COVID-19

CORONAVIRUS 1

SOCIAL DISTANCING 3

AT RISK POPULATIONS 3

PROTECT YOURSELF AND FAMILY 4

COVID-19 SYMPTOMS 4

A RESPONSE BY HEALTHCARE LEADERSHIP 5

COPING WITH STRESS 7

A QUICK REFERENCE GUIDEPublished April 13, 2020 MBHDistrict .org

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CORONAVIRUS (COVID-19)Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease or COVID-19.

The outbreak of COVID-19 was first reported on December 31, 2019, in Wuhan, China. Within a few weeks, the virus had spread rapidly throughout China and within one month to several other countries, including Italy, the U.S. and Germany.

At this time, different parts of the country are seeing different levels of COVID-19 activity. The United States nationally is in the initiation phase of the pandemic.

States in which community spread is occurring are in the acceleration phase. The duration and severity of each pandemic phase can vary depending on the characteris-tics of the virus and the public health response.

How easily a virus spreads from person to person can vary. Some viruses are highly contagious, meaning they spread easily, while other viruses do not spread as easily. The virus that causes COVID-19 seems to be spreading easily and sustainably in the community in some affected geographic areas.

PERSON TO PERSON The new COVID-19 respiratory virus spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose.

CONTAMINATED SURFACES Likewise, these same droplets land on objects and surfaces

around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth.

This publication was produced by Morongo Basin Healthcare District as a public service to the residents of the Morongo Basin. The information presented herein was sourced from the Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), and San Bernardino County Dept of Public Health.

Our intent in producing this magazine is to provide a quick reference regarding the new coronavirus (COVID-19) to help individuals and the overall community make informed decisions regarding personal and community behavior. We need to “flatten the curve” and stem the increase in spreading this disease. If we can slow the rate of infection, we can make sure our local hospital and medical providers do not become overwhelmed responding to what will surely be a spike in confirmed cases locally. We’re all in this together and it’s up to all of us to do our part every day.

Jackie Combs, RN, MSNChief Executive Officer

“Our country is in the midst of a great national trial, unlike any we have ever faced before. We’re at war with a deadly virus. Success in this fight will require the full, absolute measure of our collective strength, love, and devotion.

Each of us has the power, through our own choices and actions, to save American lives and rescue the most vulnerable among us. That’s why we really have to do what we all know is right. Every citizen is being called upon to make sacrifices. Every business is being asked to fulfill its patriotic duty. Every community is making fundamental changes to how we live, work, and interact each and every day.”

President TrumpWhite House Briefing

March 31, 2020

A NATIONALPERSPECTIVE

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ILLUSTRATIONS:• The illustration above shows how self-isolation and physical distancing can slow the infection rate,

making health resources available throughout the pandemic.

• Below illustrates how personal choices to self-isolate and maintain a 6-foot distance from others in public spaces can interrupt the spread of COVID-19.

The spread of the virus is interrupted when self-isolation is practiced and physical distancing is maintained.

= Infected = Not Infected= Social Distancing- - - -

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It seems “social distancing” has become a common phrase in our language these days, and while many believe that it refers only to avoiding public gatherings – the definition also includes personal physical distance.

In an effort to control the spread of the virus, officials from the Centers for Disease Control and Prevention (CDC) recommend that we keep a distance of six-feet from other people while in public spaces to limit the risk of being exposed to the virus.

The distance is important as the virus can be spread by infected individuals. Uncovered sneezes and coughs from an infected person can launch contaminated droplets into the air, exposing those within a six-foot radius.

When those particles land on, or unknowingly are transferred to a hard surface by the infected

person, the virus can be be passed to an uninfected person who touches that same surface.

The CDC recommends wiping commonly touched hard surfaces daily with disinfectant to prevent the transfer of the virus.

Since the Morongo Basin is a relatively small community, many of us know each other well – and while we may have greeted each other in the past with a hug or handshake at the grocery store – those gestures should now be avoided. You can still stand next to your neighbors in the grocery check-out line, just chat with that six-feet space between you.

