Coronavirus confirmed for one hospital employee, Bartow firefighter awaiting results
Cartersville Medical Center CEO Chris Mosley said as of Friday afternoon, 35 CMC patients had tested positive for COVID-19 — 10 of whom remain in the care of the local hospital.
“From day one, we’ve kept very tight control on the number of patients that we’re testing,” he said at the Bartow County Emergency Management Association (EMA) media briefing. “Every single patient who comes into our hospital [is] assessed by our infectious disease doctor before we will actually send out for testing — at this point, 65% of the test results that we’ve gotten back have been positive here in Bartow County.”
An additional 75 hospital patients, he said, have been deemed persons under investigations (PUIs) who are suspected — but not confirmed — to have the coronavirus. Of those individuals, Mosley said 42 remain at CMC while 33 have been discharged.
“Cartersville Medical Center is not overwhelmed, we’re not being overrun at this point,” he said. “We’ve prepared extensively for this crisis and we continue to execute on our disaster planning, we continue to work closely with our colleagues inside HCA Healthcare to plan for and look at opportunities to provide alternate care locations.”
To date, Mosley said no COVID-19-related deaths have been reported at the hospital. But that doesn’t mean that some of the coronavirus cases at CMC haven’t been gravely serious.
“We have had some patients who have been very sick, some patients that have been ventilated, some patients that have been transferred to places where they perform a treatment called ECMO [extracorporeal membrane oxygenation],” he said.
Among those who have tested positive for the coronavirus, Mosley said, is one CMC employee.
“That individual did self-quarantine with their family,” he said.
By Saturday afternoon, the Georgia Department of Health (DPH) indicated that Bartow had reached 56 confirmed cases of COVID-19 — the second highest tally in the entire state.
“The number, given our population, is higher than anywhere else in the state of Georgia right now, and that’s why you hear all of us in unison asking for everyone to stay in place, to not go to public gatherings and to practice social distancing,” Mosley said.
As emergency measures, Mosley said the hospital recently suspended all non-essential surgeries scheduled at CMC and ordered employees to “conserve” personal protective equipment (PPE), such as respirators.
“The supply situation for us and the health care community across the state of Georgia — really, across the country — is getting dire,” he said.
Still, he said that CMC is comparably in “a pretty decent position” regarding PPE, adding that the hospital is asking its employees to follow Centers for Disease Control and Prevention (CDC) protocols “and not go beyond those guidelines at this point.”
He said the local hospital has been working alongside the DPH to “track” patients sent home to self-quarantine.
“We’re not waiting on tests to come back in order to discharge the patients, but when we do discharge a patient, we are sending them home with explicit instructions to self-quarantine,” he said, “and as the results come back for that patient, the health department’s following up with those patients to make sure they are, in fact, self-quarantining.”
Despite the outbreak, Mosley said that, overall, emergency room volume at the local hospital is on the downturn.
“Some patients are choosing to stay away, we owe that to our communication that we’ve had between ourselves, the health department, our local primary care physicians and our local urgent cares, who are all working in conjunction with one another to keep patients, especially those who are asymptomatic, from presenting to the E.R. and requesting testing,” he said.
Whether that decreased E.R. volume portends a decrease in local COVID-19 diagnoses, Mosley said, remains to be seen.
“We don’t know what tomorrow’s going to bring,” he said, “and next week could bring another wave of patients.”
PUBLIC SAFETY PROCEDURES
Also speaking at the presser was Dwayne Jamison, who serves as both Bartow County’s fire chief and EMA director.
He said he was asked by Bartow County Commissioner Steve Taylor several weeks ago to assemble a COVID-19 task force, with an emphasis on determining what constitutes critical and non-critical services.
“We’ve met with County department heads to look at modifications to County services and to update the pandemic plans for each County department head,” he said. “Since then, many of those plans have been put into place.”
He indicated that one Bartow County Fire Department employee has been tested for COVID-19. As of press time, results are still pending.
“At this time, we are focusing on deferring COVID-19 testing as much as possible from Cartersville Medical Center, so that they can focus more on treating the sick patients that they have in the hospital,” Jamison said. “We do have now expanded testing capacity throughout the county — many of our local doctors are able to do in-house testing and send those out to private labs.”
He said requests for more PPE has been sent to both the DPH and the Georgia Emergency Management Agency. “We’re still awaiting updates on when those PPEs are going to be delivered,” he said.
In the interim, he said the BCFD has enacted a number of new policies and procedures to help curtail the spread of COVID-19 and limit possible exposures to both County personnel and residents.
