Nov. 24, 2020

During one of our St. Charles COVID-19 Incident Command calls last week, the dire situation we face became increasingly clear. On that day at that time, our Bend hospital was the only hospital in the state with any available ICU beds.  

Suddenly, the refrain I’ve been hearing from colleagues throughout the nation hit incredibly close to home. Our health care workers can no longer be considered the front line of this fight. We are now your last resort.  

You are on the front line.  

Your actions and choices can make the difference for yourself, your families and your loved ones. Because we simply may not have the beds and staff to care for you if we don’t stop the spread of the virus now. 

Please watch this latest message and share it with your friends and family. 

Your actions are more important than ever as COVID-19 is more prevalent in Central Oregon than at any other time during this pandemic. 

You can make a difference by choosing not to gather for Thanksgiving this year. Follow the advice and ideas we have received from several of our community members and have a virtual meal – share recipes with your loved ones and cook together from a distance. Make a new tradition by taking a piece of leftover pumpkin pie on a hike and eating it at the end of your climb. Take time to remember how much we still have to be grateful for – even in a year that has been fraught with challenges.  

More than anything, we need you to stay safe, stay home, wash your hands and if you do need to go out, wear a mask.  

And know that hope is on the horizon. Statewide, our hospitals are working on plans to distribute the first COVID-19 vaccines to health care workers and first responders in the coming weeks. We are starting to see the light at the end of this very long fight.  

Help us stay strong through the finish line.  

Sincerely,  

Joe  

Nov. 10, 2020

I know you are really tired of talking about COVID-19.  

Trust me, so am I.  

But what’s happening right now is highly concerning. We have 15 patients hospitalized with COVID-19 today, and over the weekend at times the number matched our previous record.  

It appears we have officially hit a third wave. But unlike the last two, we never reset back to zero hospitalized patients. Our number of inpatients has held steady in recent weeks until last Friday when it essentially doubled overnight.

We need to act now 

With the upcoming holidays, we are concerned that if people don’t act NOW to change their behavior our hospital system could become overwhelmed. As of today, we have the beds and the staff to take care of you, but your actions make a difference in helping to keep it that way.  

The virus is clearly still here and our choices are making a difference in how the disease finds places to thrive. We are seeing a fear-fatigue cycle of behavior. When we feel more afraid that the virus is circulating broadly in our communities, we pull back, isolate more and are better about wearing our masks.  

Sooner or later, fatigue sets in and we relax our standards, spend time with more people outside our normal bubbles and maybe don’t remember to wash our hands as frequently. It is becoming predictable. And while we are all exhausted by this pandemic, we know these next few months will be a crucial time to stay strong.  

Statewide, the highest number of cases continues to be in people ages 20-29. We also know from the Oregon Health Authority that most cases can be traced back to small, indoor social gatherings.

While we all know how difficult it is to remain isolated – especially now that the weather is turning colder and it’s harder to spend time together outdoors – it is still critically important.  

We have some advice as you start to make plans for the holidays:

• Keep it small – indoor gatherings should be immediate family only

• Keep it safe – if you choose to gather with those outside your immediate family, ask everyone to isolate for 14 days before the holiday and not to attend if they are feeling sick

• Make it special – use this time to create new traditions (hiking or snowshoeing instead of a big meal, making porch deliveries to those in need) and focus on the positives (no giant grocery bills or piles of dishes)

We understand that asking people not to gather for their traditional holiday celebrations is really hard. But we also know that Central Oregonians are strong. We will get through this by pulling together.

Please watch the latest from our #staystrongCO campaign featuring many of our local St. Charles providers to better understand what you can do to stay safe. We also encourage you to share these messages with your friends and family.

And if you’d like to know more about St. Charles’ ongoing response to COVID-19 along with other health system updates, we invite you to participate in our Town Hall event coming up on Nov. 19. You can register here. 

Sincerely,

Joe

Last fall, St. Charles leaders held in-person Town Hall events in La Pine, Madras, Prineville and Redmond. We served breakfast and encouraged community members to join us as we shared the latest St. Charles news and opened it up for conversation, questions and dialogue.

As always, it was fun and inspiring to get out and meet people – to hear your thoughts about your health care first-hand and to be able to share our story.

This year, of course, things look a little different as in-person gatherings are highly discouraged due to the pandemic.

While COVID-19 continues to impact the way we do things, we still believe in the importance of community conversations and are using the lessons we’ve learned from the pandemic to try something new.

