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Life in Hood River since the Covid-19 Pandemic

When the Covid-19 Pandemic arrived in Oregon in March 2020, few really knew what to expect, yet all of us did our best to try to understand what implications it would have for the safety of our patients, residents, staff and clinicians and our communities, especially the most vulnerable. Looking back, the lock-down those first few months although necessary, was dramatically impactful. Within a few days all clinic visits were virtual or by phone, all elective surgeries and procedures were cancelled, all meetings and conferences were either canceled or forced onto virtual platforms that few of us had much experience with. Many clinical rotations had to be restricted and substituted with on-line learning and hospital-based experiences. However, our residency, hospital and health center persevered along with our community.

Medical Assistants at One Community Health are set up to register and screen patients for Covid. as resident Enrique Riddle evaluates a patient in the outside exam room.

Our community health center, One Community Health, quickly pivoted to getting the infrastructure on-line to offer Video and TeleHealth visits with our EPIC electronic medical record, computers, and workstations. All were upgraded to include video and audio capability, screening protocols and social distancing were instituted. While we did miss our non-clinical staff who were now working from home, our close knit family of caregivers and support staff looked out for each other. One Community Health became the leader in the region for offering Covid-19 testing, screening, and education. Drive through clinics in our parking lot were constructed pretty much within a week, infection control training became a priority and adequate PPE was acquired to ensure our staff was protected. Testing kits and solutions and later even on-site analysis became available that provided results with in 15-minutes. While the “curve” in Oregon was pretty much flattened by the end of April, Oregon was cautious in reopening and used a logical, scientific, and public health approach to reopening. Despite the pandemic, our Health Center was able to proceed to the completion of its new state of the art facility and our move was so well-orchestrated that we were only closed for on-site clinical visits for 2 days

Our hospital gradually returned to more normal, that includes return of most of our surgical and procedural admissions and our hospital census returned to normal. We did not experience a very large hospitalized case load of Covid-19, and we worked closely with our Health System in creating a centralized Covid unit at Providence Portland Medical Center that accepted our patients who required hospitalization from our community.

As the summer harvest began, our residents were involved in numerous outreach events and Covid screening clinics for our farm-working community in orchards, packing houses, schools and the communities during the cherry harvest in the Dalles and later pear harvest in our Hood River and Columbia River Gorge Communities.

We learned on to teacn on-line, and employed social distant teaching workshops when we could. Our residents, Community and Core Faculty are becoming masters of Microsoft teams and Zoom.

Lastly, we were proud to hold one of the few graduation ceremonies in the West! Our 2020 graduates, Carly Chambers and Kate Kleaveland deserved to be recognized. While we were disappointed to not be able to share it all together in our traditional local, the Rockford Grange featuring a catered taco bar and music by our unofficial band, the Funkship.

Instead, we pivoted to an on-line Zoom graduation with over 120 participants including our residents families from all over the country. We even had a fun “roast” video presented by our residents that was a hit and you can see it on the video page. We remain ready for what comes next, we are flexible, resilient and compassionate.

This Winter of 2020-2021 has been challenging but gratefully we seem to be past the peak of it as we enter February. Our nursing home, the Hood River Care Center where we care for over 90% of the residents experienced a wave of infections and many deaths. The staff and nurses worked tirelessly to provide compassionate care, still we lost over 16 of our patients. One Community Health moved to outdoor pods for screening and triage and drive through clinics. We remain hopeful as most clinicians and clinical staff have been vaccinated with either the Moderna or Pfizer vaccines. We have begun immunizing our community and are reaching out to our underserved Farmworking and Native communities.

During this past academic year, starting in the Fall of 2021 we saw a significant increase in our hospital census with the Delta Variant wave and then the subsequent outbreaks of the Omicron variants that followed in January 2022 when again our hospital census surged and the acuity of the patients in our critical access hospital increased. However, our nursing home population remained safe and few cases of staff were positive. Our community health center developed a strong triage system with outdoor pods and received help from the Oregon Health Authority with personnel as well to help with the clinical burden. As more effective anti-viral medications became available this spring we remained on the cutting edge of providing the best health care to our patients and community. Our Population health teams along with our local health department continued to immunize and provide boosters. We look forward to the new multi-variant vaccines we are soon to be receiving this September 2022. During this past year we have spent our journal clubs reading and discussing at least one Covid related article every month.

Covid has not stopped us.

it just taught us to think, teach, care, and act differently.

We remain ready for comes next, we are flexible, resilient and compassionate

We know we will get through this.