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COVID Update & Five Commitments | A Message from CEO Dave Ressler

June 1, 2020

This is a pivotal time for our community.
 
In our continued battle against COVID-19, together we have gained ground recently as many of our local services are carefully reopening, including our restaurants and our hotels at 50% capacity, in keeping with the Pitkin County Roadmap to Reopening plan.
 
This is good and hopeful news for our community, which has sustained significant economic, social and emotional effects of COVID-19 and (for some) deadly consequences. We are able to take this important step forward because, together, we have upheld our Five Commitments to Containment and will continue to cover our faces when in public spaces, maintain our social distancing, wash our hands frequently, Quick read more or view full article and get tested when we have symptoms, and then stay at home. For more information, check out the newly-launched Pitkin County Response and Recovery Website.
 
For our part, Aspen Valley Hospital is providing the COVID testing for those who are referred by their primary care physicians with symptoms, without any cost after insurance. This past week, we also rolled out our communications tool, called the AVH Capacity Matrix, which provides the Hospital’s real-time status to the community. You can find it on the Pitkin County COVID-19 Stats webpage. This is important information for our community to have readily available, because it will indicate if the virus spread is becoming a problem again, for Aspen Valley Hospital and for our community’s safety. Public Health is also relying on this information, along with other metrics, to determine when it is safe to keep advancing along the roadmap, or when we need to pause or take a step back.
 
Meanwhile, our patients who need us continue to receive our safe and special brand of extraordinary care. Since we reopened to elective and other non-urgent services on May 1, we have been providing care to the many in our community who were waiting for essential in-person care – such as surgeries, procedures, doctor visits, studies, consultations and therapies. Thanks to our staff and physicians, these services are being delivered in a safe environment that continues to protect us and our patients from the virus. We want to assure our community and our patients that it is safe to return to AVH and our off-site locations when they need our care. That is, after all, why we are here.
 
Thank you again for playing your part, as a community that cares, in getting us to this point where we are cautiously moving forward as a hospital and a community to safely restore our lives and our economy. If we work together, along with our guests and visitors, we can continue to move forward with the County’s plan for reopening.
 
I am proud to be a part of the AVH organization that has provided the first line of defense against this virus, and I wouldn’t want to be living in any other community than ours.

Sincerely,
Dave Ressler


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COVID Q&A with Dr. Brad Holmes

June 1, 2020

At Aspen Valley Hospital, Dr. Brad Holmes is one of three hospitalists, the physicians who provide care at the bedside, managing patients who have been admitted to the hospital.

Dr. Holmes is also a member of the Medical Advisory Team to Pitkin County Public Health, and sits on a number of committees at the hospital responsible for setting protocols for ensuring safe care for all patients during the coronavirus pandemic.

“If you’re feeling sick and feel you need to come to the hospital, by all means do so,” he said. “We have set up all kinds of systems to protect people from exposure to COVID-19. We’re the community’s hospital, and we Quick read more or view full article are here to take care of people who need our help.”

Dr. Holmes sat down (virtually) for an interview to answer some of the common questions that are being asked as the economy restarts and the stay-at-home restrictions are eased.

AVH NEWSLETTER: As Aspen moves forward with its Roadmap to Reopening, why is it important for our community to adhere to the Five Commitments to Containment?

Dr. Holmes: We can’t detect everyone who has the virus. People with minimal or no symptoms can spread it without knowing they are doing so. The Five Commitments are designed to reduce the spread of the virus, and protect everyone in the community:
  • I will maintain six feet of social distance.
  • I will wash my hands often.
  • I will cover my face in public.
  • I will stay home when I am sick.
  • I will get tested immediately when I have symptoms.
 
The virus levels grow when an infected person spreads it to more than one other person, and the virus disappears if it spreads, on average, to less than one person. The goal is to limit that spread, that way the virus will die off or at least not surge. The commitments are designed to do that.

Is warmer weather going to help reduce the spread of COVID-19?

We can be hopeful, but we don’t really know with this virus.

If we adhere to the commitments as a community, we’re going to reduce transmission of the virus. Fewer people will be infected, which means fewer hospitalizations, less deaths and in general less people getting sick and having to miss work. We’ll be able to keep business open. I think those are all the reasons to stick with this. If we go the opposite direction, the community will have to go back to the way it was with stay-at-home orders and businesses shutting down once again. Nobody wants that to happen.

Is it really necessary to wear a mask? Why?

