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As the COVID-19 vaccine distribution process continues to evolve, it is important to me that you continue to receive accurate and up-to-date information.  

Please know that while St. Charles is helping in every way we can to distribute vaccines to our Central Oregon communities – we are partners in the process and are only one piece of a much larger puzzle.  

Vaccine distribution starts at the national level. The federal government decides how many vaccines each state will receive each week. In Oregon, we have been receiving about 100,000 doses per week of first and second doses for the entire state.  

From there, the Oregon Health Authority decides how many vaccines to send to approved vaccine distribution sites throughout the state. Those sites include county health departments, hospitals, primary care clinics, pharmacies and other health care providers who have gone through a state application process.

At the local level, we are following the state’s guidance on groups of people who are eligible to receive the vaccine. Our three Central Oregon counties were able to quickly vaccinate the majority of those in the first phases and moved ahead of the state’s schedule for a period of time. Now that we are receiving a smaller number of first doses from the state, we have had to slow down our distribution. This week, Deschutes County received only 1,200 first doses and made the decision to distribute those doses mostly to primary care providers for administration to their patients in the senior population who are eligible. Jefferson and Crook counties also received a small number of doses that they are handling through their clinics.

It remains our hope that we will receive another large allotment of vaccine so we can continue our large-scale vaccination efforts at the Deschutes County Fair & Expo Center in the coming weeks. The Oregon Health Authority is working on a new vaccine allocation plan and we expect to receive those details early next week.  

For now, the best thing you can do is register at https://vaccine.deschutes.org to be notified when you are eligible and to receive regular updates.  

We greatly appreciate your patience as we continue to do our best to vaccinate our population as quickly as possible.  

Sincerely,  

Joe

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BEND, Ore. — The Oregon Health Authority (OHA) has notified St. Charles Redmond that all COVID-19 tests in the previous 14 days related to the Redmond outbreak resulted negative, prompting the agency to lift the COVID-19 “outbreak” status of the hospital.

The health system’s investigation of the outbreak, which was traced to 28 people including 25 caregivers, revealed the source was a COVID-positive patient. 

Though the outbreak has resolved, many of the changes instituted at the Redmond hospital remain in effect, including:

  • Increasing air exchanges to at least six times per hour, and even more frequently in patient rooms 
  • Increasing air filtration to more than the CDC recommendation (+90% filtration at .3 microns) 
  • Instructing caregivers who are within an arm’s length of a patient with respiratory symptoms for more than 15 minutes to use N95 respirators and eye protection throughout their shift while the outbreak is ongoing 
  • Adding hand sanitizer and cleaning supplies to more locations throughout the facility 
  • Asking caregivers to eat in the cafeteria or on the outside patio rather than in break rooms to create a larger space between caregivers when their masks are down
  • Reducing maximum capacity in all break rooms and conference rooms to ensure physical distancing can be maintained 

Starting Wednesday, visitation restrictions will be lifted to allow one visitor per patient, per day.

“I have been impressed by the commitment and resilience of the Redmond community, caregivers, patients and their families to come together and comply with enhanced restrictions so we could resolve the outbreak as quickly as possible,” said St. Charles Redmond Chief Nursing Officer James Reedy. “We have learned lessons that we will continue to practice.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,500 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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Rachel North was on the other side of the parking lot lane at the Deschutes County Fair & Expo Center when an elderly woman started shouting questions at her.

“How am I supposed to get in this thing?” the mobility-challenged woman barked as she tried to maneuver into a golf cart. “I can’t get in this thing. I need a wheelchair!”

Her tone was either impatient and mean or simply firm and direct, probably depending on the disposition of the person to whom it was directed. In North, she had found the perfect recipient.

“We’ve got wheelchairs,” North said gently, with a big smile on her face. “You get back in the car and wait, and I’ll make sure we get a wheelchair out here to you.”

