Friday, June 5, 2020

Conversation with Samaritan’s Dr. Ogden about COVID-19

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Samaritan North Lincoln Hospital
Samaritan North Lincoln Hospital

COVID -19 has forced social change in our everyday lives, created fears among many and uncertainty throughout the entire nation and the world. The global pandemic disturbs not only our lifestyle and the economy, it has placed extreme stress on the healthcare system. Things may never be the same because of this coronavirus, and that may not be all that bad!

The other day, I reached out to Lesley Ogden, MD, CEO of both Samaritan North Lincoln Hospital in Lincoln City and Samaritan Pacific Communities Hospital in Newport, to get some insight on the Covid-19 situation on the central Oregon coast, and what this may mean for society and healthcare in the future.

Kusz:  When did you start at Samaritan? I remember meeting you for the first time and you made an impression on our community upon your arrival!

Dr. Lesley Ogden
Lesley Ogden, MD, CEO of both Samaritan North Lincoln Hospital in Lincoln City and Samaritan Pacific Communities Hospital in Newport

Dr. Ogden: In 2006, I was at OHSU in Portland and was job hunting around Portland – not in the city, but in the suburbs – when I saw there was a job opening in Lincoln City. I thought to come out here to take a look. I found the people and the place so nice. So, I ended up moving here and I’ve been here ever since. I can’t believe it’s been that long!

Kusz:  Dr. Ogden, how are you doing?

Dr. Ogden: Thank you for asking. You know, I think I am equipped to deal with something like this because of my background in emergency medicine. I have had a lot of people tell me, “you’re just enormously calm.” I say, “well, I think you’d be dismayed if your emergency physician was not.” None of us have ever lived through something quite like this, with this level of widespread infection, this level of activity from our government, and interventions to the level that we are completely changing our lives in order to try to affect how infection rates work, so this is new territory for all of us. I do have my moments of pondering and frankly feeling WOW, a little overwhelmed, but then you come back to science and facts, and how we’re going to get through this and that’s what centers me.

Kusz:  How is the staff coping, and what is the general mood at Samaritan?

Dr. Ogden:  People know it’s not going to be the Zombie Apocalypse. In reality, it’s an infectious disease. I think people get very nervous when they read what’s happening in different parts of our country and in different parts of the world. Our staff is getting more and more used to being very cautious and also being cautiously optimistic. Depending on how this goes, maybe we [Lincoln County and Oregon] won’t see the worst of it.

We are so enormously lucky in some ways to be where we are, and I am lucky to work with a company like Samaritan that is a non-profit and can do things that are mission-driven and that somehow has the materials and folks that were able to find the supplies that are needed and really give us a leg up. Of course, we haven’t seen a surge and we haven’t seen the personal protective equipment [PPE] shortages like they’ve seen in other areas. We still use a lot of PPE because we treat every patient as presumptive COVID.

Kusz: Once you have a presumptive COVID-19 patient, what protocols are in place to protect staff?

Dr. Ogden: These days, you can’t be too careful. We understand that many people are asymptomatic and can be spreading the virus without knowing it. We have protocols that staff who are working in a patient-facing area are recommended to wear a mask at all times. It is our nature to take care of people and we have difficulty in medicine staying more than six feet away from each other all the time. Frankly, we can’t always tell who has COVID-19. So, our thought is to mask everybody to reduce the potential transmission. Anyone who has respiratory symptoms is presumptive positive, so they get a mask the moment they step up to our doors. Then we wear full personal protective equipment, even if we think there is the slightness possibility they have COVID, because we need to protect our workforce. Especially in a small hospital, we don’t have a large staff, so if one gets sick, that could be a staff member that makes or breaks us. So, we just need to be extra vigilant! We’re treating everyone as a COVID patient until we sort it all out.

Kusz: National news is bleak, predicting a surge of new cases, especially in New York, Florida, Louisiana, Michigan and several other cities and states. Yet, Georgia beaches are reopening and several states still do not have shelter-in-place orders and are making their own guidelines. Do you think the national response should be coordinated?

Dr. Ogden:  Yes, yes, yes, very much! I think the reason you’re seeing so many different movements, in so many different states, is lack of leadership from the top. I think if we had strong leaders who understand science, who understand what we we’re up against and could lead us all together in the same direction, I think you would see very different outcomes than what you’re seeing in pockets of areas that are just “allowed” to go crazy with infection rates.  That’s not how you control a pandemic.

You can see in Washington and Oregon with our local and state leadership, we’ve been able to move the meter, and it is very unfortunate that we did not have the strong leadership at our national level to be able to do the same things that we’ve been able to do at the state and local level.

Kusz:  In Oregon and Lincoln County, what should people continue to do? I’m afraid some people are going to be looking at the headlines, “The cases are flattening out,” or feel the risk is lessening. That message, at this particular point, can be dangerous. What are your feelings?