Yes, you should wear a mask. We know that by wearing homemade masks there is a good chance you will to some extent reduce your chance of getting the virus. And with people who have the virus but don’t have symptoms or have minimal symptoms, wearing a mask will reduce the amount of viral particles they expose other people to. When they sneeze or cough, the secretions will go into the mask, making it less likely they will infect other people.

Most experts believe that wearing a mask really helps. But it’s not one hundred percent effective, which is why it’s important to maintain a 6-foot distance from other people, wash your hands frequently, and live by the other commitments.

Can you bust this myth? The COVID virus isn’t any more dangerous than the flu.

COVID-19 is unlike any respiratory virus that I’ve seen before. Even here in our small town, we’ve had a number of people end up hospitalized and severely sick with COVID-19. We know it can adversely affect older people, but we’ve seen younger people end up very sick and on ventilators and life support.

Even the milder version that does not require hospitalization is not a pleasant experience. People have come out publicly and said that even though they did not end up being severely ill, it was a terrible experience that they never want to go through again. This includes young, healthy people and even elite athletes like Vonn Miller from the Denver Broncos.

It is also more contagious than the flu. Some estimates I’ve seen indicate it is twice as contagious as the flu.

What tests are Aspen Valley Hospital currently using?

We are using a variety of tests, including PCR testing of nasal swabs and saliva as well as antibody testing, but we are constantly re-evaluating to determine which tests available are the most accurate and will get us the results the fastest.

Currently, the samples are being collected and then sent out to an outside laboratory, but AVH has recently ordered a PCR test that we’ll be able to perform here in our facility. Instead of a 48- to 72-hour turnaround time, we should be able to have results in a couple of hours. We are working to secure a steady supply of these tests, just in case we get another surge.

How is PCR testing different from antibody testing?

The PCR test tells you whether or not you have the virus in your system right now. When somebody comes in and they are sick and we want to know if they have the virus, this is the test that we use. In order for this type of test to work, we need to get a swab or a sample that actually has the virus in it. Then we run it through the PCR machine that will detect whether it’s present.

The antibody test is a blood test that detects if you have antibodies to this coronavirus. It does not tell us if you have it right now, but does show whether you have been exposed to this virus sometime since the outbreak began. With the antibody test, we think it takes two weeks or so before you will have antibodies in your blood that we can detect. We also know that some people will not develop antibodies at all.

It is important to keep in mind that these tests are not perfect. With PCR testing, about 20 percent of people who actually have the virus end up testing negative. Antibody tests can also produce false positives, meaning the test result comes back positive, but you’ve never actually been exposed to the disease.

Can you bust this myth? COVID really only affects vulnerable populations, like those who are age 60 and older.

People of all ages are at risk. Aspen Valley Hospital had to transfer a few people on life support to other facilities. These weren’t older people who are considered to be at high risk of severe illness. They were people under 50 years old who did not have significant underlying medical problems. I know of people in their 30s ending up on life support elsewhere in Colorado.

That being said, older people, especially over 70, are at much higher risk of having severe complications from COVID-19. The same is true for people who have underlying significant medical problems.

When will it be possible to get an antibody test for the community?

It is currently available through people’s primary care physicians. But we want to caution people that even if you test positive, you should not lower your guard. We simply don’t know yet whether people can be re-infected by the virus and then spread it to other people. And as I’ve said, these antibody tests are not perfect.  

Using the Five Commitments is the best way to protect yourself and everyone else in the community.

What are some recommendations you have for keeping healthy and maintaining physical and mental wellness during this crisis?

Taking care of yourself is important. Make sure you’re eating well and getting regular sleep and plenty of exercise.
Finding time for yourself to do something that you enjoy can make you feel better. Yoga and meditation can be helpful. Being outside can be good for you both mentally and physically. The weather is great now, so I encourage people to do something they love, whether it's a run, a hike, biking, fishing or some other activity.

Also, connecting with friends and family can help. Even though we’re not able to see the people we care about in person as much as we would like, the world today allows us to interact with each other easily over video chat and with phone calls.

Do you have anything else to add?

We’ve made a lot of progress and shown we can start to suppress this coronavirus and are now working to open things back up. Unfortunately, the virus is not going to disappear. We are in this for the long haul, which is why it’s important to stick to the Five Commitments and get tested if you are sick. That way we can keep the virus suppressed and continue to do things we love.

