COVID-19 Updates and Information
Updated 5/27/20 (Para español, haga clic aquí)
These are the cumulative COVID-19 results for Mammoth Hospital since March 15, 2020:
|Number of Tests performed||Positive results||Negative results||Hospitalizations||Deaths|
*These numbers reflect cases reported at Mammoth Hospital. These statistics may not reflect total number of cases in Mono County.
As of today, May 27, 2020, Mammoth Hospital’s status for admitting patients to the hospital is GREEN*
*GREEN – able to care for any patients requiring admission
YELLOW – nearing capacity, but still able to care for all patients requiring admission
RED – At or beyond capacity, with limited resources. May not be able to care for all patients requiring admission
Listen to our Chief Medical Officer, Craig Burrows, MD in his radio interview with local station, KMMT here.
A Letter of Thanks to our guests, second homeowners, and all those who love Mammoth Lakes and Mono County
Thank you for giving us a fighting chance.
We all find solace in the mountains—that’s why we’ve made our lives here, why we vacation here, and why we love it here. On behalf of our entire community, we are so incredibly grateful to you for staying home during the challenging first weeks of the COVID pandemic.
Because of your selflessness, and your committed regard for the greater good, you flattened the curve, and gave Mammoth Hospital the time needed to prepare. And prepare we did. We transformed our small critical access hospital into a facility ready to care for patients with COVID-19. Because you sheltered in place, physical distanced, maintained hygiene, and covered up, over the past seven weeks we were able accomplish all the following:
- The surge capacity of the hospital has increased from 17 to 40+ patients.
- All hospital personnel and visitors are required to wear facial coverings.
- ICU bed capacity has increased from 2 to 6 ventilated patients.
- There is daily screening and temperature checks for all hospital staff and visitors.
- The inventory of Personal Protective Equipment (PPE) is at 60 days on hand during a surge.
- There is staff housing available and patient overflow capacity.
- COVID positive and negative zones have been established.
- Patients can be tested and cared for at home.
- Rapid in-house testing is now in place.
- Work from home policies and processes limit the number of employees in the hospital.
- Labor pools and cross training of staff are in place to be surge-ready.
- A telemedicine program allows patients to access care from home.
We ask that you please continue to be patient with us. Understand that our greatest objective is avoiding a surge of patients. As Mono County reopens, things will look different. We will still need to physically distance. We will all need to be patient, slow down, and exercise kindness with strangers, neighbors, and the workers who serve us. We will all be required to wear face coverings while out in public. This is new territory for all of us, but we are adaptable—it is one of our greatest strengths as human beings. Please know as much as we want you back here with us for a beautiful Sierra summer, we are still following Governor Gavin Newsom’s directives, and will not move ahead of the state’s directives.
We stand at the ready, as excited as you are to get back to the places we know and love, and to know the mountains will be calling again. Take heart—we will be together again soon.
Wash. Cover. Distance. Be kind to one another.
Mammoth Hospital | Mono County Public Health | Mono County | Town of Mammoth Lakes | Mammoth Lakes Police Department | Mammoth Lakes Fire Department | Mono County Sheriff
How do we host gatherings safely in the age of COVID? Dr. Howell gives us tips in the latest video in our series below.
How do you do group activities in the era of COVID-19? Dr. Kyle Howell explains in the video below.
How do you recreate outside in the era of COVID-19? Dr. Kyle Howell explains in the video below.
Providing Medically Necessary, Time Sensitive Health Care Services
This week, the California Department of Public Health (CDPH) issued an advisory to all hospitals in the state entitled “Resuming California’s Deferred and Preventive Health Care.” It described the growing problem of deferred medical care as creating its own public health impacts, which “must be addressed as soon as practicable.”
The CDPH advisory provided guidance for the resumption of medical services including elective and non-urgent procedures at hospitals, outpatient care including primary care and specialty care in physician offices and health centers, behavioral health, long term care, ancillary, pharmacy, and dental services. These services should resume with a focus on “care that has been postponed including preventive care such as well-child visits and vaccination, adult clinical preventive services and routine dental services.” The advisory included a recommendation to “maximize the use of telehealth/telephonic modality.” It also expressed an expectation that “specific regions of California may resume services before the entire State is able to.”
General considerations for resuming services from CDPD include:
- COVID-19 infection rates
- COVID-19 hospitalizations
- COVID-19 emergency room admissions
- COVID-19 ICU utilization
- Skilled Nursing Facilities outbreaks
- PPE supply
- Testing availability to healthcare workers and patients
- Availability of qualified healthcare workers
- Establishment of safe patient flow processes and infection control precautions
The advisory stated that “Providers and facilities are encouraged to gradually resume full scope of services when possible and safe to do so.”
At Mammoth Hospital we have reviewed and incorporated the CDPH guidelines in our “Hospital Phased Reopening Plan.” In our planning process, we set for ourselves three overall goals and requirements:
- Adherence to patient and staff safety requirements in each department.
- A phased approach, bringing up patient care volume gradually to assure that safety protocols can be maintained.
- The scoring and categorization of patients whose care and conditions are medically necessary and time sensitive.
For the last two months, we have been working on three primary goals related to COVID-19 response:
- Increase surge capacity.
- Don’t be a vector for transmission of the virus.
- Slow transmission and flatten the curve through messaging, by example, and with interagency work.
We are surge ready. We can flex up our capacity from 17 beds to 60. Of those, we can go from 2 ICU beds 10. We now have six ventilators, up from four, and a PPE supply of 60 days of surge use. We have designated COVID positive and COVID negative zones throughout the hospital and clinics, established restricted access into our facilities, and instituted risk-based PPE protocols, all to protect patients, staff, and the community.
Currently we have nearly two hundred patients whose procedures and surgeries have been delayed due to our curtailment of elective medical procedures. The Hospital Phased Reopening plan, in support of CDPH’s call for gradual resumption of full scope of services, eases us back into caring for the medical needs of our community. We have established four levels of care resumption based on factors including the invasive nature of procedures, length of time of procedures, expected patient length of stay in the hospital, number of staff needed, and expected PPE use.