As she pulled away from the woman’s car, North laughed good-naturedly at the exchange. “I work for the Transportation Security Administration (in the Redmond Airport), and that can be a little rough, you know?” she said. “I’ve been seasoned. I’ve got days and days of stories. This is a piece of cake for me.”

It was a Saturday morning at the fairgrounds, and hundreds of people age 75 and older were arriving to receive their first dose of the COVID-19 vaccine. The weather was cold and unusually blustery, and patchy snow and ice on the ground made access to the large-scale vaccine site inside — operated by St. Charles and Deschutes County, with help from the Oregon National Guard — particularly tricky.

That’s where North and her fellow golf-cart drivers came in. Their mission was simple: Crisscross the parking lot looking for cars with their hazard lights blinking. That was a sign that someone inside (or standing nearby) needed assistance.

“Sometimes,” she said, “they might be waving their arms or honking their horn.”

North is just one of “several hundred” volunteers who have helped make the fairgrounds vaccination site a success over the past few weeks, said Trevor Janeck, a talent acquisition manager at St. Charles who is helping to oversee the volunteer effort. In addition to ferrying people from the parking lot to the door, volunteers are greeting people as they enter, registering patients and helping guide them through the process, among other jobs.

Their efforts have not only been a vital part of the operation so far, they’ve been inspiring, Janeck said.

“The response from the community on this has been incredible,” he said. “Everyone who has volunteered has been so kind and so willing to do whatever it takes to make this place work as smoothly and efficiently as possible. And almost every one of them says more or less the same thing: ‘It’s just so important that we get this vaccine to people, and I want to help however I can.’”

More than 1,000 people have signed up to volunteer at the St. Charles website and at Deschutes County’s website, which is more than the fairgrounds site can even use.

“We’ve had to turn people away,” Janeck said. “It’s just been overwhelming.”

One of those volunteers is Teague Hatfield, owner of the Birkenstock store in downtown Bend. On a recent weekend, he was stationed just outside the clinic, greeting everyone who walked by and funneling people toward the check-in area. He said he signed up after a co-worker volunteered and encouraged him to do so.

“I came out a couple days ago and, honestly, it was just a ball,” he said. “People were in good spirits and it felt like it was helpful, so I came back to do it again.”

Hatfield said he was impressed by the operation and planned to take a shift per week as long as volunteers are needed.

“We’ve all been sitting around waiting for something to happen, so this is exciting that it is happening,” he said. “And being out here, like 99.9% of the people have been friendly and appreciative and the whole bit. This is what I’ve done my whole life, just talked to people.”

On the other side of the clinic, Wendy Worstell stood near in the hallway between the vaccination area and the recovery room, where patients are asked to wait for 15 minutes to make sure they don’t have a reaction. Her job? To make sure no one wandered through without getting their shot.

Worstell is a retired registered nurse with a daughter who teaches for Bend-La Pine Schools. She is currently splitting time between Central Oregon and Eugene and said she came to the fairgrounds to do whatever she could to help.

“I just think it’s hugely important that when we have a pandemic like this, that whoever can step up steps up and helps get the vaccines out there,” she said. “This has been wonderful. I’m so impressed.”

Back out in the parking lot, North dropped off one woman at the front door and started backing her golf cart up to make another run into the sea of blinking hazard lights. With her knit hat pulled down to her eyebrows and her mask up over her nose, she looked like she could’ve been warmer at home. But that really wasn’t an option, she said.

“I volunteer for the Assistance League of Bend. I volunteer for the Nature Center in Sunriver. It’s what you do when you live here,” she said. “I just had the day off and I could sit inside and watch Netflix or I could come out and do a nice thing for people.”

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Two days of work. One day off. Then two night shifts, followed by four days off. And repeat.

How you view that kind of work schedule depends on your natural disposition, your approach to life, your domestic situation and other personal circumstances. Some may find it appealing, while others may see it as incompatible with a well-balanced existence.

