home is also closed to visitors. Visits to the hospital and village clinics should be limited to patients who have appointments and who are picking up medications. All other matters should be handled by phone, if possible.

NSHC's Fireweed Cafe is serving meals to only patients and employees. In order to comply with the State of Alaska's mandate on food establishments, staff is only serving one customer inside the cafeteria at a time.

Behavioral Health Services is not allowing visitors at its west campus location in Nome. Patients and those with official business are being allowed in by appointment only.

The Emergency Department is limiting visitors as well. If a patient is under 18, they are permitted one parent/guardian visitor. Patients who are aged 18-55 are not permitted visitors. Patients who are 55 and older are permitted one family member, as long as they are older than 18, at the discretion of ED staff. The following may be permitted visitors/escorts: elders who need assistance, anyone who has a special need (physical or mental), and anyone who needs an interpreter or patient advocate.

Employee Travel: NSHC employees who are returning from travel outside the region within the last two weeks must contact Karla Homelvig or Megan Mackiernan via email before returning to work. Employees must notify Karla or Megan if their spouse/significant other/roommate has traveled to a location where the virus is prevalent as well. Employees are asked to consider future travel plans carefully and determine whether they are able to take an additional two weeks off of work if they are unexpectedly quarantined.

Village Medical Travel: In an effort to safeguard and minimize the risk of COVID-19 exposure to the region’s villages, NSHC is temporarily altering the processes of provider visits to the villages and patient visits to Nome. Read the PSA in its entirety here.

Village Communication: Print resources on COVID-19 mitigation information were sent to village clinics to be distributed around communities. The resources included flyers on stopping the spread of germs, hand washing, the symptoms of COVID-19, and how to create a handwash solution using liquid bleach.

Conserving Supplies: Both employees and the public should be aware that NSHC is conserving its medical supplies. Nationwide, health care facilities are experiencing a shortage of different medical supplies. Of note: only patients who are coughing and sneezing should wear masks, which are available upon entry to the hospital or clinics. Masks are used to contain germs and protect others from exposure. Only specialized, fitted masks used by health care providers are effective in blocking out germs from the outside.

Employees should check with their supervisors for the latest recommendations on PPE. Patients and the public should know that NSHC staff will continue to care for them in a safe manner.

Mark Peterson, MD - Medical Director: "NSHC physicians and staff are working directly with ANTHC and the State of Alaska on a daily basis in preparation for the possibility of COVID-19 infections in our region. We are fully staffed and have procedures in place in all departments for the safe evaluation and treatment of any patients who might present with COVID-19. We are preparing for any situation that may present."

Terry O'Malia, DO - Director of ER and Acute Care: "The ER and Acute Care units are open 24/7 and are fully staffed. Our physicians have done and will continue to do ongoing training specific to COVID-19 identification and care. We have not seen any cases of COVID-19. We are capable of dealing with the COVID-19 virus per CDC and Alaska Department of Health and Social Services recommendations. We ask that you call in advance of coming to the ED, if at all possible, so that we are aware that you are coming. Calling ahead allows us to better prepare for your treatment when you arrive."

Gary Kulka, MD - Director of Clinical Services: "Primary Care Clinic is open with regular hours of operation. The clinic is operating with a full staff, and we will continue to see our regular patients. However, we are asking those who are over age 60, or those who are immunosuppressed, to delay routine appointments for the next 30-60 days due to these patients being at higher risk. If patients are unsure if they should come in or not, we urge them to call and ask a member of the staff."

Nationwide: Read up on all COVID-19 information from the Centers for Disease Control and Prevention website.

Statewide: Do you have non-clinical questions about COVID-19? You can utilize the Alaska 211 hotline and speak with a medical volunteer. Find all Alaska DHSS recommendations and mandates here.

Regional: If you are experiencing symptoms of COVID-19 (fever, cough, shortness of breath) and you believe you may have come into contact with the virus, you should call NSHC's Nurse Call Line before going to your provider to be seen: 907-443-6411. All the latest public safety announcements from NSHC can be found on our website.