Beginning on May 4, we will start providing medically necessary time sensitive services at our first level of procedures. This includes colonoscopies, manipulations under anesthesia, gynecologic D&C, and certain dental procedures. We will also be seeing more clinic patients via telehealth and, as needed, in person. We will assess our ability to resume these medical services while maintaining safe and preventive operations, adhering to the processes that have created our success to be surge ready and not be a vector for transmission.
Additionally, we closely watch the trends in new cases and hospitalizations locally, statewide, and across the country. We have established clear triggers for returning hospital operations back to a more restrictive profile should we deem it necessary in order to maintain needed surge capacity.
Mammoth Hospital has updated information for the public regarding COVID-19 testing. Currently, there are two primary types of tests for COVID-19. One is a nasal swab test, and the other is a blood test.
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Nasal Swab Testing is looking for an active COVID-19 infection using a molecular test known as Polymerase Chain Reaction, or PCR. The swab is inserted into the nose and is then sent to the lab to look for the presence of genetic material from the virus. The test is most likely be positive early in the progression of the illness. It is important to remember the test is not perfect, and if a person with symptoms suggestive of COVID-19 tests negative, that person still needs to be treated as if the test were positive. This means isolation from others for at least 10 days, along with three days with no fever AND no other symptoms.
For patients who meet testing criteria, nasal swab testing is currently available at Mammoth Hospital. It also may be available through the Toiyabe Indian Health Project (Coleville/Walker and Bishop clinics) and at Northern Inyo Hospital in Bishop.
Antibody Tests are blood tests looking for the antibodies that create immunity after exposure to the virus. These antibodies start to appear about two weeks after infection, and may be helpful in determining who is no longer at risk to becoming infected in the future. It will be a very important test for the community in the weeks and months to come as the prevalence (the number of people infected) becomes greater.
Presently, the number of people infected in Mono County is believed to be very low, probably not more than 2-4% of the population. Even if 5% of the population were infected and now had antibodies, the problem with the currently available tests is they are not sensitive enough (the test will not identify everyone who has antibodies) or specific enough (the test will incorrectly identify patients to have antibodies when they do not).
To further explain this, consider a population with 10,000 people and a prevalence of 5%. That means 500 people actually have antibodies. The test being used has a sensitivity and a specificity of 95%, which means 475 out of 500 people will be correctly identified as having antibodies. However, 475 people will be INCORRECTLY identified as having antibodies. Thus, of the 950 people told they are immune, this is true for only HALF of them! What this means is half the people believed to be immune in fact have no protection and remain at risk of infection. So until the prevalence is higher, this test is not reliable or helpful.
Current antibody tests are either not reliable enough, or they are not FDA-approved. As a result, Mammoth Hospital does not recommend antibody testing at this time. As testing becomes more reliable and the indications for testing become better defined, this recommendation will surely change.
If you or a family member are sick, please call the Mono County COVID-19 response team nurse hotline at 211 or (760) 924-1830. A Registered Nurse is available 7 days/week from 8:00 a.m. to 5:00 p.m. The nurse will advise you on if you are safe to stay home and isolate, or if you need to be seen by a healthcare professional at Mammoth Hospital. You will also be given resources on how to help keep you and your family safe.
Rapid in-house testing comes to Mammoth Hospital!
This is a huge deal for us, and we could not have done it without our laboratory team, who tirelessly worked to develop and validate our new rapid in-house test.
Here’s the skinny:
Q: How long does it take to get results?
A: Results are obtained in approximately one hour.
Q: How is the test performed?
A: The test is still performed using a nasal swab (yes, it’s really uncomfortable, as you can tell by Dr. Burrows’ face).
Q: Does this mean anyone can get tested?
A: You must still meet testing criteria as defined by Mammoth Hospital and Mono County Public Health. If you are symptomatic, or if you have been specifically referred by the Public Health Department for testing, you qualify for a test. Please contact Mono County Public Health’s nurse hotline at 211 or 760-924-1830.
Q: What about antibody testing?
A: We realize that this is big on everyone’s minds, but unfortunately we do not have antibody testing in Mono County, and we do not have an ETA for this test at this time.
In summation: Thank you, Mammoth Hospital team, for all your hard work on getting this rolling. We are an amazing team caring for an amazing community. Every small decision we make saves lives. We cannot overstate how much each of you have helped us crush the curve. Keep it up!
Distance. Wash. Cover.
Mammoth Hospital is looking for volunteers to help with the COVID-19 pandemic to support our local community in the upcoming days, weeks, and months. If you would like to volunteer and be on call to help support our community, we would love to hear from you.
A wide range of opportunities exist that our community will need help with should this pandemic come to a critical point. Your skills, knowledge, and experience could have a huge impact towards supporting each other during this challenging time.
Volunteers play a vital role at Mammoth Hospital and we are always in need of caring, compassionate individual to help us carry out our mission.
National Volunteer Week is coming up April 19 – 25, 2020, now is the perfect time to get involved.
For more information on volunteering, please contact Jane Grossblatt, firstname.lastname@example.org or 760-914-0782.
We are looking for volunteers of all types and are directly hiring Registered Nurses. If you are seeking employment, please go to our website to apply at https://mammoth-hospital.breezy.hr Thanks!
When will things go back to normal?
This is the question on everyone’s mind. We, as Californians and as Mono County residents especially, have done such a good job at social distancing that we have actually been effective in slowing the spread of COVID-19 in our community, and in our state as a whole. Our efforts have literally saved lives!
Now that we are prepared for what a surge in cases looks like, and are confident that our plans are solid, we can begin to peer into the future for what a return to “normal” might look like for our community.
Our leadership is working with Mono County Emergency Operations Command (EOC) to develop a plan for this. We know businesses and families are hurting from the economic losses this virus has caused, but we also know that we need to look at the curve closely to understand the timing, so that we don’t lose all the gains we have fought so hard to make.
In this short video, Drs. Kyle Howell and Craig Burrows explain why we need to ease social distancing restrictions gradually, so we don’t end up back at square one.
There is hope, and there will come a time when things start running again. But right now, we need to keep up the hard work, buy stock in sweatpants and Netflix, and keep crushing the curve. It’s working!
Thank you, from the bottom of our hearts.
Thank you for the muffins. We need them when we don’t have time to stop and eat a meal.