Dr. Ogden:  Yes, I agree with you. I’m worried that if people think that things are all rosy, they will slide back and stop being so thoughtful about what they’re doing. That they will stop social distancing and stop isolating. If people come back together in groups, that will allow the virus to spread. I think we’re on the right course, but staying on that course means continuing to do what we’ve been doing and not backsliding and not going back to the way it was. We need to continue to hold the line.

Kusz:  How do you think this may change the future of medicine and hospital care on the coast?

Dr. Ogden: I’m very pleased with the cooperation of scientists and pharmaceutical companies worldwide making an effort to come up with a vaccine. I hope that this level of cooperation means a new day in pharmaceuticals, though I don’t know how hard to hold onto that hope, but that would be wonderful.

Another thing I’m really worried about is hospital closures. I meet with CEOs from all over the state twice a week, and once a week with the rural hospitals. There are only about 30 of us rural hospitals, and some are really struggling. I have never been so thankful to part of a system [Samaritan] that had some cash on hand. We have stopped all elective procedures [because of COVID], so we’re bringing in less than half of the revenues we did before. The question now is, “how long can you be able to do that?” With the Governor’s order lasting until mid-June, which is still two months away, can we continue to employee everybody when we don’t have that money coming in? We’re certainly going to try and we’re very fortunate again to be part of a system, but there are some hospitals in our state and some of them on the Oregon coast that are not as fortunate. I hope that we do see a changing landscape that would allow them to remain open.

Kusz:  What effects will COVID-19 have on the healthcare system globally and societal views on disease prevention in the future?

Dr. Ogden: I have no doubt that this is going to change healthcare forever. We will never, ever go back to how it how it was before. In fact, the longer this lasts I think the more sustainable change you’ll see. We’ve been working for years to get telehealth as a force but we didn’t have a mechanism to get paid for it. So, very quickly, that barrier went away and now we are actually doing more of our clinic visits by telehealth than we are in person. So, for the very first time, we’re shifting that number, training our physicians to use technology in this manner – and I don’t think we’ll ever go backwards on that. It’s not that medicine will change so that we never see a patient in person again. It’s that you’ll be able use technology differently, that you can see person that doesn’t need to be touched. Because so much of healthcare is checking in, seeing that the medicine we’ve prescribed is working. “Oh, it worked little, well maybe we need to up the dose.” It’s those sorts of conversations that don’t require the laying on of hands that can really be done so much more efficiently with telehealth.

Along with that is the decrease of regulations. We are an industry that is regulated like crazy.   With COVID-19 we have seen things happen very rapidly, with some practices just thrown to the wayside, and rightfully so, in order to see what we can do to care better for patients, especially to see what we can do in surge planning. I think going back on all of these things is going to be extremely hard for the government to do, now that they see what we can do and how far we can take it for the good [of the patient] without those regulations in place. I think we were over-regulated.

I also think we’ll see an increase in environmental hygiene. Everybody is cleaning everything all the time, everywhere you go – from the supermarket, to the drugstore, to every business that is open. If you have to get in an elevator, you’ll see people not getting on the elevator with anyone else; they’ll wait until the next car. Making sure the area around you is clean and making sure that you are in command of your social distancing. I’m not sure that type of behavior is going to wear off very quickly.

Kusz:  Is there a message you’d like to tell the community?

Dr. Ogden: We’re still taking care of everything. People still need to be hospitalized, they continue to need our care and we continue to care for everyone that needs it. We’re very lucky that the vast majority of folks [with COVID] that we take care of are recovering, and there’s always amazing stories associated with each of them.

I think the most heartfelt thing that we’re seeing right now in the community is people recognizing the struggle going on. Somebody from the community posted cards at the staff door of our Newport hospital, thanking the healthcare workers. Somebody else at North Lincoln in Lincoln City sent flowers to all of the staff and a nice, big card that just said, “thank you.” We’re receiving all these “thank you for doing what you’re doing” messages! It is very uplifting for healthcare workers, who don’t often get thanks for what they’re doing. It is really neat. It brought smiles to our faces, which could not be more treasured in these times.

To learn more about Samaritan Health Services visit their website and see our previous coverage of the new Samaritan North Lincoln Hospital.

TRAUMA ROOM SNLH

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Jim Kusz
Jim Kusz
Oregon Coast Community College, Disaster Preparedness Educator

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11 COMMENTS

  1. Dr. Ogden, we have the strongest leadership in the world with President Trump! It’s the governors who need to get their act together!

  2. lack of leadership from the top. I think if we had strong leaders who understand science, who understand what we we’re up against and could lead us all together in the same direction.

    it is very unfortunate that we did not have the strong leadership at our national level.

    Agree!!! Trump. . . . . .. . . . …. ….. …. Your Fired!

  3. Billy Bob, you need to further your education. Learn to spell or use correct English.
    America will never see another President as great as our President Trump. He has been a great inspiration to this nation as his leadership is flawless.