That includes requiring all BCFD employees, including administrative staff, to have their temperatures taken at the beginning and end of every shift and a protocol requiring employees to fill out exposure reports when responding to calls involving potentially ill individuals.
The County’s fire stations, he added, are no longer allowing visitors.
“We don’t have a direct treatment to stop it but what we can do as citizens, what we’re calling on our citizens and businesses to do, is do the right thing and maintain social distancing and be patient,” he said. “We do not know how long this is going to last, but we hope that if everybody does what they’re asked to do, we can limit the spread of this in our community.”
Another procedural change is the limiting of first responders actually sent into residences on emergency calls. Now, Jamison said just one responder is allowed to enter a home, building or office to conduct an initial “patient report," with additional personnel subsequently sent in to provide whatever emergency services are required.
“We are asking anybody exhibiting any kind of respiratory symptoms to put on a surgical mask, and that is to protect the first responders,” he said.
Jamison said discussions have been held with the local faith-based community.
“We have not asked them, by any means, to stop worshipping,” he said, “just to modify the way they’re getting the message out and limit attendance at church, or cancel the church services altogether and do it online.”
City of Cartersville Fire Chief Scott Carter said that, overall, call volume within the municipality has seemed to slow down as of late. Still, he said his department, like Jamison’s, continues to see an uptick in calls involving individuals reporting possible COVID-19 symptoms.
“We’re doing standard, universal precautions,” Carter said. “Beyond that, Cartersville, we have everything under control.”
PUBLIC HEALTH CONCERNS
In the wake of the COVID-19 outbreak, Bartow County Health Department Nurse Manager Cyndi Carter said the agency is conducting “essential services only,” primarily revolving around tuberculosis cases.
“And those patients, we will go out to their car,” she said. “Any of those patients that may have to come in for any lab work or anything, they’re screened fully before they come in to be seen.”
At this point, she said the health department is working alongside federal, state and local officials to extend COVID-19 testing “as much as possible.”
Still, she acknowledges that testing capacity remains restricted. As of Saturday afternoon, the DPH indicates that almost 2,300 tests have been completed by commercial laboratories, while, to date, the State lab has completed only 772.
“We’re limiting our testing to those who are high-risk populations, to first responders and the health care workers, trying to make sure that those are the ones that we’re focusing on, and of course, those who are symptomatic,” she said. “We have to fight this as a community as a whole, and I’ve seen this community come together in massive ways for things a lot less than this, so I know that we can rise to the occasion for this.”
Carter addressed what, on the surface, appears to be Bartow County’s disproportionately high rate of coronavirus diagnoses.
“Some of the patients in Rome may be from Bartow County, but some of the patients that are here in Bartow County may be from another facility,” she said. “Some of the patients are getting moved around, depending on the availability of the hospitals, and that makes a difference right there.”
The community’s response to the crisis, she said, remains a constant learning experience. “And we can all only handle what’s in front of us at the time,” she said.
In the wake of employees at Anheuser-Busch and Shaw Industries testing positive for the coronavirus, Carter addressed the protocols employers are urged to follow when workers are suspected to have COVID-19.
“These people are supposed to contact a health care provider or an urgent care facility and they are screened,” she said. “And if they qualify for the testing, they are sent to a testing site [and] then they are screened to find out where they are so they can go to the closest one to them.”
Carter noted that the CDC’s National Notifiable Diseases Surveillance System is required to be contacted when positive COVID-19 tests results are returned. However, she did not indicate whether or not employers have a legal responsibility to publicize incidents of workers testing positive for the coronavirus.
“We can’t be responsible for everybody that does or does not report, but it is a notifiable disease,” she said. “And once their test is positive, it’s reported to the CDC or the State lab.”
She said she did not know what legal consequences — if any — await employers who do not notify the public of incidents of workers testing positive for the coronavirus.
“That is above my pay grade,” she said.
COUNTY AND MUNICIPAL RESPONSES
Two representatives of the City of Cartersville were on hand at Friday’s briefing, including Mayor Matt Santini.
“By and large, our community has been very receptive to following those CDC protocols,” he said. “The decisions that we make as a City, that I’m going to make as the mayor of the City, are going to be guided by the health care professionals, the State and their guidance and our public safety officials and our city manager.”
Cartersville City Manager Tamara Brock said that each department within the municipality has created a contingency plan for services. Beginning Monday, she said the City will work on rotating shifts and limit the number of staff in offices. Yard waste and recycling services, she said, will also be suspended at that point.