Thank you for the coffee, which perks us up on long shifts.
Thank you for the fresh juice—it keeps our immune systems humming.
Thank you for the masks, which are so stylish that we playfully argue over our favorites. We have had so many donated that we have literally lost count. Because of you, we are able to give our patients masks to take home, so they can protect others.
Thank you for bringing your children to draw colorful chalk messages of encouragement and support outside our windows—they literally brought many of us to tears.
Thank you for donating. Your time, your money, your efforts. No matter how much or how little you have to give, it all makes a difference.
Thank you for emailing email@example.com to see how you can help us fulfill our mission: To promote the health and well-being of our residents and (when they return) guests.
In this time of so much uncertainty, there is one thing we are sure of—it is you, our volunteers, who are keeping us whole.
Every day, there is a new reminder of all there is to be thankful for.
#mammothsaysthanks is a way that each of us can recognize all we do for each other every day, whether you work at Mammoth Hospital and want to thank the sewing team for your new head cover, or whether you are in self-quarantine and want to thank your neighbor for leaving food on your doorstep.
You can use it to thank Sierra Dog Ventures for walking your dog because you can’t get home right now.
You can use it to thank Mammoth Mountain and Mammoth Mountain Community Foundation for running the PPE drive (don’t forget—their hours are M, W, F from 10 a.m.-2 p.m. at the ticket office in the Village!).
You can give a shout out to your friend who brought you a smoothie from Elixir Superfood & Juice.
You can thank Visit Mammoth for running the food bank that kept your refrigerator full this week.
You can thank Eastern Sierra Love (easternsierralove.com) for matching you with the donor who paid your electric bill so your family stayed warm during the recent snow.
There is so much goodness all around us. #mammothsaysthanks.
“You may feel like giving in. Don’t.”
We get it. It feels like we’ve been at this a long time. March lasted about 97 days, and April is forecast to last even longer. We’ve got snow, but we can’t ski. And as soon as we saw some daffodils poke their heads above the soil, the snow began to fall again.
It’s almost Easter. Our kids should be out collecting eggs filled with jellybeans. We miss hugging people. We miss the gym. We certainly don’t want to try our jeans on.
Mammoth Hospital’s staff stand ready to fight an unseen enemy. But instead of crashing through the gates, it lurks in homes whose residents are staying put. Our efforts are working. Every day that passes means one less day the virus spreads. But it’s not easy.
“You will feel discouraged. You should. This is normal in chaos,” writes Jonathan Smith, a lecturer in epidemiology at Yale University. In a letter to his neighbors, Smith reminds them to stay the course.
“This enemy that we are facing is very good at what it does… Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives,” he writes. “You may feel like giving in. Don’t.”
It is human nature to make the assumption that, because our hospital is not overwhelmed, that we have won the war. That it is okay to stop by and see a friend we haven’t seen in weeks. We’ve all been thinking it. We’d be lying if we said we hadn’t. But the war continues, even though it appears we are succeeding in this first battle.
“You should perceive your entire [household] to function as a single individual unit,” writes Smith. “If one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with.”
Our community is tight-knit. We help each other out, always. We deliver meals when our friends have babies and go for dog walks together. Staying apart is one of the hardest things we’ve ever done.
“In contrast to hand-washing and other personal measures,” Smith writes, “social distancing measures are not about individuals, they are about societies working in unison… this unprecedented outbreak will not be overcome in one grand, sweeping gesture, but rather by the collection of individual choices our community makes in the coming months.”
In this time, we will learn to find joy in new ways, like joining in the Social Distancing Easter Egg Hunt sponsored by Mammoth Parks & Recreation, signing up for virtual date nights and tastings which support local restaurants, with “quarantine kitchen” Zoom meetings and FaceTime trivia nights.
We will wear face coverings when we visit the grocery store and, especially, the hospital. We do this not to protect ourselves, but to protect each other. We will stay informed about hospital testing numbers in our closest metropolitan areas, so that we are prepared for waves of infection that may be coming our way. We will vet our news sources. We will not let fear rule our minds—but we will stay vigilant.
We will show each other our love through the painful process of remaining separated.
Only by staying apart, together, can we do this. Stay strong, Mammoth.
An Open Letter to our Beloved Visitors:
We, the first responders (firefighters, paramedics, nurses, doctors, law enforcement and healthcare providers), members of the Unified Command Emergency Operations Center (EOC), members of the Mammoth Hospital Medical Staff, Members of the Mammoth Hospital Incident Management Team, the Mono County Public Health Officer, and elected officials of Mono County and the Town of Mammoth Lakes raise our voice in plea and concern for our beloved visitors to this area.
Mono County is a rural county with limited resources. COVID-19 is a respiratory illness which causes extremely low oxygen levels. Mono County is at high elevation, and the town of Mammoth Lakes sits at approximately 8,000 feet. Due to elevation, patients with severe respiratory illnesses are often transferred to hospitals out of the area that can provide intensive care support over a sustained period of time. Our one hospital has two intensive care beds, four ventilators and one Intensivist who is board certified in pulmonary and critical care medicine. As the COVID-19 pandemic progresses, those referral hospitals could become saturated with intensive care patients limiting our ability to transfer. In that situation, an influx of patients at Mammoth Hospital could mean that we may have to make life and death decisions as to who will receive critical care measures such as life support with mechanical ventilation.
Although the current number of COVID-19 cases in Mono County remains relatively low, the per capita rate remains one of the highest in California. We are concerned that an influx of people coming into the area could overwhelm our local healthcare resources.
Mono County, which includes the Town of Mammoth Lakes, has issued Stay at Home orders that are in alignment with orders of the State of California. These orders prohibit all non-essential travel. We are appealing to everyone to follow the Stay at Home orders in order to keep everyone safe.
We care deeply about the well-being of our residents, second homeowners, and visitors.
Please help us to help you be safe and healthy:
- Travel only when necessary per the Stay at Home orders
- If Mono County is home for you, please stay at home
- If Mono County is not home for you, please remain at your home
To our beloved visitors, we cannot wait to welcome you back with open arms.
The Mountains Will Be Calling Again. Until then: Distance, Wash, Cover, Love Each Other!