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COVID-19 Community Update | A Message from CEO Dave Ressler

April 30, 2020

Dear Community,

Since initiating community testing last Friday, April 24, Aspen Valley Hospital has had less than 30 patients referred to our Respiratory Evaluation Tent for a COVID test by their primary care physician. This is very good news, for all of us, that the number of people in the community with at least minor symptoms is quite small. This means that we have collectively succeeded in our efforts to suppress the spread of the virus in our community through dutiful compliance with social distancing. Our partners at Pitkin County Public Health are working hard to build the team necessary to contain the virus among those who do test positive by using Quick read more or view full article a process called contact tracing. Testing and contact tracing are two important steps in the “Box It In” containment strategy we are now using to tamp down and manage the virus in our community.

AVH is playing an important role with the Box It In strategy, while the Public Health Department gradually and carefully lifts the restrictive public health orders over time. We were able to initiate broad testing, because:
  • We carefully preserved our limited personal protective equipment (PPE) and testing supplies.
  • New testing capacity has been created by private and hospital laboratories.
  • Our community suppressed the incidence of the virus to manageable levels.
  • Our staff is back to near full strength as well, without the higher levels of illness of a few weeks ago.
Containment at this phase continues to protect AVH from an overwhelming demand on our limited capacity as a small, community hospital.

Beginning today, May 1, AVH is pleased to gradually and responsibly resume some non-urgent and non-emergent surgeries and procedures, now that we can be assured of a safe environment for our patients and our staff. Our Primary Care and Orthopedic clinics will be able to start seeing more patients in-person, while our Otolaryngology/ENT and Ophthalmology clinics will require additional preparation to see patients, so their re-opening will happen later. At the same time, we still encourage and will provide telemedicine services that we have honed over the past weeks, along with other technological alternatives to in-person consultations.

We know that, while not urgent or emergent, many patients are in need of essential healthcare services, including in-person physician office visits, diagnostic services such as X-rays and laboratory studies, rehabilitative support, and surgical procedures. Our schedulers will be reaching out to patients on our waiting list, as we are able to accommodate their needs.

It will take time and continued patience for our community, and the nation, to find our way back to economic vitality and the lifestyles we so enjoyed before the virus. But we will get there, together. In the meantime, we are very thankful for the community’s overwhelming support of our frontline heroes at AVH, our community’s essential workers, our local families, and our businesses that are looking forward to brighter days.

We are proud to be your community hospital, and we are privileged to serve you in ways we never thought we would.
 
Sincerely,
Dave Ressler

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Spotlight: Virtual Visits at After-Hours Medical Care in Basalt

April 30, 2020
The advent of COVID-19 has resulted in a decline in visits to the After-Hours Medical Care clinic as well as Aspen Valley Hospital’s Emergency Department, and that worries Dr. Joshua Seymour, Medical Director at After-Hours Medical Care.
 
“I want people to know that we are open and here to treat community members for all their injuries and ailments,” Dr. Seymour said. “We have a strong core group of doctors and nurses on duty, and we’ve taken every precaution to ensure our patients’ safety.”
 
After-Hours Medical Care in Basalt is the only after hours care clinic between Aspen and Rifle, so it serves an important role for area residents. The clinic is open Quick read more or view full article from 3 – 11 p.m. Monday through Friday, and 8 a.m. – 5 p.m. on weekends.
 
One of the newest systems the clinic has incorporated to enhance safety is telemedicine, which connects doctors and patients via their phones or computers for an online—or virtual—face-to-face visit. Telemedicine supplements other systems and protocols that have been in effect at the clinic since February to protect both patients and providers from exposure to COVID-19.
 
“With our telemedicine practice up and running, we are able to serve some of our patients’ primary care needs and safely talk with people who are experiencing COVID-19 symptoms,” Dr. Seymour explained.
 
The addition of telemedicine is one of several changes at the clinic designed to keep patients and staff safe. When a patient drives up, they will find a sign on the door asking them to call the front desk where a staff member will ask them a few questions to help determine their needs and whether they may have been exposed to COVID-19. Patients are encouraged to call 970-544-1250 before driving to the clinic.
 
Most people are admitted after answering the questions and satisfying the staff that they are not likely to have been exposed to COVID-19. They are treated by doctors and nurses wearing the personal protective equipment (PPE) that the state of Colorado and Aspen Valley Hospital require. Surfaces are disinfected after each visit as well.
 
For patients who are afraid to visit a medical facility, or those who are beginning to experience COVID-19 symptoms, a telemedicine visit allows them to safely talk with a doctor to help decide what’s right for their care.
 