Either way, that kind of schedule is known as rapidly rotating shift work, and according to Dr. Dave Dedrick, it tends to be hard on human beings’ internal clock.

“Some people would look at that and say, ‘Well, the majority of that time, they’re on days,’” said Dedrick, clinical division director – medical specialties for St. Charles Medical Group. “But those two nights where the work happens outside our normal circadian rhythm puts a tax on the body, because when we’re not in line with our circadian rhythm, our body doesn’t know what to do.”

Dedrick explained the circadian rhythm: “All of these things run like a beautiful orchestra, if you will, and you’re relying on the timing of one part of your body doing something in synchrony with another part,” he said. “The circadian rhythm is the drum major that helps organize all of that, and when it gets out of sync, the wheels come off the cart.”

About three years ago, Dedrick worked with Bend Police to study how the department’s shift schedule affected officers’ sleep patterns and to screen them for sleep apnea. That work was part of a larger effort to improve the health of the unit – an effort that resulted in the introduction of a wellness program that includes yoga practice, mindfulness training and peer support.

Now, he’s doing similar work with the Deschutes County Sheriff’s Office, whose officers work a standard schedule of – you guessed it – two days on, one day off, then two night shifts, followed by four days off. The county reached out to Dedrick last fall as part of its Health of the Force Initiative, which aims to provide tools and resources for deputies to care for their physical, mental and spiritual well-being, said Sheriff L. Shane Nelson.

“The law enforcement profession is stressful on our deputy sheriffs, and their families,” Nelson said. “I work with great teammates. We want to do all we can to improve and take care of them and their families in order to ensure successful careers in providing excellent public safety and customer service.”

Dedrick’s work with the Sheriff’s office will happen through an investigator-initiated clinical trial designed to study how rapidly rotating shift work affects conditions that can lead to cardiovascular morbidity and mortality, such as high blood pressure, high blood sugar and cholesterol levels, sleep apnea and excess body fat around the waist.

“We don’t think of police officers as being a marginalized population, but when it comes to health outcomes, they are very marginalized,” Dedrick said. “They really do very poorly. Part of it is the stress, and part of it is the sleep.”

Dedrick’s trial with the Sheriff’s office is unique in that, thanks to the officers’ schedules, each of the 19 people involved can serve as their own control. Here’s how it will work:

  • First, St. Charles collected baseline health data on each officer while they were working the rapidly rotating shift schedule.
  • In mid-January, about half of those 19 officers started working all days, and the rest started working all nights. They will do that for about two months and then collect the same baseline data.
  • After two months, the two groups will trade shifts and collect data again.
  • Near the end of the trial, Dedrick and two partners – Dr. Mark Backus of Cascade Internal Medicine Partners and Dr. Richard MacDonnell of MyMD Personal Medicine – will analyze the data and then hand it over to a statistician to “grind the numbers,” Dedrick said.

St. Charles’ Research Department is setting protocol, obtaining regulatory approvals, coordinating with patients and generally overseeing the trial to ensure the data is completely anonymous and to eliminate any possibility of investigator bias by “letting the data speak for itself,” said Noura Sall, research manager for the health system.

“Often for our trials, the recipe is written by someone somewhere else who works in a particular industry and comes to us and says, ‘Here it is, please follow it to the letter,’” she said. “This time, one of our physicians has an idea and we’re the ones helping to write that recipe. It’s fun and it’s exciting.”

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Every single person reading this, I’m sure, is ready to be done with this pandemic.

I know I am. There is light at the end of the tunnel, it’s true. At the same time, we are more than a year into a reality altered by COVID-19, and I’m tired of it. I’m sure you are, too.

As always, though, I’m looking for silver linings. And there’s been a silver lining happening at the Deschutes County Fair  & Expo Center over the past month.