Mammoth Hospital // Mono County Public Health // Mono County // Town of Mammoth Lakes // Mammoth Lakes Police Department // Mammoth Lakes Fire Department // Mono County Sheriff
Make your own mask in just one minute!
Thank you to the New York Times for the coverage of the challenges we face as a small mountain resort town.
We appreciate ABC News for covering the unique challenges faced by rural hospitals and giving our issues a strong voice.
On a related note, here is a recent open letter to our residents on the importance of staying safe right now.
Mono County residents, friends, and neighbors,
We sincerely hope that you are all staying healthy and safe in this time of uncertainty and stress.
With the closure of Mammoth Mountain Ski Area, more people have been heading out into the Eastern Sierra backcountry. We understand the draw of the mountains, but given the current situation, we feel it is necessary to remind everyone about what backcountry travel means at this time.
The pandemic is creating unprecedented challenges to our healthcare system, and in our rural community, services are already very limited. Recognize that if you do choose to recreate in the backcountry and are injured or are involved in an avalanche, our usual systems for rescue may not be available. While there are currently no inpatients in the hospital, any injury right now requiring a hospital visit will add undue burden on our already strained hospital. Specifically, treating anyone who injures themselves in the backcountry uses our vital personal protective equipment we need in order to treat the coming surge of COVID-19 patients.
Anytime you travel in the backcountry when there is snow on the ground, avalanches are possible. And while we all want to get fresh tracks out there, know that your personal decisions affect small communities with few resources.
The decision you make to stay home is bigger than one person. It affects the safety of all of us.
This is a time to avoid the backcountry. It’s the responsible thing to do.
Mammoth Hospital supports the use of masks by the general public. Watch the video below on effectively slowing the spread by using masks.
Mammoth Hospital supports the use of masks by the general public. This has been shown to slow the spread of COVID-19 due to the fact that the virus is present in many people who don’t show symptoms.
Simple masks that cover the mouth and nose may help prevent the spread of COVID-19. When you wear a mask, it helps you avoid transmitting the virus to surfaces, which could result in infecting others.
Masks need to be used correctly to be effective at stopping the virus. Users of masks should follow these instructions in order to avoid accidental mask to hand to surface contamination:
- Always wash your hands after touching your mask.
- Never touch the inside of your mask.
- When not in use, store your mask in a paper bag.
- Wash your hands after placing a mask on your face.
- When using a homemade mask, store it in a paper bag while not in use so it does not contaminate surfaces.
- Wash homemade cloth masks with hot water and soap daily to kill infectious material on the surface of the mask.
We strongly encourage the use of homemade cloth masks. Masks are in short supply, so whether you are given a mask or make your own, please take care of it!
Together, we can help to keep all of us safe!
Distance. Wash. Cover.
Personal Protective Equipment Links:
We express our heartfelt appreciation for all of the kind words, art, and notes of encouragement all over the sidewalks outside our hospital.
Thank you to the Anderson family, to Laurel, Aspen, and Sierra, and to countless others for covering our campus with love and positivity during this challenging time.
We are so grateful to all of you and to Mammoth Lakes Chamber of Commerce for organizing this amazing endeavor.
We love you all and are in this together! For photos visit our Facebook page here.
Mono County Health Department and Mammoth Hospital
March 31, 2020 – The first death of a Mono County resident due to COVID-19 has been confirmed.
The death occurred on Tuesday, March 31, 2020. The patient was a male in his 60’s. In addition to being infected with COVID-19, he was known to have other chronic medical conditions. He presented to Mammoth Hospital in critical condition. He was then transferred to another facility for further management, but his condition continued to deteriorate, and he ultimately died due to multiple complications related to COVID-19.
“We extend our deepest sympathies to the patient’s family and loved ones during this time of loss,” said Tom Parker, CEO of Mammoth Hospital. “This loss is deeply felt by our entire community. Now more than ever, each of us must do our part to prevent the spread of this virus.”
Both Mono County Director of Public Health Tom Boo, MD, and Mammoth Hospital Chief Medical Officer Craig Burrows, MD, said the death underscores the importance of protecting our community members during this ongoing pandemic.
Dr. Boo and Dr. Burrows emphasized the importance of all Mono and Inyo County residents in doing their part to slow the spread of the virus by continuing with all social distancing efforts and to adhere to the Stay At Home Order issued by Governor Newsom on Thursday, March 19, 2020.
Steps that everyone can take to slow the spread of the virus include: Being mindful of the critical importance for social / physical distance, wash your hands frequently, and cover your mouth when you sneeze or cough.
Stay healthy. Stay safe. Love each other.
A quick note on elevation and COVID-19:
“At sea level, you are breathing 21% oxygen,” says Mammoth Hospital Chief Medical Officer, Craig Burrows. “At 8,000 feet, our altitude, you are breathing 15% oxygen, which is roughly 30% less. For people unaccustomed to our elevation, this difference is what people feel when they travel from Los Angeles to Mammoth on a good day, and why they may feel short of breath. When you are ill with a lung infection, the problem becomes more pronounced, and what you may have been able to contend with at sea level now becomes much more problematic. Many of these previously healthy patients now require supplemental oxygen both in the hospital as well as upon discharge until they are able to return to sea level.” Our small critical access hospital only has four ventilators, and we very much hope we don’t need them all at once.
A huge thank you to our community!
Thank you to our generous community for all of the donations of Personal Protective Equipment (PPE) with our Donation Drive! We have had a great outpouring of support. Our amazing sewing team has been willing to donate time to fabricate masks, shoe covers, and head covers. Right now our top three are masks, shoe covers, and head covers. We have received more than enough vacuum bags, so we are no longer needing these. If you have sewing-related questions, please contact Lily Olvera, who takes the sewing lead by email firstname.lastname@example.org.
Link to masks here: (https://www.youtube.com/watch…)
Links to shoe covers here: <https://dianarambles.com/category/diycraft/sewing/>
Link to head covers here: https://freepatterns4scrubhats.blogspot.com/…/classic-scrub…>
Also, we cannot thank you enough for your kindness towards our employees and medical staff over the last week, from shoveling our walkways, to personal notes of thanks and encouragement, your huge outpouring of support has been amazing and we are humbled to serve this great community!