“There will be no utility service disruptions related to the COVID-19,” she said. “However, please be aware that there may be a response delay in our service calls.”
On the County level, Olson said that utilities like water department services continue to function without any disruptions.
“Its lobby is closed but you can pay online or through the drive-thru,” he said. “I’ve been puzzled by all the scenes of people filling up SUVs with water bottles, there’s not a threat to the water supply.”
Nor did Olson say he believes there were any threats to the national “distribution system,” stating that there are no concerns about food shortages with grocery stores continually “amping” up their inventories.
“It’s kind of like when we had our hurricane situation years ago,” he said. “When everybody rushes to the grocery store to get their toilet paper all at once, it empties the shelves — that’s not necessary.”
While the recently enacted emergency resolution prevents many businesses from housing more than 10 people at once throughout Bartow, Olson said those same restrictions will not apply to other high-traffic establishments, such as supermarkets or big box stores.
“The fact that there may be more than 10 people in a Walmart doesn’t mean they’re gathering as a tight group,” he said. “We’re really talking about bars, restaurants, movie theaters and others where we’re still seeing some aggregation.”
At this juncture, Olson said he does not envision the County enacting a curfew as have other local governments in Georgia, such as the City of South Fulton.
“People have got to get out and buy their food and get to their jobs and stuff,” he said. “So I think it’s large groups that are the concern, not necessarily having people out and about.”
The COVID-19 outbreak, he said, has required some changes to Bartow County Sheriff’s Office procedures — including the release of individuals from pretrial detention at the Bartow County Jail.
“A lot of people are getting released on [own-recognizance] bonds,” he said. “They have a mechanism to release people with a little more credit for time served in this circumstance, if they’re a non-violent offender.”
To date, Olson said there have been no confirmed reports of any Bartow County Jail inmates testing positive for COVID-19.
“They have a robust medical unit and medical staff that’s keeping a close eye, screening everybody who comes in for any symptoms,” he said. “So far, knock on wood, no incidents at the jail, so we’re in good shape there.”
EXPLAINING THE RATE
Public officials and health care experts seemed to agree on one of the root causes of Bartow’s inordinately high coronavirus diagnosis rate.
“Early on, we did see this linked back to a specific event and we saw a number of patients that were presenting to us that had some connection to that event,” Mosley said. “From there, though, we think that the spread is such that it’s not related exclusively to that event at this point.”
While public health officials tiptoed around explicitly naming the venue, Olson had no problems labeling The Church at Liberty Square in Cartersville as ground zero for the County’s coronavirus outbreak.
In particular, he pinpointed a service held at the church on March 1.
“It was a packed house of all the congregants and a lot of people coming back to visit, and I believe it was somebody in the choir who tested positive,” he said, “and this obviously was before social distancing was in effect so people are shaking hands and hugging and so forth, and that seems to be where the node got started.”
At least one person who attended functions at the church earlier this month — 65-year-old Rome resident Elizabeth Wells — has died from COVID-19 complications.
Those in attendance at the March 1 church service included two elected officials — District 14 State Sen. Bruce Thompson (R, White) and Commissioner Taylor, who was on hand to read a proclamation honoring The Rev. K. Ray Looney, Jr.
Olson said that Thompson was subsequently hospitalized in the intensive care unit of Northside Hospital in Cherokee County. Through social media postings, Thompson indicated his ailment wasn't COVID-19, but a severe case of pneumonia.
He said Taylor, however, has shown no symptoms of contracting the coronavirus.
“So he didn’t, I guess, come in contact with anybody who had it,” Olson said.
Regardless of how the highly contagious virus was introduced to the local community, Mosley said it is pivotal that Bartow residents continue to practice “social distancing” and avoid gatherings of more than 10 people at a time.
“We’ve got an outbreak here in Bartow County, and this is what we have to do,” he said. “We have to take these measures in order to curtail the extent of the outbreak … it’s a community-wide effort, it’s not just the hospital, it’s not just fire and rescue and police, it’s also the local churches, it’s also our school boards.”
While many CMC employees have went above and beyond the call of duty amidst the public health crisis, Mosley singled out the work of Dr. Aman Mongia — the hospital’s infectious disease specialist.
“We owe [him] such a debt of gratitude at this point for being the expert on the ground and taking great care of the people of Cartersville and Bartow County,” he said. “He has been working 24/7, essentially, for two weeks, on behalf of this community.”