“It starts with a phone call so we can talk to the patient and figure out what’s best for them,” Dr. Seymour said. “That could be a visit to the clinic so we can examine you in person, a telemedicine visit or referral to higher level of care.”
 
The After-Hours Medical Care clinic provides a full range of medical care. It provides access to primary care services and specialists when needed. If a patient comes in with an injury or ailment that requires a specialist, the clinic can reach the on-call doctor from the various clinics, including OrthoAspen, Cardiology, Ophthalmology, Otolaryngology (Ear, Nose, Throat) and Women’s Health.

It can also be used to help patients with more serious COVID-19 symptoms arrange an examination in the Respiratory Evaluation Tent at Aspen Valley Hospital.
 
The important thing is for people to know that After-Hours Medical Care is there to meet all their needs, from sprains and cuts to more serious needs. The staff has taken every precaution to ensure everyone’s safety.
 
“We are open daily to help people for their injuries and ailments, and telemedicine gives us another tool to do that.” Dr. Seymour said. “We don’t want people to be home sick and too worried to talk with a doctor.”

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Q&A with AVH's First Telemedicine Patient

April 29, 2020
For Lucinda Westerlind, Aspen Valley Primary Care’s new telemedicine option worked out to be just what she needed. She and her family live on five acres in Rifle, while her primary care physician, Dr. Karen Locke, has her office in Basalt.
 
Lucinda is one of Aspen Valley Hospital’s first patients to utilize telemedicine services that recently came online at the five Center for Medical Care clinics, part of Aspen Valley Hospital’s network of care.
 
The five clinics — Aspen Valley Primary Care, OrthoAspen, Cardiology, Ophthalmology and Otolaryngology (Ear, Nose, Throat) — were planning to launch telemedicine services later this year, but as the COVID-19 crisis grew that timeline accelerated. Working with AVH’s IT department and Chief Transformation Officer Elaine Gerson, they were able Quick read more or view full article to implement more than three months ahead of schedule.
 
Lucinda Westerlind has graciously agreed to publicly share her experience with the new system, which is proving to be a vital tool in the effort to stem the spread of COVID-19.
 
Aspen Valley Hospital: How long has Dr. Locke been your doctor?
 
Lucinda Westerlind: I’ve been a patient with Dr. Locke ever since she and her husband came to town, so I was in their first batch. I used to live in Carbondale and work in Basalt, and now I live in Rifle, which works well for our family. But I like the care I receive from the Lockes (Karen and Kelly), so I’ve kept seeing them.
 
AVH: Why did you end up utilizing the new telemedicine option?
 
LW: I had heard that it would be something my doctors would be offering, so I asked for a televisit. I probably wouldn’t have sought it out if it weren’t for COVID-19.  If I can see the doctor and don’t have to risk being exposed, that’s a win-win.
 
AVH: Why did you need to see a doctor?
 
LW: I woke up last week I had a rash under my arm. It was bright red, and I thought it might shingles. I knew if I got an antiviral treatment quickly it would help reduce the symptoms, so I called the office and asked for a virtual visit. 
 
AVH: Our telemedicine option requires that you be enrolled in using the Aspen Valley Hospital’s Patient Portal, which is part of our electronic health record platform, and have the Healow app on your smart phone or computer. Did you have any trouble getting that set up?
 
LW: No, it wasn’t any trouble at all. The office had me fill out a short form so I could access the Patient Portal. I had not downloaded Healow yet, so they sent me very clear instructions and a link to the app.
 
AVH: Did you use your smart phone or home computer for the visit?
 
LW: I used my phone. We did just like it was a Zoom call, where you see the other person in real time.
 
AVH: How did it go?
 
LW: It went great. Dr. Locke gave me instructions about how to move the phone and point the camera so she could see what the rash looked like, which helped her identify what it was. It was much better than just talking on the phone.
 
AVH:  Was it shingles, as you suspected?
 
LW: Thankfully, no. Dr. Locke gave me clear parameters about how I should care for it and what changes to look for that would require me to call her back.
 
AVH: Would you consider using the telemedicine option again?
 
LW: Yes, I feel like I received good care. I felt secure in terms of privacy and medical recommendations. It was so ideal, because I didn’t have to leave the home and the doctor was able to prescribe care. I have even recommended it to my friends. If you need medical attention, it’s a great alternative to going into the doctor’s office.
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