Speaking of our great community, a huge thanks from us to Visit Mammoth for offering a food bank three days a week, which makes all the difference for our locals during this challenging time. Get over there Mondays Wednesdays and Fridays from 10 am – 12 pm and 3 – 5 pm at the Promenade on Main Street (previously known as the Luxury Outlet Mall) next to Black Velvet Coffee and Sun & Ski Sports. If you wish to donate money to the food bank, you can do so online via PayPal.
Here’s that link: https://www.visitmammoth.com/…/mammoth-lakes-opens-communit…
Remember to stay safe and to love each other.
Distance. Wash. Cover.
Watch Dr. Craig Burrows and Dr. Richard Koehler share some important messages on KRNV News 4 this evening on the unique challenges our hospital faces with the COVID-19 pandemic.
PRESS RELEASE: (Para español, haga clic aquí)
Mono County Health Department and Mammoth Hospital
More Positive Cases of COVID-19 in Mono County
March 26, 2020 – Mono County has received positive COVID-19 test results for two more people, and Tuolomne County has informed us of a person with a Merced address who acquired the infection in Mono County being treated in Tuolomne. Two of these three people are hospitalized and one is critically ill with respiratory failure. All are, or were recently, Mammoth area residents. This brings the total number of cases in Mono County to six (6). One case was linked to a known case and had been identified as a contact. Although the person in the Tuolomne hospital was living in Mammoth Lakes and acquired the infection here, it will be technically counted as a case in Merced or Tuolumne.
The Mono County Health Department has initiated contact tracing for each of these case-patients. People found to have been in close contact will be asked to quarantine themselves and monitor for symptoms.
While three new cases is alarming, it is also expected. Accelerating numbers of recognized and suspected infections demonstrate more clearly than ever that we are not immune from the epidemic affecting the rest of the world.
“We are somewhat reassured that the “Stay At Home” Order is in effect, but it is simply too soon to see any results,” says Tom Boo, Public Health Officer for Mono County. “We hope, and do anticipate, that new cases will come at a slower rate in the coming weeks.”
Dr. Boo further implores the community to continue, to double down in, practicing social, or as some are calling it, physical distancing.
“We face an extremely serious situation and fervently hope that all our efforts to promote distancing, from simple recommendations to the California “Stay At Home” Order to restrictions on hotels, motels, VRBOs and campgrounds, will reduce the impact on our community, especially elderly and medically vulnerable adults, who have higher rates of severe disease.”
Please be reminded that the number of positive tests in Mono County, as in the rest of the country, poorly reflects the extent of the virus’ spread because of overwhelmed laboratories. At the request of the state we will be doing less testing for the time being, not more. At this time testing will be largely limited to people requiring hospitalization. Therefore, the number of people who have severe disease, requiring hospitalization seems the best indicator to follow.
We do not know with any confidence the percentage of people with COVID-19 disease who develop severe disease, but the state health department and others are using a working estimate of 5-10%. That means that for every severe case we find there are probably 10-20 others we have not detected. The current number of confirmed cases requiring hospitalization in Mammoth Lakes and the surrounding area is four (4).
The doubling time for this virus appears to be between 4 and 6 days under normal circumstances. We hope that it will be longer with good social distancing. The California Department of Public Health believes that current measures will decrease transmission by 30-70%.
The pandemic is here and it poses an immediate threat to our community, especially vulnerable people and our hospitals. We are urgently trying to avoid replicating in California the terrible scenes from Italy and Wuhan City of hospitals unable to provide care to those who need it, and many deaths.
Every one of us has a responsibility to reduce the spread of this virus. Please comply with California’s order to “Stay At Home” except for essential activities.
Thank you to EVERYONE in our community who has offered to help our healthcare employees. If you know a healthcare worker, here are some ways that you can help him/her right now:
1. Shovel a healthcare worker’s walkway
2. Walk a healthcare worker’s dog
3. Clear snow off of a healthcare worker’s car
4. Send a message of support to a healthcare worker
5. Make dinner for a healthcare worker (using lots of hand hygiene!)
6. Send a message of support to a healthcare worker’s spouse. Many of our spouses are spending LONG hours at home alone caring for our children and handling everything while we are at the Hospital getting prepared to help our patients
7. Offer to grocery shop for a healthcare worker family
8. Send a restaurant gift card to a healthcare worker
9. Take the garbage out for a healthcare worker
10. Bring requested items to the community drive (link to post here: https://www.facebook.com/search/top/…)
11. STAY HOME! One of the best ways you can care for healthcare worker’s right now is by not taking an active role in spreading this disease.
We’ve also received hundreds of emails and messages about sewing and we are so grateful for this. If you want to help us by sewing materials to help protect our healthcare providers, here’s what you can do:
– Masks (If you don’t have elastic, please use ribbon or sewn ties that are long enough to be tied into a good sized bow at the back of a person’s head as good alternatives.)
– Scrubs of all sizes
(Link here: https://5outof4.com/product/pajama-pants/)
– Scrub hats
(Link here: https://freepatterns4scrubhats.blogspot.com/…/classic-scrub…)
– Shoe covers (For scrub tops, we suggest just tracing an outline of a scrub top, cutting two pieces and sewing them together, hemming the edges. This would make it easiest to make various sizes. They could ideally put patch pockets on them. There are lots of patterns, but we couldn’t find an easy free pattern. There are also some easy video tutorials if people want to search for it that way.)
(Link here: (https://dianarambles.com/category/diycraft/sewing/)
We prefer that this is all to be 100% cotton material (quilting weight). Please find ways of getting your own fabric for this. Once completed, drop off your finished products to the Family Medicine clinic entrance or the SPORT building clinic entrance. We have greeters with boxes ready to receive them. They will then be washed and put into use by Mammoth Hospital employees.
If you have questions related to sewing, please contact Lily Olvera, our sewing lead via email at email@example.com
Mono County Health Department and Mammoth Hospital
Third and Fourth Positive Cases of COVID-19 In Mono County
March 25,2020 – A positive COVID-19 test result was received late March 24 from a Mammoth area resident who is critically ill in Reno hospital. We transferred this patient a few days ago. This patient, who cannot be interviewed because of his/her condition has no known links to other cases. This individual potentially exposed a number of people in different settings and the Health Department has contacted and evaluated as many of these as possible, recommending 14-day self-quarantine and monitoring.