It is our hope that you will join us.

At 5:30 p.m. on Nov. 19, we will hold a virtual town hall. The beginning of the program will include a brief presentation from me, Dr. Jeff Absalon, our chief physician executive, and Jenn Welander, our chief financial officer. We will review the current “state of St. Charles,” along with our COVID-19 response and recovery and some general health system financial information.

Then, we’ll move into several virtual break-out rooms. You will have the chance to register in advance and decide which community you are most interested in learning more about. Sessions in each break-out room will be led by St. Charles caregivers from Bend, Madras, La Pine, Redmond, Prineville and Sisters with time for questions and discussion.

We want to hear how you are doing, what you need from your local health care system and how we can best serve you. We also want you to understand the challenges the health care industry faces and how the pandemic has increased some of those challenges.

Please register for this event today and encourage your friends and family to join us as well.

We are looking forward to a fun, informative and community-building night.

Sincerely,
Joe

Oct. 20, 2020

Our opinion: This election, vote for healthy communities

Last week in Oregon, ballots were mailed to our homes, providing registered voters with an opportunity to have their voices heard on many important issues.

St. Charles Health System is endorsing two of those issues that we think are in alignment with our vision of “creating America’s healthiest community, together,” and I would like to share with you our reasons why.

Measure 108: Tobacco and e-cigarette tax increase for health programs 

We support Measure 108 because research has shown us that the single best way to reduce vaping and smoking is to increase the cost. If vapes and tobacco products are taxed more and thus cost more, we expect fewer people will use them, saving lives. 

As it stands now, Oregon doesn’t tax nicotine vapes one penny and has some of the lowest tobacco taxes in the country. We find this concerning since youth vaping in our state has increased 80 percent in the past two years alone. Tobacco companies are targeting kids with candy-flavored vapes that taste like gummy bears or cotton candy and are selling them for as little as 99 cents. According to the Journal of American Medicine, young people who vape are nearly three times more likely to start smoking cigarettes. 

Measure 108 was also written so that the dollars raised can only be used for tobacco cessation and prevention programs and to fund the Oregon Health Plan, which serves one in four Oregonians (including more than 400,000 children in our state), and nearly 56,000 people in Central Oregon. Measure 108 will protect this vital coverage, ensuring people continue getting the care they need, when they need it.

Measure 9-135: Bonds for traffic flow, east-west connections, neighborhood safety improvements

As a health care organization, we recognize that the path to good health starts outside of the walls of our hospitals and clinics. It involves not just the work of St. Charles, but also our cities, our schools, our nonprofit partners and our many wonderful local businesses coming together to ensure people who live here are safe and well-supported.

We support Measure 9-135 because it would allow the city of Bend to issue $190 million in bonds and invest that money in an increasingly stressed infrastructure. Passing the measure would help create safer street crossings and build a new network of sidewalks, bike lanes and bus pull-outs. These improvements would make it safer for our kids to get to school, for pedestrians and cyclists to get around and make navigating town easier for drivers.

Passing Measure 9-135 would also help fix dozens of intersections to reduce bottlenecks, build a bridge at Reed Market and upgrade traffic signals to improve traffic flow. It would improve east-west connectivity by building new links between existing roads, ensuring we can all get across town safely and smoothly however we travel.

As Bend grows, we think it’s important to protect our quality of life and our burgeoning economy. We need to preserve the vitality of our neighborhoods, improve the safety of our streets and help our local businesses thrive. For all of these reasons, we’d like to see this measure pass.

Make your voice heard

Whatever your opinion on these and other issues, I encourage you to vote and make your voice heard. As Americans, it’s one of our great privileges and responsibilities.

Remember, the last day to safely return your ballot by mail is Oct. 27. 

Be well,

Joe

Stay strong Central Oregon 

In the past seven months, 22 people have died in Central Oregon because of the COVID-19 pandemic. 

Since March, 1,598 Central Oregonians have been struck ill with this virus – many of them have had significant health impacts and some have had a protracted illness with long-lasting symptoms. 

So far, 150 people have been discharged from a St. Charles hospital after needing care related to COVID-19. Of those, 31 have spent time in the ICU. The average length of stay for an ICU patient with COVID-19 is more than 15 days. 

This past week, we had another 97 positive COVID-19 cases in Central Oregon. That number is higher than it has been since early August. 