If we all do our part in observing the self-isolation recommendation, adhere to the six-foot parameter when we venture into public spaces, and follow the other precautions, such as washing our hands frequently, we can significantly slow the spread of the virus within our community.

SOCIAL DISTANCING: What does it mean and why is it important?

AT RISK POPULATIONSBased on currently available information and clinical expertise, the CDC cautions that there are groups of people who are at greater risk than others for contracting the COVID-19 virus.

• People aged 65 years and older

• People who live in a nursing home or long-term care facility

• People with chronic lung disease or moderate to severe asthma

• People who have serious heart conditions

• People who are immunocom-promised, including cancer treatment, smokers, bone marrow or organ transplan-tation, immune deficiencies, pooly controlled HIV or AIDS, and prolonged use of corti-costeroids and other immune weakening medications

• People with severe obesity (body mass index/BMI of 40 or higher)

• People with diabetes

• People with chronic kidney disease undergoing dialysis

• People with liver disease

• Women who are pregnant should be monitored since they are known to be at risk with severe viral illnesses. However, to date, data on COVID-19 has not shown an increased risk.

Such individuals should carefully follow CDC, state and county guidelines and precautions, and consult their healthcare provider as needed.

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PROTECT YOURSELF AND FAMILY FROM COVID-19Because there currently is no vaccine to prevent COVID-19, the best way to prevent illness is to avoid exposure to it. The CDC recommends the following precautions to protect yourself and family members.

CLEAN YOUR HANDS: frequently throughout the day wash your hands often with soap and warm water for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.

COVER coughs and sneezes with a tissue. Throw used tissues in the trash and immediately wash your hands.

AVOID TOUCHING your eyes, nose and mouth with unwashed hands. These are the points of entry for the virus.

WEAR A MASK. The CDC now recommends wearing a basic cloth mask while out in public. Medical or surgical grade masks, such as N95 should be used by health professionals only.

STAY HOME from work, school and all activities where

your potential for exposure is increased. Venture out only for essential services and supplies.

KEEP YOUR DISTANCE. In an effort to control the spread of the virus, CDC officials recommend that we keep a distance of six-feet from other people while in public spaces.

CLEAN AND DISINFECT frequently touched surfaces every day. This includes tables, doorknobs, light switches, handles,

phones , remote controls, keyboard, toilets,and faucets. Most common EPA-registered household disin-fectants will work. Use products appropriate for the surface.

STAY INFORMED and in touch. Get up-to-date information about local COVID-19 activity from public health officials. Visit wp.sbcounty.gov/dph/coronavirus for COVID-19 statistics in San Bernardino County.

BE AWARE OF COVID-19 SYMPTOMS which include a fever greater than 100.4 degrees Farenheit, cough and/or shortness of breath.

If you experience these symptoms and suspect you are infected with the virus, stay home and monitor your symptoms. Current recommen-dations are to stay home at least 14 days from sympton onset.

Call your healthcare provider about your health status.

Seek prompt medical attention if your illness worsens, especially increased difficulty breathing. The CDC advises that if you develop trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face, seek immediate medical attention. Call 911 or call the hospital emergency room before leaving the house.

Separate yourself from other people in your home. As much as possible, stay in a designated room away from others; use a separate bathroom.

Avoid sharing household items such as dishes, drinking glasses, eating utensils, towels and bedding.

Wear a facemask when around other people, especially when entering a medical facility.

Prem Salhotra, MD, Chief Medical Officer for Morongo Basin Community Health Centers encourages you to follow CDC, state and county guidelines, including washing hands frequently and disinfecting commonly touched surfaces, etc.

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On March 27, Dawn Rowe, San Bernardino County, Third District Supervisor; Karen Faulis, CEO of Hi-Desert Medical Center; and Jackie Combs, CEO of Morongo Basin Health District, published letters to the community to inform what each entity is doing on behalf of the community in response to the COVID-19 outbreak.