Subsequently, we received results from a fourth case, also a Mammoth area resident. This patient was mildly ill and was only tested on March 21 because of a potential workplace contact with our first case. This individual has been self-isolating with a significant other who also recently had a mild illness. We transferred another suspected patient to Reno the evening of March 24, and yet another suspected patient is hospitalized locally in stable condition. In these suspect cases tests have been submitted and are pending. At this time, we have two critically ill Mono County residents, one with confirmed and the other with suspected COVID-19 infection.
The accelerating numbers of recognized and suspected infections demonstrates more clearly than ever that we have an epidemic in the Mammoth area. Remember that for every case we diagnose there are probably 10-20 others in the community, especially with the inadequate testing situation in the United States. We implore the community to continue, to double down on, practicing social, or as some are calling it, “physical distancing.”
Mono County Health Officer, Tom Boo, MD said, “This is an extremely serious situation and we fervently hope that all our efforts to promote distancing, from simple recommendations to the California “Stay At Home” Order to restrictions on hotels, motels, VRBOs and campgrounds, will reduce the impact on our community, especially elderly and medically vulnerable adults, who have higher rates of severe disease.
If social distancing does not work, if we continue to see accelerating COVID-19 numbers in coming weeks, we anticipate potentially serious impacts on Mammoth Hospital, which has been working intensively for weeks to prepare for such possibility.”
Yesterday, March 24, in response to local reports of sick workers present in essential businesses serving the public , Dr. Tom Boo issued a Public Health Order prohibiting the presence of persons with illness in workplaces, with possible penalties including fines, forced closure of workplaces with quarantine orders for co-workers, and even imprisonment. It is an effort to reinforce our messages to stay home when you are sick. He said that reports from the public about sick people in public-facing jobs or from concerned co-workers will be investigated.
The pandemic is here, representing an immediate threat to our community, especially vulnerable people and our hospital’s ability to keep up with increased demand for medical care. Together, with the Unified Command Team (County, Town, Hospital), we are urgently trying to avoid replicating in California the terrible scenes from Italy and Wuhan City of hospitals unable to provide care to those who need it, and many deaths. Every one of us has a responsibility to reduce the spread of this virus. Please comply with California’s “Stay At Home” Order except for essential activities.
Please be reminded that the number of positive tests in Mono County as in the rest of the country, poorly reflects the extent of the virus’ spread because of overwhelmed laboratories. For the time being, testing will be largely limited to people requiring hospitalization.
Mammoth Hospital Chief Medical Officer, Craig Burrows and Nelida Garcia clear up some common misconceptions regarding testing in the video below:
The Importance of social distancing for our outdoor community – hear it from Wave Rave’s Steve Klassen and Mammoth Hospital nurse, Jason Lakey in the videos below:
A positive COVID-19 test result was received late March 23, a specimen collected seven days earlier from a young Mammoth Lakes area woman with an influenza-like illness (fever, body aches and cough). She is Mono County’s second confirmed COVID-19 case and she has fully recovered. Since the onset of her illness she has been appropriately self-isolating, minimizing the risk of transmission to others.
This case has no apparent link to our first case and demonstrates again that community transmission of COVID-19 is occurring. In addition, two other Mammoth Lakes area persons were hospitalized over the weekend with suspected coronavirus infection, with results pending.
Most people with COVID-19 have mild disease, as in the case announced today. The risk of severe disease requiring hospitalization is most likely between 5 and 10%, so that for each person hospitalized there are many other unrecognized cases in the community.
The pandemic is here and it is poses an immediate threat to our community, especially vulnerable people and our hospitals. We are urgently trying to avoid replicating in California the terrible scenes from Italy and Wuhan City of hospitals unable to provide care to those who need it, and many deaths. Every one of us has a responsibility to reduce the spread of this virus. Please comply with California’s order to stay home except for essential activities. And if you are sick, please do as this young woman has done and stay home and avoid others.
Currently there are no patients in the hospital who have tested positive for COVID-19. The inpatient that had tested positive has been discharged, is now on self-quarantine, and has been referred to Mono County Public Health for continued monitoring.
On Sunday a patient was transferred to a higher level of care at another facility. He was also tested, but whose results have not yet been received.
At present, two of the patients admitted to the hospital have also been tested, and their results are not yet known.
We have received many questions about our testing criteria. A recent video by our Chief Medical Officer, Dr. Craig Burrows explains the criteria in detail in the video at the top of this page.
Testing Criteria in summary:
- Only patients who are symptomatic and require admission to the hospital
- Health care workers who are symptomatic so we can determine if they are able to continue caring for patients
- Patients who are specifically referred by the public health department for testing
The Hospital Incident Management Team, department managers and physicians have all been working on a facility plan to create COVID Positive and COVID Negative zones in the hospital. This plan will be implemented Wednesday.
To be better prepared for higher patient volumes, we are cross-training EMT’s and Ortho PA’s to assist with respiratory therapy management.
Many people want to know how long the COVID-19 virus can live on various surfaces. According to the most recent studies here are some of the survival times:
- 72 hours on plastic surfaces
- 48 hours on stainless steel
- 24 hours on cardboard
- 4 hours on copper
- 3 hours in the air
Mammoth Hospital received confirmation today of the first case of COVID-19 in our community. For anyone who is wanting to know who that person is and “did I come in contact with him/her?” the answer is that nearly everyone has a high likelihood of having been exposed in some way to someone with COVID-19. This is only the first confirmed test in Mammoth Lakes, and not the first case. And there is a BIG difference. Everyone in the community must assume that the virus has spread worldwide at this point: in Mammoth, Bishop, San Francisco, Los Angeles, Seattle, the West Coast, the East Coast, the United States, North America, South America, Europe, the Middle East, Asia, Africa, Australia. EVERYWHERE. And with that assumption, everyone must act accordingly. It does not matter if the person was a local, a tourist, or what nationality he/she was. We have to act as if everyone may have it.
The physicians, nurses, and administrators serving on the Hospital Incident Management Team reviewed new projections today showing the growth rate of spread under different conditions. The single most impactful condition is the degree to which the community engages in Social Distancing.