And yesterday marked the highest number of positive COVID-19 cases in the state since the pandemic began. 

All of this is to say that COVID-19 continues to be a real and very serious threat. Our numbers are up, which translates to people needing costly intensive care that could result in a lifetime of health-related struggles. 

Families throughout our region are mourning the loved ones they have lost. 

No matter how fatigued you may be by the restrictions in place and changes to our lives, we can’t give up. In fact, now is the time to continue staying strong and fighting even harder to protect ourselves and our loved ones. 

Several medical providers in our Central Oregon communities have messages to share with you about why all of this remains important. Please take a moment to listen to Dr. Natalie Good from Prineville, Dr. Alwin Borgmann of La Pine and Dr. Shiloh Tippet of Madras.

They understand that COVID-19 is serious. And they care about your health and the health of our communities. I hope you will listen to them. That you will continue to wash your hands, wear a mask, physically distance yourself from others and stay home whenever possible. 

I also hope you will take the advice of our medical professionals and be sure to get your flu shot as soon as possible. Dr. Sanaz Askari shares why this year the flu shot is more important than ever. 

Stay strong Central Oregon. Together, we will get through this. 

Sincerely, 

Joe 

Watching the many wildfires burning in Oregon over the past week has been terrifying, heartbreaking and exhausting – both physically and emotionally. Like you, I understand the concerns about the hazardous air quality and I’m worried about all those who have been displaced by this horrific natural disaster.

On top of all of that, we are still focusing on responding to the COVID-19 pandemic and are now preparing for our annual flu season. It’s a lot, but I want you to know that St. Charles is here for you and continuing to provide the community with information, resources and the care you need.

The good news, on the COVID-19 front, is that our hospitalization numbers remain low and because we have worked together in our communities to contain the spread of the virus many of our kids are able to return to school sooner than expected. We need to keep this up by continuing to wear masks, wash hands and physically distance. For some of our team’s latest understanding of the COVID-19 virus, please watch this video featuring Dr. Bob Pfister.

Wildfires and smoke

Now that we have wildfires causing people to seek emergency shelter across the state, we are concerned the virus could find new, vulnerable populations in which to spread. It is incredibly important that we do our best to support those in need during this time.

Here are several resources for ways to help put together by the Central Oregon Emergency Information Network:

• Red Cross Cascades Region: 
  • Donations can be made to your local chapter at redcross.org/donate and to register to volunteer, redcross.org/volunteer.
• 2020 Community Rebuilding Fund, established by Governor Kate Brown, is a partnership between the Meyer Memorial Trust, the Ford Family Foundation, and the Oregon Community Foundation:
  • Donations can be made for long-term recovery: https://oregoncf.org/oregon-wildfire-relief-recovery/community-rebuilding-fund/ and immediate relief: https://oregoncf.org/oregon-wildfire-relief-recovery/donate-to-support-wildfire-emergency-relief/.
• Oregon Office of Emergency Management:
  • The Disaster Volunteer and Donations Portal is a hub for signing up to volunteer as well as making a financial or material donation. https://oregonrecovers.communityos.org/
• Salvation Army Cascades’ Division Emergency Disaster Services:
  • Teams have been activated, providing meals and resources across nine counties in Oregon, donations and volunteers are needed.
• Wildland Firefighter Foundation:
  • Where compassion spreads like wildfire, raising money to provide financial support to families of those who died or were injured in the line of duty while fighting wildland fires.

In addition to these many resources, the Oregon Association of Hospitals and Health Systems has established a fund to specifically help the more than 100 health care workers in the state who have lost their homes. You can learn more about this effort here.

For those of you concerned about the health effects of exposure to the wildfire smoke, please watch this video featuring Dr. Nathan Ansbaugh, one of our emergency physicians. The main takeaway is to stay indoors if you are at high risk of having lung issues. We are all hoping for clearer skies going into this weekend.

The flu

While many of the things affecting our lives are outside of our control – a pandemic, wildfires and smoke – there is one action we can proactively take to help ourselves over the next few months and it’s actually quite simple.

Please, get your flu shot. 

If you are a person who doesn’t normally think about getting a flu shot, this is the year to make it a priority. You will protect yourself and your loved ones from the flu and you’ll be helping our team at St. Charles by not inundating our hospital beds with flu patients.

Thank you for doing your part to keep all of us as healthy as possible.

