Truckee, Tahoe health-care providers pivot to new approaches amid pandemic
As people lament canceled flights and park closures, Truckee health professionals contend with the private and public risk factors of providing essential services — prenatal care, dental care and psychological care, to name a few.
“All diseases need timely attention,” said Harry Weis, president and CEO of Tahoe Forest Hospital System. “Certain health challenges haven’t put themselves on hold during the pandemic.”
Tahoe Forest Health is a nonprofit that has treated the North Lake Tahoe region’s medical needs since its origin in 1949. Now, Weis said the system is weathering a financial storm, losing “several hundreds of thousands” on PPE each month, state-required, COVID-19-related drug inventories and staffing additional personnel for the 24-hour nurse hotline and drive-thru testing center.
“We’re happy hospitalizations were significantly lower than predicted, and the death rates,” Weis said of the local impact of the virus. He said state and county forecasts predicted over 10 times the patient volume actually tallied during the pandemic’s first spring wave.
“We have experienced a significant decline of patient volume in the hospital,” Weis said. “We’ve seen our revenues fall significantly in Incline Village and Truckee, while our expenses climb.”
Weis said Tahoe Forest Health experienced a relatively light year overall, in terms of treating not only the coronavirus but the annual iteration of the flu.
Although he is optimistic about the health system expanding services to meet the needs of the public and stabilize financially, he anticipates a slow normalizing process.
“There will be some impediments to hitting ideal volume levels just because we’re doing physical distancing,” Weis said.
As the hospital system continues to expand its services over the next four to six weeks, it remains mindful of its employees and patients well-being — coronavirus-related or not. Weis said some services will be provided via telehealth, but acknowledged that babies continue to be delivered and serious ailments continue to be treated on site.
“If people have illnesses or health concerns, do not procrastinate,” Weis said. “People hesitate to receive care when they have a significant health challenge in a time like this, and we don’t want to see that happen in our community.”
NOT BACK TO NORMAL
Truckee dentist Dr. Jason Baldwin makes his bread and butter from oral exams, putting him in the dragon’s mouth of the coronavirus.
Baldwin originally anticipated a week-long closure, and furloughed his employees after Gov. Gavin Newsom issued the shelter-in-place order in March. Now, he takes emergency phone calls to his cellphone and if necessary, treats patients solo in an office that generally remains locked during normal business hours.
Baldwin keeps abreast of some of the new protocols offered by the Centers for Disease Control, the American Dental Association and the California Dental Association, but must conduct personal research to prepare his practice for reopening.
Baldwin said Truckee’s small size helps contribute to a quality network of health-care providers in his field, which has been helpful to process and consider changes in business.
“This is gonna be a painful process for everyone, but what I do love about this town is that everyone is coming together and helping people out,” he said.
Baldwin suspects that not only will protocols change in dental offices like his own, but the space’s interior design and architecture. He said patients will remain in their cars before their appointments, rather than sharing a waiting room. Baldwin said from a sterilization perspective, not much has changed.
“We’ve always been prepared for this, but now we’ll wipe down door handles, counter surfaces, more often,” Baldwin said.
Because dentistry creates aerosol, Baldwin said he anticipates the architecture and interior design of open-bay offices like his own to completely change in the future. He said certain equipment will also change.
“Currently we have on order medical grade air purifiers, in each treatment room and reception, to reduce the possibility of transmission through aerosol,” Baldwin said. “Future office designs may use a concept called negative pressure, which uses air conditioning and heating system to suck the air out of the room and reduce the chance of spreading the virus.”
Baldwin applied for the Paycheck Protection Program and the Economic Injury Disaster Loan, both of which are still pending. His only revenue source are the emergency procedures he performs on an unsustainable basis.
“It’s nowhere near what we would generate a day to keep the doors open,” Baldwin said. “Fiscally, I’m not sure how much of an impact this is gonna have. I have been trying not to think about it right now.”
Baldwin anticipates a phased reopening wherein the clinic’s capacity is limited by social distancing requirements and the limited availability of protective equipment. He is looking forward to returning to work, but does not anticipate his schedule or his office returning to the way things were any time soon.
“There will be a need, but I don’t think once they say this is all clear that things are going to go back to normal,” Baldwin said.
TURNING TO TELEHEALTH
The schedule for Stacey Stahl, a licensed clinical social worker in Truckee, has stayed pretty booked in light of COVID-19.
She said she is one of the few therapists in Truckee who accepts insurance, making her more accessible to patients who are unable to afford the cost of therapy out of their own pocket. Stahl said the psychological effects of the coronavirus and the shelter-in-place order has delayed the progress of patients she anticipated “graduating” already.
“Fewer people are graduating from services, which means there aren’t many openings for new clients,” Stahl said.
Stahl said clients who normally seek out Vitamin D and fresh air as their summer therapy feel limited.
Despite the increase in need for such services, Stahl said the pandemic has limited her professional capacity.
“I’ve had to limit the number of slots I have available. I’m trying to simultaneously take care of my child’s needs and my own family’s needs,” Stahl said.
She said she feels lucky to be an essential worker, and is conducting 80% of her work via telehealth. Before the pandemic, only 10% of her clients were served remotely because she prefers conducting therapy in-person.
“To be able to offer a comforting touch — a hug, being able to shake somebody’s hand — all of those things are benefits of in-person therapy,” Stahl said.
Even the physical act of nearing two people in verbal conflict has a huge benefit in reducing the clients’ reactivity, Stahl said.
Stahl said the Therapists Association has not reached out, but she has conducted her own research and took cues from the town and county on safety precautions.
“If you’re going to be practicing,” she said, “… you’re going to be in the business of reducing the risk of spreading the virus.”
Rebecca O’Neil is a reporter for the Sierra Sun. Contact her at firstname.lastname@example.org.
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The total number of confirmed COVID-19 cases in Nevada County had reached 8,060 by Thursday morning. There are 315 new cases since Sept. 10, indicating a 4% increase over last week.