DAWN ROWE, COUNTY SUPERVISOR:

As your County Supervisor, I want to keep our Morongo Basin residents informed about the county’s response to COVID-19. The County of San Bernardino is utilizing a multi-pronged approach to address this pandemic. Managing the delivery of emergency and healthcare services is paramount, but we must also take steps to provide direct assistance to our residents during this unprece-dented time in history.

On March 24, the Board of Supervisors unanimously approved a moratorium on residental and commercial evictions and foreclosures that appies to properties in the unin-corporated areas of the county. In addition, the county Tax Collector pledged to waive penalties for property owners who are unable to pay their property taxes.

On the emergency managament side, the Office of Emergency Services (OES) is activated to Level 1, its highest level, and is coordinating activities among the various county departments

and 24 cities within our county. OES is also working in concert with Morongo Basin Healthcare District and Hi-Desert Medical Center to ensure we have capacity to handle a potential influx of patients. Furthermore, the San Bernardino County Fire Department is operating an Incident Command Post, similar to what you’d see in response to a large wildland fire, to manage first-responder resources and flex staffing to areas of the county that need it most.

The San Berardino County Department of Public Health is also a critical component to the COVID-19 response. On March 27, the department conducted its first drive-thru test site with more to follow. The public can sign-up for an appointment by visiting wp.sbcounty.gov/dph/coronavirus or calling 909-252-4406, or you can contact your primary care physician to request private testing.

At the local level, I’m working with federal officials to institute a complete closure of Joshua Tree National park. The Morongo Basin shouldn’t be a travel destination for tourists while we have a stay-at-home order in effect. Similarly, the county issued a directive requiring the closure of vacation rentals for the duration of the order. I’m also coordinating a weekly call with community leaders to keep them informed as this event unfolds.

To address many of the questions and concerns from the public

related to this crisis, the county established a Joint Information Center (JIC) last week. I encourage residents to contact the JIC at 909-387-3911 to find out how the county can assist you and your family as we deal with COVID-19 together.

KAREN FAULIS, CEO HI-DESERT MEDICAL CENTER:

Hi-Desert Medical Center stands united in serving the community and in facing new challenges due to COVID-19. Like you, every one of our physicians and staff members has been impacted by this pandemic, and we have made swift changes to ensure we’re meeting all public health safety measures. I am proud to be the CEO of such a caring and dedicated team.

We want you to know that we are here for you, ready to provide care in every way. We are working closely with the Morongo Basin Healthcare District, San Bernardino County Department of Public Health, and the California Department of Public Health, following guidance issued by the Center for Disease Control and Prevention, to respond to any potential COVID-19 cases that may present at our hospital. We routinely treat infectious diseases and we have strong infection control policies, procedures and systems in place to screen and treat patients. We have taken the appropriate steps to train professionals and have the necessary equipment to react accordingly. We can safely and appropriately care for our

A RESPONSE TO COVID-19 BY LOCAL HEALTHCARE LEADERS

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patients with the necessary supplies and equipment.

Even as some aspects of care may temporarily change, you can count on Hi-Desert Medical Center to be here for you and your loved ones. Although there might be some modifications, our emergecy room and staff are here 24/7 for medical care, all urgent and emergency care needs, and for COVID-19 and non-COVID-19 related issues. You’ll receive unin-terrupted care for chronic medical conditions, urgent surgical needs, maternal care, and other medical issues that require inpatient care.

The patient care environment has changed with increased safety precautions, which is why we have temporarily suspended patient visits (with limited exceptions) to the hospital and Continuing Care Center. We realize that family and friends are imperative to the recovery process and we encourage continous connection with patients via virtual visits on Face Time, Skype and other applications. Know that our staff is providing care and comfort to our patients as they would for their own families. We have strategies in place to add significant capacty to our hospital should the need arise. Our surge plans include adding beds in our recovery room and pre-op areas, converting space in our front lobby and Helen Gray Education Center, and erecting an outdoor tent to accomodate increased inpatient and ED volume.

The health of our physicians and staff on the front lines is also crucial to our success in fighting the surge of patients we anticipate. We have dedicated staff screening patients who are entering our facility and have taken measures to ensure all physicians and employees are screened.