Sincerely,

Joe

An inside look at COVID-19 in our Intensive Care Unit

Many people have asked us what it’s like right now for our caregivers working on the front lines with COVID-19 patients. 

In this video, we give you an inside look at what goes on in the St. Charles Bend ICU when a patient with COVID-19 needs critical care. Even with the additional safety equipment, the stress and the fear of fighting this pandemic, our caregivers are proud to be here to serve our community and care for you and your loved ones.

Please take two minutes to watch the video and remember that you can help us by taking every precaution to avoid contracting and spreading COVID-19.

Our Central Oregon numbers are fluctuating – both inside and outside of our hospitals. But the trends continue to show that interventions like masking, physically distancing and practicing good hand hygiene do make a difference. Thank you to those of you who are taking COVID-19 seriously. Your actions are saving lives. 

Your safety, our priority

Throughout our hospitals and clinics, St. Charles has put many safety precautions into place in order to protect you and our health care workforce. 

Protecting the safety of our caregivers has been our top priority since the beginning of the pandemic. We care about our team’s health and safety and we know that keeping them well is critical to ensuring they are able to care for you. 

Still, this is a highly contagious disease, and we have had 17 St. Charles caregivers test positive for COVID-19 since the pandemic began in March. None of these cases have been confirmed as due to a workplace exposure and many have been related to known community exposures.

With more than 4,500 employees, this was to be expected. But I want you to know that our St. Charles caregivers are all required to adhere to our universal masking policy and to immediately report any COVID-19 symptoms to our Caregiver Health team. If they have symptoms, they are tested and not allowed to return to work until it is safe for them to do so. We follow testing and work restriction guidelines for our staff from the Centers for Disease Control and Prevention and the Oregon Health Authority. 

We take our responsibility to protect them and you very seriously. 

That’s why you will continue to experience screening questions at the entrances to our facilities. You'll notice plexiglass dividers protecting you and our caregivers from each other. And it's why this week we expanded and clarified our universal masking policy to ensure patients and visitors understand how it applies to them. Patients are required to wear a mask when inside any of our facilities unless they are asked to remove it by a health care provider. 

We greatly appreciate your help in adhering to our policies as we all continue to fight COVID-19 together.

Sincerely,

Joe

These are interesting times here at St. Charles, and in the world of health care as a whole. We're facing historic upheaval in an industry that was already fundamentally broken and needs to change in a way that benefits our patients.

At the same time, however, I see incredible opportunity as a result of COVID-19, which has forced health systems like ours to rethink and transform the way we do things in a matter of days or weeks. Without the push of a pandemic, those kinds of changes might have otherwise taken months or even years.

Because those changes have come so rapidly over the past few months, now is an excellent time to analyze what we've done, how it has worked and how we can sustain the progress we've made.

That's where you, our community, comes in.

In last month's St. Charles newsletter, we rolled out a new survey focused on innovation in health care and I'm happy to announce that nearly 1,100 people have responded. If you were one of them, please accept my sincere thanks.

In the survey, we asked a handful of questions about our current health care system and we solicited ideas for improvement. We are still working through the responses, but we're already seeing some trends in the feedback that will help guide the way we think about the services we provide as we go forward.

For example, we know that about two-thirds of respondents have already had a virtual visit with St. Charles in the past six months. And generally speaking, they liked the convenience and safety of meeting with a physician by email, phone or video. More than half said they would consider continuing virtual visits even after in-person visits are an option again. Said one respondent: "It's about time we're doing this!"

Not everyone agrees, of course. There are many of you who believe a virtual visit can never provide the same kind of experience you get in a face-to-face meeting with your physician. Understandably so.

This is just a tiny sliver of the data we'll be able to glean from our innovation survey, and I look forward to sharing more about the results in the future. In the meantime, we're meeting with virtual focus groups made up of survey respondents to have more in-depth discussions about the future of health care in Central Oregon.

Those are exactly the kinds of discussions that I and other leaders at St. Charles love to have. We are in this field for a reason. We are passionate about providing people with the care they need in the most efficient and affordable way possible. And each and every one of us is committed to making St. Charles a better place to receive care.

Sometimes, though, we get so caught up in the day-to-day operations of the health system, we don't have as much time as we would like to think about the future from a big-picture perspective.

I'll bet at least some of you out there can relate.

So as we move forward through this process, I'm choosing to be grateful that, for all its negatives, COVID-19 has brought transformation to St. Charles. We're excited to see where it goes from here.