That’s where, in collaboration with Deschutes County Health Services and the Oregon National Guard, we’re administering doses of COVID-19 vaccine to as many Central Oregonians as we possibly can, based on available supply and the state’s sequencing plan. We believe we’ve completed vaccinating most of the Oregon Health Authority's Phase 1A and group 1 of Phase 1B, which cover local health care workers, first responders, educators, childcare providers, corrections officers and staff at long-term care facilities, among others. Since Jan. 20, we’ve administered vaccines to more than 30,000 people, including many seniors.

And we haven’t wasted a single dose. If you’ve heard otherwise, you’ve heard a false rumor. We haven’t wasted a dose, and we will not waste a dose. 

Vaccinating thousands of people is a very good thing, of course, but that’s not necessarily the silver lining I’m talking about.

The silver lining I see at the fairgrounds is one powered by communication, coordination and collaboration. I see an organized and efficient operation stood up in days by a number of smart people who are dedicated to working tirelessly for the betterment of Central Oregon. I know it took many hours of thinking and talking and planning by folks who don’t work together regularly, but who came together to bring this vaccination site to life.

Those people built online schedules and sent out invitations to sign up. They printed and hung signs and stuck tape on the floor to ensure smooth flow. They set up a registration process and a respite room. They created a temporary pharmacy out of thin air. They recruited experienced vaccinators to administer the vaccines.

We have doctors and nurses and pharmacists and patient access pros out at the fairgrounds because they know how important this is and they want to help. We have executives volunteering to spend weekend days there, just to do whatever is needed at any given moment. We have hundreds of people from across our communities showing up to volunteer, simply because they believe it is the right thing to do.

We are not the only organization involved in this effort, of course — not by a long shot. Many local entities have played a part in this process, and if I tried to thank them all, I would inevitably miss one. So, for now, I’ll just offer up an enthusiastic “thanks!” to Deschutes County for its partnership in making the fairgrounds vaccination site a success and to the Oregon National Guard for sending troops to help out. We are fortunate to have partners who are as committed to getting this vaccine into arms and ending this pandemic as we are here at St. Charles.

All of this makes me smile. And I’m not the only one. Over and over again, as educators and others flocked to the fairgrounds in recent weeks, we heard positive feedback about the operation: Easy. Fast. Professional. Safe. “It didn’t even hurt!” Even when some folks had to wait in line out in the cold, never did we hear anyone complain. The place has been buzzing with positivity.

That’s a testament to the teams that made it happen and the time they’ve put into it. Again, I want to express my sincere gratitude to each and every one of them.

Stay safe out there.

Sincerely,
Joe

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Grand Rounds - Feb. 5, 2021
"The Many Faces of High Risk Influenza: Best Practices for Recognition and Treatment"

Speaker: William A. Fischer II, MD. Associate Professor of Medicine Division of Pulmonary and Critical Care Medicine Institute for Global Health and Infectious Diseases, The University of North Carolina School of Medicine, Chapel Hill, NC

Access the recording

Objectives

  1. Recognize appropriate candidates for influenza treatment or prophylaxis based on guideline-recommended characteristics, without unnecessary testing.
  2. Individualize influenza treatment and prophylaxis plans for patients who are at risk for influenza-related complications based on the latest evidence.

Accreditation: Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Paradigm Medical Communications, LLC designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is supported by an educational grant from Genentech, a member of the Roche Group.

Target Audience: This activity has been designed to address the educational needs of clinicians involved in the care of patients with or at risk for influenza, including those specializing in internal medicine, family medicine, hospital medicine, gynecology, emergency medicine, and critical care. It may also benefit other clinicians who are interested or involved in the care of patients with or at risk for influenza.

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at 541-706-4680, [email protected]. For CME or Clerkship questions, contact Sheila Jordan, MMGT, CHCP, Manager of Continuing Medical Education at 541-706-6780, [email protected].

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This week, I’ve got good news and bad news for you related to our ongoing COVID-19 vaccine rollout.

The good news

Thanks to an incredible effort including St. Charles, Deschutes, Crook and Jefferson counties and the Oregon National Guard, more than 31,000 people in the tri-county area have already received the first dose of the COVID-19 vaccine. That group includes health care workers, educators, first responders and more.

