Updates on coronavirus from Big Bend Regional Medical Center (3/18)

ALPINE — In a teleconference with reporters on Wednesday, the Big Bend Regional Medical Center gave updates on the coronavirus, including on testing capacity and the hospital’s ability to handle a public health crisis.

In a presentation, Dr. Ekta Escovar, a doctor at the hospital, stressed that “containment has failed.”

She declined to comment on how the United States had gotten to this point, noting that such public policy decisions were “so far above my paygrade.” But she urged local businesses and residents to do their part to minimize the spread of the novel coronavirus, by following guidance for the general public (like frequent handwashing) and for business owners (like switching to to-go orders or limiting certain service hours to only the elderly).

At the time of Wednesday’s call, 1268 people in Texas had been tested for coronavirus, of which around 60 were positive, Escovar said. (As of press time, those figures have risen to 1,907 Texans tested, 83 positive results and two deaths in Texas from the virus, according to new figures released by the state on Wednesday.) But as the rate of coronavirus spread picks up nationwide, figures like that will change more and more frequently. Right now, the Texas Department of State Health Services is releasing by-county case counts of coronavirus cases in Texas every day at noon.

Protocol has also changed regarding “presumptive” versus “confirmed” coronavirus cases. Under the previous rules, a positive result for coronavirus from a hospital or lab was a “presumptive” case. Those samples were then sent to the Centers of Disease Control and Prevention. If the CDC also got a positive result, that case was then “confirmed.”

But with the CDC so far confirming all presumptive cases nationally, those rules have changed, and officials were now treating presumptive coronavirus cases as confirmed, Escovar said. That’s good news for reporters, officials and the general public, since it means statistics distributed by Texas will be more reliable and not days behind.

On testing, Escovar said that “clinicians would like to have more testing capabilities” and said the federal and state governments had promised to ramp up testing in the coming weeks. She also said the hospital’s current practice of first testing people for the flu — and then testing for coronavirus if they tested negative — was backed by science, which showed that less than two percent of coronavirus patients worldwide had co-infection with another illness like the flu.

The hospital is still urging West Texans to self-quarantine for 14 days if they’ve recently traveled to a “high-risk” area of the United States, which are places with confirmed community spread, Escovar said. At press time, those locations include: California, Colorado, Florida, Georgia, New Jersey, New York, Oregon, Washington, the Boston area, the Dallas area, the Houston area, the Las Vegas area and the New Orleans area. Escovar said BBRMC was working to provide up-to-date guidance on travel but said there “may be a delay” as new cases pop up hour-by-hour in the United States.

In general, Escovar said, it was a good idea to “stop traveling to big cities as much as possible.” As days go on, and caseloads pick up in populated places like El Paso, the risk of bringing a contagion back to the Big Bend will increase, Escovar said.

At press time, coronavirus has an estimated fatality rate of 1.8, with around 80 percent of deaths affecting people over 60. That rate is constantly changing, as more deaths and confirmed cases around the world cause public-health workers to adjust their estimates.

Still, Escovar said that fatality rates — though significantly worse than seasonal flu — were not “the main concern.” Instead, the hospital is concerned with hospitalization rates. About 10 percent of coronavirus patients need hospitalization, and the average stay is three to six weeks, she said. That’s significantly higher than the 0.05 percent hospitalization rate for seasonal flu and could put a strain on healthcare services.

BBRMC has 25 beds and two ventilators/respirators. Escovar said the hospital’s capacity would depend on the condition of incoming patients. Even with 25 beds, the hospital couldn’t necessarily care for 25 “very very very sick patients,” she said. It will also need to continue providing its non-coronavirus services, including childbirth and trauma care for car accident victims, she said.

Still, Escovar stressed that relationships with other hospitals in El Paso and elsewhere “are still intact” and that BBRMC could send critical patients elsewhere. It’s not yet clear what BBRMC’s back-up plan will be if those regional metro-area hospitals become overwhelmed by their own local patients.

In an interview with The Big Bend Sentinel last week, Ruth Hucke, a spokeswoman for BBRMC, outlined guidance for people who fear they may have coronavirus. Those same rules still apply:

— Like other healthcare facilities, BBRMC is asking people who worry they might have coronavirus (but are not suffering serious symptoms) to call ahead rather than visiting in person. The best way is for people to first contact their personal physician, she said. The hospital can also be reached at 432-837-3447 (for the ER/hospital) or 432-837-0430 (for the clinic).

— She urged people to not hesitate coming in IF they are experiencing severe symptoms like breathing difficulties, if they’re in older age groups and especially if they have reason to believe they might have coronavirus, such as travel to a high-risk area or contact with a confirmed patient. BBRMC has a special entrance for coronavirus patients and will minimize contact with the rest of the facility, she said. In the meantime, BBRMC is still taking regular patients and appointments. “If we happen to get a case locally, that may change,” she said.

In the call Friday, Hucke also said she was “very confident” BBRMC could handle a healthcare crisis even with its limited facilities. Tents and mobile units are “always in good repair” and “ready to go,” she said.

She cited preparations, drills and plans between BBRMC and the regional advisory council, which has already prepared for crises in the event of possible incidents like a mass shooting or a train accident.