Sincerely,
Joe

It’s been an interesting few weeks of ups and downs on the COVID-19 front. Our hospitalizations have stabilized somewhat from a high of 11 earlier this month, but positive test results in all three of our counties continue to climb.  

Sadly, we also experienced the first two deaths of Central Oregon residents from the virus, one in Crook County and one in Deschutes County. Our thoughts go out to the families and friends of these individuals and all those suffering due to impacts from the ongoing pandemic.

In addition, Deschutes County reported the first known outbreak in a local memory care facility. Our team was happy to provide testing and other support as part of the response effort and has been proud of how Mt. Bachelor Memory Care has handled the difficult situation. Again, we hold those dealing with these infections in our hearts.  

Explaining the numbers

As of this morning, we have seven patients hospitalized with COVID-19 and five of them are in the Intensive Care Unit. Since we started releasing this information to the public regularly, we have had a lot of questions that show we need to put the numbers into context.  

In order to best group and care for COVID-19 patients, we made the decision early on to treat all positive cases at the Bend hospital and we are continuing to follow this practice. We have 24 ICU beds in Bend and six in Redmond for a total of 30 throughout the health system. So, while having five COVID-19 patients in the ICU may seem like it’s not too big of a deal, it is important to remember that many patients need ICU care for other reasons like heart attacks, strokes or car accidents.

Today, 20 of our 30 ICU beds in the system are occupied.

When virus numbers climb, we do become concerned about the long-term impact on our patients, caregivers and community. This is where your actions continue to make a huge difference in our success. We appreciate all those of you who are doing your part to stay home when possible, wear a mask when in public, wash your hands frequently and physically distance from those not in your immediate households.

Just like you, we at St. Charles are learning how to live in this next phase of our reality. We must manage an ongoing response to the pandemic while also providing critical preventive care services, much-needed surgical services and more to our communities.

It is a never-ending balancing act – with the top priority being to keep our patients and caregivers safe.

Thank you for your ongoing support throughout this very difficult journey.  

Sincerely,  

Joe

What happens next in the COVID-19 pandemic is up to us. 

That was Gov. Kate Brown’s message yesterday to our news media here in Central Oregon, where the number of COVID-19 cases is on the rise.

At St. Charles, COVID-19 hospitalizations rose dramatically last week, nearly doubling from six to 11 in a 24-hour period. We have been preparing for such a surge for months and have capacity to treat many more COVID-19 patients while still caring for anyone who might come through our doors. But the concern is the exponential growth. Prior to this month, we saw at most 40 new cases in a week. In the most recent seven-day period, we saw 106—and there is no sign of it slowing.

We know we can curb the transmission of the virus by wearing face coverings, maintaining our physical distance from others and washing our hands. But this concerning rise in cases and indeed the number of COVID-positive patients in our Bend hospital tells us that too few people are heeding this public health advice. (You can now check our number of hospitalizations daily here.)

Some people believe that the dropping mortality rate of COVID-19 is evidence that the virus is not as serious as we once thought. The reality is the mortality rate now is lower than what we saw earlier in the pandemic because the most recent uptick in cases is among the very young and healthy—folks in that 20 to 40 age group. As the number of cases go up, however, there is reason to believe the virus will find headway into our more vulnerable populations. 

In an interview with The Bulletin Monday, the governor stressed that we are at a critical juncture in our response. If we don’t act now to minimize our risk of exposure, she’ll have no choice but to close businesses once again.

“Behavior needs to change,” she told the newspaper. “If it doesn’t change, it will overwhelm our health care system. My tools are limited. I can close businesses down. I can close medical and dental clinics. I don’t want to do that.

“If we can work together to slow the transmission, to slow the number of cases, I won’t have to take more restrictive action. It’s up to all of us.”

Let me say it, too: behavior needs to change, or we will look no different than Arizona or Texas where health systems are being overrun and COVID-19 is taking more lives.

In a video posted to our social media channels over the Fourth of July weekend, Dr. Nathan Ansbaugh, one of our Emergency Department physicians, issued an urgent plea to the community: “In the last several days in the Emergency Department, I’ve taken care of half a dozen or so of new diagnoses of COVID,” he said. “My goal is not to point fingers; my goal is not to scare everyone. But my goal is to communicate an honest, somewhat desperation about what’s happening here and to ask that everyone who lives in this community takes care of this community.”