On Jan. 25, we opened up vaccinations to all Central Oregonians age 75 and older, which was ahead of the Oregon Health Authority’s sequencing schedule. We were able to do this because we had already vaccinated the vast majority of those who fall into the first phases of the plan. By doing so, we were able to make our way through a large allotment of vaccine – more than 10,000 doses last week.

The bad news

The state, which controls distribution of the COVID-19 vaccine, is not sending us more first-doses this week. Instead, OHA is redirecting most doses to health systems in the Portland area that are continuing to vaccinate those in the first phases. We are unsure when new first doses will be allocated to us, but we expect this situation could continue for the next several weeks.

This is disappointing, but we feel fortunate that we have been able to get such a great start on vaccinating our most vulnerable residents. It’s also important to remember that we’re truly all battling this pandemic together, because the virus doesn’t differentiate between Central Oregon and the Willamette Valley. It doesn’t recognize county borders or turn around rather than brave snowy mountain passes. If COVID-19 is spreading in Portland, we will be affected. We need as many people as possible vaccinated, no matter where they live.

For those of you who have received your first dose, please know that we have been assured by the state that we will receive second doses of the vaccine. Our second dose clinics will continue as planned.

When we opened up vaccines to a larger population it caused some confusion and a whole flood of questions coming our way last week. In the first 24 hours, we received more than 2,500 voicemail messages on our COVID-19 vaccine scheduling hotline and it took a team of people several days to get through them. We apologize to those of you who had to wait for answers, but we are pleased to say that all those who called either received their vaccine or were contacted with more information thanks to an incredible team effort. 

While I know navigating the system has been difficult for some, we have also been overwhelmed with positive messages from those who have received their vaccine. You can watch one of our 91-year-old patients in this video and hear first-hand about the experience.  

Many thanks to those of you who took the time to write and share your feelings about receiving your first dose. It is heart-warming to hear these stories and know that all this very hard work is making a difference in our COVID-19 fight.  

Sincerely,

Joe

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Grand Rounds - Jan. 29, 2021
"COVID-19 Vaccines"

Speaker: Moshe Arditi, MD. Academic Director, Division of Infectious Diseases in the Department of Medicine Executive; Vice Chair for Research, Pediatrics Cedars, Sinai Medical Center; Professor of Pediatrics, David Geffen School of Medicine at UCLA

Objectives

  1. Be familiar with the current COVID-19 vaccines
  2. Be familiar with the efficacy and safety data with the COVID-19 vaccines
  3. Be familiar with the current prioritization for vaccine delivery

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at 541-706-4680, [email protected]. For CME or Clerkship questions, contact Sheila Jordan, MMGT, CHCP, Manager of Continuing Medical Education at 541-706-6780, [email protected].

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Shelly Handkins

Shelly joined the board in 2021 after 29 years with Providence Health System, where she worked as Chief Financial Officer of Providence Health Plan, Chief Financial Officer of the health system’s Oregon region and Group Vice President of Payor Contracting for more than 50 Providence hospitals, all employed physicians and ambulatory services across five states.

Handkins is now retired, and in addition to the St. Charles board, she also serves on the board of Lifeworks Northwest, a Portland-based network of behavioral health care providers.

Reason for service: “I have a deep passion for working to deploy affordable, high-quality health care in a population health-based model in order to improve the long-term health of our communities.”

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Ann E. Rhoads, CPA

Board Chair

Ann joined the board in 2021 after 33 years as an audit professional with PricewaterhouseCoopers, LLP, including 16 years as an audit partner. She is also on the board for Bend’s Tower Theatre Foundation.

Rhoads has previously served on two other St. Charles committees: the audit and compliance committee and the investment sub-committee.

Reason for service: “I believe access to health care is fundamental to a thriving community and I hope to contribute to our community through St. Charles board service.”