Consider what we know about COVID-19, and how it spreads. Our current best guess is that if we do nothing to change our behavior, the number people infected will double every 4 days. That means today with one patient. In four days, there will be 2 patients. And what follows is this:
|Today on 3/21/2020||1 patient|
|3/25/2020||2 new patients|
|3/29/2020||4 new patients|
|4/2/2020||8 new patients|
|4/6/2020||16 new patients|
|4/10/2020||32 new patients|
|4/14/2020||64 new patients|
|4/18/2020||132 new patients|
|4/22/2020||264 new patients|
|4/26/2020||512 new patients|
So assuming no one dies, in just one month, we will have over 1,000 patients with COVID-19. The challenge is we do not know precisely how many of these patients will actually be sick, how many will need to be hospitalized, how many will need to be in the intensive care unit on a ventilator. That said, our projection at this point is that 5% of infected patients will need to be hospitalized, which means of those 1,000 people, 50 will need to be admitted to the hospital in the next month, and that is when we start with JUST ONE patient! The reality is that we likely have many more people in Mono County who are already infected. So, the numbers are almost certainly much higher than the above example. It is of critical importance to note that Mammoth Hospital is a small hospital with only 17 beds!
So what can you do to prevent this from becoming a situation we cannot possibly handle?
The point of Social Distancing is to keep the illness from spreading so quickly that the need for healthcare resources exceeds capacity. Right now, if we put an estimate on how well we are doing our part to Socially Distance, let’s assume our success rate is 25%, meaning on average we have all cut our social interactions by 25%. If we maintain that rate, and look at a population of 25,000 people (Mono County, Inyo County, and visitors) we will have our absolutely worst day in about two months, which means on that day alone, we will have 23 patients requiring life support (ventilator) in the intensive care unit, and 111 patients needing inpatient hospitalization. These projections far exceed the Hospital’s 17 bed capacity and our ability to care for no more than 4 people on life support at one time.
Now imagine if our success rate for Social Distancing is improved to 60%. So we stay at home, make our own coffee, go for walks by ourselves, and stop going to parties with our friends – a tall order for all of us without question. Now our absolutely worst day is just over three months out. On that day, we have nine people in the hospital, and two people on life support in the intensive care unit. Because of what we all do to Social Distance, our 17-bed hospital now has a much better chance to take care of everyone!
We know this new normal may not be a fun practice or one that is convenient. It’s not your usual routine, and during times of stress we like to be close to our friends and our family members. Do not revert to your regular routines. It is so important to stay the course!
Here are some things you can do to cope. Stay connected to your friends and family through the use of video conferencing. Check in on loved ones who just need a call. Have a Google hangout or FaceTime chat. Exercise indoors or outdoors while maintaining a safe distance from others. Get outside for a walk and refresh yourself with the cool air. We are lucky to have some of the best views in the world just out our front doors.
If you are a “list person” here are our suggested Do’s and strongly advised Don’ts of Social Distancing:
- Work out on your own.
- When you need to go out, do what you need to take care of, and get home. Be efficient!
- Call people to talk.
- Get out and walk, either with your dogs or on your own.
- Arrange an appointment with Behavioral Health if you need help with coping or anxiety.
- Get outside. We could all use some Vitamin D!
- Email or use social media to connect with friends and family to let them know how you are and find out how they are.
- Go out to get coffee, and then stop and socialize.
- Have dinner or parties with friends.
- Socialize at the grocery store.
- Hug or shake hands when you see a friend.
- Linger after getting take-out food.
- Socialize on Lake Mary Road, the gorge, or in the backcountry.
- Have play dates for your kids.
- Loiter at the post office.
- Work out in groups.
As always, we are here to help. If you need someone to talk to, call our Behavioral Health team at (760) 924-4333 and we will schedule one of our providers to talk with you via video chat.
So please, keep in mind that what you do (or don’t do) makes an enormous difference in how we are going to get through this! We are all in this together, literally!
Wash. Cover. DISTANCE.
Mammoth Hospital Press Release
Presumptive Positive Case of COVID-19
Mammoth Lakes, CA
March 21, 2020, 8:00 am
Mammoth Hospital has identified a patient who is positive for COVID-19. The initial test with a positive result was performed by LabCorp.
Patient is a local male in his 40s currently hospitalized for the past 7 days. His COVID-19 positive status is now confirmed.
The patient was recognized as a suspect case on the day of admission and has been in isolation. In addition, the Mono County Public Health Department has been identifying contacts of this patient and these people are self-quarantining at home with health department supervision. The investigation and monitoring is ongoing.
If you have symptoms of cough or fever but feel you can care for yourself at home, please stay at home under self-quarantine, avoid contact with others, and get plenty of rest.
Remember the basics: Wash. Cover. Distance.
View a message from Mammoth Hospital CEO, Tom Parker on what the hospital is doing to keep our community safe here.
Stay at Home
We ask that anyone who is not a primary resident of Mammoth Lakes or providing essential services to our residents NOT visit Mammoth Lakes for the time being. The reason is simple. Fewer people in town means less demand for healthcare services. It helps us to better meet the needs of those who are primary residents. While we have world class services in many medical specialties we are also a small hospital. And, while we are taking many actions to preserve resources for the expected increase of patients, fewer people in town will allow us to stretch those resources further through the pandemic.
Outdoor Recreation Can Be Therapeutic – Keep it Safe
With the closure of the Mountain comes the need for many to turn to other recreational activities. For now, we ask that you take a risk adverse approach to recreation. Unnecessary injuries in our community requires an expenditure of limited resources that can be avoided. We also ask that you follow the governor’s directive to practice effective social distancing as you recreate.
A huge thanks to the Mammoth Hospital Auxiliary
We express heart-felt thanks to the Mammoth Hospital Auxiliary for it generous donation of $109,000 toward life-saving equipment. As we are able to acquire critically needed supplies and equipment, we will put this generous gift to use. When The Cast Off reopens know that a few hours of volunteer help there goes a long way, and you get to hang out with some of Mammoth’s finest!
Masks and Personal Protective Equipment
The hospital has received multiple requests for masks and other medical supplies. Our conservation efforts with respect to supplies does not allow us to provide any to other organizations. We are working hard to have enough to protect front-line healthcare workers so they will be able to treat those who become acutely ill.