As we navigate the effects of COVID-19, we expect more changes and challenges ahead. The support and generosity of the communities we serve has been heartwarming and uplifting to our staff. We appreciate the donations of medical supplies and other offers of support.

We encourage our communities to stay safe at home and heed the direction of public health officials. We are here for our patients and are ready to serve those who need our help in the coming weeks and months.

JACKIE COMBS, CEO MORONGO BASIN HEALTHCARE DISTRICT:

Leaders of Morongo Basin Healthcare District and the Community Health Center

“There’s no magic bullet. There’s no magic vaccine or therapy. It’s just behaviors.

Each of our behaviors translating into something that changes the course of this viral

pandemic over the next 30 days.”

Deborah Brix, M.D., White House Briefing, March 31, 2020

continuously monitor local, regional and state public health concerns and emerging information on COVID-19. During these trying and unsettling times, it’s important to know that your healthcare district, together with Hi-Desert Medical Center and the County of San Bernardino, are working to prepare for the long term implications of this pandemic.

The Morongo Basin Healthcare District operates two community health clinics known as Morongo Basin Community Health Center. Located in both Yucca Valley and 29 Palms, these clinics provide affordable healthcare for everyone. We stand ready to deploy our staff as backup to support Hi-Desert Medical Center in the event of an increase in COVI-19 patients.

It’s important to know that if you are diagnosed with COVID-19, and if you live with others, you must ALL stay at home and follow your medical provider’s direction.

We are concerned about your health and safety. If you have fever with respiratory symptoms, stay home and call your medical provider. If you have difficulty breathing and need medical care, call the hospital or 911.

We need to “flatten the curve” and stem the increase in spreading this disease. If we can slow the rate of infection, we can make sure our local hospital and medical providers do not become overwhelmed responding to what will surely be a spike in confirmed cases here locally.

We’re in this together and it’s up to all of us to do our part every day.

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6530 La Contenta Rd #100 Yucca Valley CA 92284

COVID-19: STRESS AND COPINGThe outbreak of COVID-19 may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.

Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

Stress during an infectious disease outbreak can include fear and worry about your own health and the health of your loved ones; changes in sleep and eating patterns; difficulty sleeping or concentrat-ing; worsening of chronic health problems, and increased use of alcohol, tobacco or other drugs.

Taking care of yourself, your friends and family can help you cope with stress. Here are some things you can do to support yourself during this stressful time:

• Take breaks from watching, reading or listening to news stories. Hearing about the

WE’RE JUST A PHONE CALL AWAY!MORONGO BASIN COMMUNITY HEALTH CENTER

During the COVID-19 outbreak, our clinics in 29 Palms and Yucca Valley are available to take your call. Most of our patient visits are now being handled by telephone or through an interactive, face-to-face online “patient visit” with our medical providers, available through a cell phone or other electronic devices.

And our patient portal allows patients to obtain lab results, book appointments, track and reorder medications, and exchange messages with their medical provider.

For more information call 760-365-9305.

pandemic repeatedly can be upsetting.

• Take care of your body. Stretch, or meditate. Eat healthy, exercise regularly, get plenty of sleep and avoid alcohol and drugs.

• Stay in touch with friends and family outside of your household. Use social media, face-to-face applications or telephone calls. Especially reach out to those who are alone.

• Spend time with family and pets in your household. Find creative activities to do together.

• Be proactive: protect your household by observing CDC, state and county guidelines. Disinfect hard surfaces, and wash your hands frequently.

• Being prepared can reduce stress. Make a list of emergency contacts such as your healthcare provider, pharmacy, family and friends who may be able to provide support during the illness. List medications and dosages should you be admitted to the hospital; list any pertinent medical history and allergies, including food allergies.

Psychiatrict, Austin Puglisi, MD, at Morongo Basin Community Health Center reminds us that this current state is temporary, and to seek help if needed.

The American Academy

of Pediatrics encourages

childhood vaccines be given to

those children that need them

during this COVID-19 outbreak.

Call Morongo Basin

Community Health Center

for an appointment:

760-365-9305