  4. I can’t believe a person that runs 2 hospitals is this political. Does she not realize that this President is the one who saved our country from from a pandemic? Can you image what would have happened if Obama or Hillary had been in office? Now there is a real scary thought!!!!

    BTW where is the stimulus check from the federal government? Let’s see……oh that is right I forgot it is in our governors hands. Who know how long Brown will wait till we get our checks. You want to be mad at someone maybe you should tell her how you feel about not getting money for food!!!!!

  5. Fran, thank you for your great words about our President. I agree, she made this political and therefore, I find her unworthy of any trust. Our President from the very beginning was criticized for his quick action in stopping China’s traffic to the USA. He has worked harder each and every day giving talks, holding press conferences, etc. He is an amazing leader.

  6. Went to college! I Presume you went to the school of FOX propaganda! My post is a copy past of what the doc said up above.
    The bottom line is mine!
    The messed up dot dot dot is a joke on Trumps tweets.
    Fran you’re so misinformed!
    Thanks for your post Irene, Fran (same person). now go drink your orange cool aid!

  7. The coronavirus emerged in China in late December. The Trump administration received its first formal notification of the outbreak on January 3. The first confirmed case in the United States was diagnosed in mid-January. Financial markets in the United States suffered the first of a sequence of crashes on February 24. The first person known to have succumbed to COVID-19, the disease caused by the coronavirus, in the United States died on February 29. The 100th died on March 17. By March 20, New York City alone had confirmed 5,600 cases. Not until March 21—the day the U.S. Department of Health and Human Services placed its first large-scale order for N95 masks—did the White House begin marshaling a national supply chain to meet the threat in earnest. “What they’ve done over the last 13 days has been really extraordinary,” Jared Kushner said on April 3, implicitly acknowledging the waste of weeks between January 3 and March 21.
    The lying about the coronavirus by hosts on Fox News and conservative talk radio is Trump’s fault: They did it to protect him.
    Ten weeks of insisting that the coronavirus is a harmless flu that would miraculously go away on its own? 15 sick now, 0 sick next week! Trump’s fault again.
    This is a hoax done up by the democrats! Trump’s fault again.
    There are tons of examples, just google and read/watch multiple news sources, even the other side.

  8. I’m sorry Irene and Fran you have been misinformed. Donald Trump claimed that this was just like the flu and ignored a call to arms, and did not call for the country to attack this virus until we were already in trouble. And unfortunately Donald Trump disassembled the pandemic team several months before that. And if you are looking for your stimulus checks those are coming from the federal government ladies, more specifically directly from the IRS. Kate Brown, Is not issuing those checks! Let’s not be disrespectful to community leaders. Or to other people if you are enjoying the leader ship of Donald Trump then that is your opinion, but before you Comment on something you should get your facts straight first.

  9. Thank you Tammy and Billy Bob. Your explanations were spot on. Fran and Irene have apparently not read what you wrote. I wonder, Fran and Irene, if you have anyone in your near orbit such as family or co-workers, here in Lincoln County, who have been sick with all the symptoms of the Corona virus, but were told by their clinic or the doctor to go home and quarantine and “presume they have Covid19” because they were not considered to be in the “at risk” groups because no tests were available for them. I know a few people who have experienced this in our own community. With no test to confirm that these people have Covid19, no one who had contact with them was notified or tested. Only 1% of the population of the US has been tested, but this fact needs to be placed in perspective with a timeline. On February 28, at a political rally, more than a month after learning the pandemic, Trump called it the Corona Virus Hoax. He blamed it on the democrats. On March 3rd, the CDC confirmed the first case in Oregon. 70 days were lost because of Trump’s inept leadership. We still don’t have enough testing and no roadmap and no one at the helm. He has abdicated leadership to the state’s governors and thank goodness, we have a good and responsive governor. His abdication had a purpose, as it turned out; he has recently blamed the governors for the lack of his administrations short-comings. He deflects blame for everything onto someone else, and Fran and Irene, you have bought it – you drank the cool-aid. More than 16,000 people dead now in the United States, and all Trump can do is blame others, such as the governors, for the disaster. He takes no responsibility for lack of preparedness, lack of strategy, lack of cohesion, lack of tests, or for the general confusion and for such insane outcomes like the competitive bidding for PPE and ventilators. Not once has Trump been humbled or shown humility to the citizens of the US for the loss of life. His daily diatribes and appearances are not for you and not for me. He could care less about us. Trump says nothing of substance. If he delivers a fact, a true fact, he has to read it because he does not believe it. He ad libs the rest, and his own advisors come on afterwards to clean up his lies and mis-statements. He does those dog and pony shows for himself. At no time have I believed or felt like he was a leader through this crisis. I am so grateful for people and administrators like Leslie Ogden, and our medical professionals who are not sugar coating what is going on or how difficult it is to navigate through the mess the Trump administration has created.

  10. Janellemub, your comment is nonsense, but still somehow makes more sense than anything fran/irene/loriann defecated into this discussion.

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