Mammoth Hospital Clinic Plan
Our definition of normal has become anything but normal not only in Mammoth Lakes, but all around the world. As we all struggle to adjust to our situation, Mammoth Hospital is working to make certain that all of your health care needs are met to the best of our ability. Because of the need for social distancing and all the other efforts being taken to contain COVID-19, we will be drastically changing the way we go about taking care of our patients. Please review the following information for details on how your upcoming appointment will be impacted:
Surgery At Mammoth Hospital – All elective surgeries are now suspended as of 03/17/2020 to try to limit both patient and staff exposure to COVID-19. We are also trying to conserve the supplies we may need to care for patients with COVID-19 like masks, gowns, gloves, medications, and most importantly, staff.
Emergency cases that cannot wait will be performed as usual. Other cases will be done based on the surgeon’s judgement.
Wellness Visits – As a rule, wellness visits like annual check-ups will be suspended until further notice. If such a visit is felt to be needed, it will likely be done using FaceTime, phone, or Skype.
In-Person Clinic Visits – If your provider feels you need to be seen in person, you will still be seen in clinic, assuming you have no cold symptoms such as fever or cough. Examples include but are not limited to newborn follow up exams, post-partum follow up exams, 3rd trimester prenatal care, visits that include vaccination for pediatrics, adult vaccination for Pneumonia-Flu-Shingles, and immediate post-op visits. There is no way to account for every possible circumstance, so please expect that the visit may first be scheduled as a FaceTime or phone visit. If your provider then feels you need to be seen, you will be instructed to come to the clinic
Sick Visits Other than for flu-like illness – If you want to be seen for medical issue that is not the development of flu-like symptoms, please expect that the first evaluation may be with an appointment that is scheduled to take place over FaceTime or the phone. Examples of this type of visit include orthopedic injuries, new onset of ear pain, abdominal pain, Nausea/vomiting, or new onset fatigue/lightheadedness, etc. Again, your provider will decide if you need to come into the clinic.
Behavioral Health – As many of these visits as possible will be scheduled to take place using FaceTime or the phone. As long as there are not any symptoms of a new flu-like illness, behavioral health issues can also be seen in clinic if felt to be necessary by your provider. Other visits can also be seen in person, again based on the judgement of the provider.
Dental Clinic Visits – The dental clinic will only be open to see patients with dental emergencies, such as a cracked tooth, new onset tooth pain, or a dental infection.
Specialty Clinic Visits – Unlike other clinics, many of these visits have been requested by other providers, and are for things that cannot necessarily wait. Certainly, if the patient can wait, we will ask that the visit be cancelled and scheduled for a later date. Otherwise, the patient can be seen in clinic as long as there are no flu-like symptoms. As is true for the other clinics, the need for the patient to be seen will be left up to the provider.
Rehabilitation Visits – Physical and Occupational therapy are going to be limited to acute post-op visits and wound care. Where possible, all other visits will be conducted via FaceTime or phone, where therapists will work with patients to continue with their rehabilitation plans
We understand that visits done by phone or by Facetime are not as good as seeing your provider in person, but we believe this is the best way we can continue to care for our patients. On behalf of all of us here at Mammoth Hospital, we want to thank you for your understanding in patience in what we are doing to try and keep all of us safe. For any medical related questions, call our Emergency Department at (760) 924-4076.
Remember to stay safe and to love each other.
Wash. Cover. Distance.
Simply put: “Wash, Cover, and Distance.”
1. Wash your hands often. This is BY FAR the best way to prevent the transmission of disease, including the FLU and COVID-19.
2. Cover your mouth and nose with your elbow when you cough or sneeze.
3. Stay more than 3 feet apart from each other, and avoid being in groups of more than 10 people.
And as always, if you are feeling sick, please stay home to avoid infecting other people!
Fighting the spread of COVID-19 takes all of us in our community working together. At Mammoth Hospital, here are some of the things we are doing to keep us all safe and healthy:
• Elective surgery cases and clinic visits are either being postponed or rescheduled as a phone/video visit when possible.
• Patients who require surgery or clinic visits will still be seen, but only if it is felt to be absolutely necessary.
• Any patients requiring emergent medical attention for any reason will of course be seen as they always are.
• Greeters are now at every patient entrance to screen patients for fever, cough, or shortness of breath. Any patient with these symptoms will be given a mask to wear and directed to the Emergency Department with the phone number to call to speak with an Emergency Room nurse.
• Non-essential entrances and exits are closed to the public. This is an important safety measure to ensure that only designated employees enter our facilities.
• As a part of social distancing, Mammoth Hospital is limiting visitors. Adult patients may be accompanied by one assigned care companion only if the adult patient is not capable of making medical decisions on their own behalf. Patients under the age of 18 may be accompanied by one parent or guardian.
• Mammoth Hospital is now operating a limited “car clinic,” where patients can be seen in their own vehicles. The goal is to not only protect patients from coming into contact with others who may be sick, but to also minimize contact with health care providers. Here’s how it works:
o When a patient enters the main hospital entrance, a greeter will ask for the purpose of the visit.
o If this is for a flu-like illness, or concerns about COVID-19, the person will be asked to mask and clean their hands. The greeter will collect the patient’s name, phone number, and date of birth.
o A nurse will then come out and determine if the patient can be assessed from their car, or if they need to be seen in the Emergency Room.
o Patients who are felt to be a candidate for a “car visit” will be instructed to return to their car, and will then be called by the emergency room doctor.
o After an initial assessment over the phone, the doctor will determine if the remainder of the assessment can be done in the car. If so, the patient will be directed to the exam area.
o Further testing of the patient will be determined by the physician at that time.
By working together with our community members, our goal at Mammoth Hospital is to slow the transmission of the COVID-19 virus in order to care for as many people as we possibly can. To the community, we ask for your cooperation and understanding.
On behalf of all of us at Mammoth Hospital, thank you for doing you part to protect yourselves and our community, and helping us to put “Patients First!”
For the most up-to date information and recommendations, please refer to the CDC website, at https://www.cdc.gov/coronavirus/2019-ncov/index.html