The Big Sandy Mountaineer -

The community is the first responder and the first line of defense. The public is responsible for stopping the spread of COVID-19, and it is going to be harder to continue social distancing the longer it delays. Recently there was an internet conference call with local medical personnel and city and county officials. Those present were Shaud Schwarzbach, Big Sandy Mayor; Darin Schuster, County Commissioner; Heather Wolery, Principal of Big Sandy Public Schools; Leah Griffith, CEO of Big Sandy Medical Center (BSMC); Krystyl Kulbeck, Physician Assistant at BSMC; Zane Bendig, Nurse Practitioner at BSMC; and myself. The purpose of the meeting was to make sure everyone was on the same page and doing everything they can to keep our citizens healthy.

BSMC's objective is to keep COVID-19 out of the facility. They appreciate and rely on the community's help to keep things reinforced. Leah Griffith said, "We are screening everybody who comes into the building with a questionnaire and temperature test. Every visitor and employee is screened every time. Visitation to the long term care residents is restricted. Outpatients for physical therapy and the clinic are still coming in. Providers are still scheduling routine visits to the clinic. We need all patients to continue to call first so we can screen them." Their internal strategies are working so far; patients are calling first; employees are reporting symptoms; cleaning high-touch areas is a priority; staff is now wearing surgical masks on the long term care side, and providers and other staff are prepared.

Is there a protocol in place between our medical facility and state personnel? Yes, the facility staff responds to daily emails, as does every medical and hospital in the state, providing the status of every medical hospital. The shared information includes PPE supplies, bed availability, and staffing. This process aids in getting access to emergency resources, if possible, to not overwhelm facilities. If there was an emergency declaration, Shaud said, "We take the lead from the medical center, so the city has the medical center's back." Darin said, "We (the county) could have $44,000 rather quickly, if necessary." If the staff becomes ill and unable to work, BSMC could ask the governor for support from the national guard.

Because of the hard flu season in December, BSMC was ahead of the curve in preparation for keeping the residents as healthy as possible. They had already been limited visitation, and the residents were on board and involved in those decisions. Currently, they are separated but not isolated. Activities are still ongoing while being mindful of social distancing and small groups. Family visitation, in some cases, can still happen with planned accommodations. The primary goal at this time is to keep their residents happy and healthy.

Besides needing to keep their residents safe internally, the other reason BSMC asks the community to follow recommendations and guidelines diligently is, although they are prepared to care for patients, there are limitations. BSMC is unable to care for patients who need ventilators and only has a few beds to place patients awaiting test results, and with low staff levels available, it would be scary. BSMC does not have ventilators and cannot due to staffing and licensing requirements. Zane said the reason we need to stay so diligent in Big Sandy is no larger hospital will accept a sick person unless they need to have a ventilator and then only if they had a bed available. If it becomes obvious an individual will need a ventilator, Krystyl and Zane will attempt to make arrangements for you to go to a larger tertiary facility. However, that depends on the number of ICU beds and ventilators available at that hospital at that time. Those, too, are limited based on the large area covered by the more extensive facilities' service areas. If Montana gets a surge of patients needing that type of

special care, the results could cripple the healthcare system and result in poor outcomes for patients.

As far as COVID-19 testing supplies, BSMC does have limited testing available and is hoping to get quick results testing at some point. There are specific criteria that must be followed to justify testing. When I asked what those criteria were, the providers said they could tell me; but honestly, it changes from day today. The best thing is to call and not make those criteria decisions yourself. Krystyl was quick to point out, however, that even if the test is negative if you have the symptoms, you need to be self-quarantined. You cannot rely on the results of the test. At the time of this conference call, there had only been three tests conducted in Chouteau County; and all three were negative. Also, at that time, BSMC had 17 tests remaining. When you take a test, it is currently transported to the hospital in Havre and then on to the state lab in Helena. "We can get the results within 24 hours if the timing is right."

BSMC wants patients to know they can provide telehealth services through Zoom if anyone needs an appointment with Krystyl or Zane as long as the visit does not require a hands-on assessment. Appointments can be made by calling the clinic at 378-2189. You are also encouraged to call and speak with a provider regarding symptoms you may be having, questions regarding COVID-19, and any other concerns you may have. They are there to help and strive to keep the community healthy.

Community members might be getting tired and frustrated and be tempted not to follow the social distancing recommendations. It will get harder as we stay apart from one another. Mental health could come into play. Three community pastors are willing to talk to you about your frustrations, depression, and loneliness. Call Pastor Sean Janssan at 262-0235, Pastor Erik Sietsema at 399-3803, and Rich Jespersen at 680-7080.

High traffic areas within the community include the bank, the post office, the grocery store, and the pharmacy. It is essential we follow the rules and do not violate the social distancing part of it. We have probably all been guilty of making slips, but now is not the time to do so. We cannot become complacent. Practice social distancing; wash your hands; cover coughs and sneezes; limit contact to those within your household only; make essential trips once per week, and take care of your loved ones. The group at the meeting agree that the message is about staying the course for as long as it takes in hopes of stopping this virus from reaching the Big Sandy community.

The Grocery Store is fully supportive of serving the community. You can call in your order, or Deb also said you may text her if you are comfortable with that at 8688-0810. They will put your order together and bring it out to your vehicle. The Senior Center, The Mint, and Pep's are taking call-in orders. You can continue to support their businesses and celebrate activities by eating out (sort of). The pharmacy is also open. You need to call, and they will meet you at the window. The bank remains open but only allows one customer at a time into the lobby. All deposits can be made through the door, or you can drop them off at the dropbox.

This is a difficult time, mainly because the kids want to get together. We can be creative in supporting them and their need for social interaction. Find ways to interact safely and devote time to addressing their mental health. There was some excellent news Krystyl said, "Today the peak day (for Montana) has been changed to April 13. Currently, we are not short of beds or ventilators in the state of Montana." We can only hope it remains that way while doing our part.

In the end, Big Sandy medical providers and town officials urge the community to continue staying the course and do the right things. No matter your political or conspiracy beliefs, the threat is real. The threat is the virus. We are all responsible for our own actions to avoid community acquirement and the spread of COVID-19.