With COVID-19 hospitalizations increasing, St. Charles Health System urges community to celebrate Fourth of July at home, limit interactions to a small group of people

BEND, Ore. – At St. Charles, COVID-19 hospitalizations have nearly doubled in the past 24 hours, and our data modeling shows that we are heading for a bigger surge than the one we experienced in April.

The bottom line is if behavior doesn’t change in our community, we will overwhelm our health system’s capacity in the coming weeks.

We know people are looking forward to celebrating the holiday weekend with family and friends. However, we are not in a position to celebrate in the ways we’re used to. After Memorial Day weekend gatherings, COVID-19 cases accelerated. This virus does not take holidays off, and our actions now will determine where we stand later in July.

To keep you, your loved ones and your community safe, we urge you to:

1. Stay home if you feel sick.
2. Think hard about your Fourth of July plans. Please strongly consider celebrating at home this year, and limiting your interactions to a very small group of people.
3. If you go out in public, it is absolutely vital that you wear a mask at all times.
4. Follow physical distancing guidelines.
5. Wash your hands. Wash your hands. Wash your hands.

St. Charles Health System has been preparing for a surge of COVID-19 patients since January, and our facilities remain a safe place for care of any kind. If you experience a medical emergency and need to seek care, please do not hesitate to visit a St. Charles hospital.

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, 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 4,200 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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Throughout much of the spring, Central Oregonians stepped up and supported St. Charles Health System in a variety of ways: by donating money for caregivers on the front line of the fight against COVID-19, by delivering a bounty of food and drinks to essential workers at the organization’s hospitals and by hand-crafting more than 10,000 cloth masks to supplement the system’s supply of medical-grade masks.

So when it came time to thank the community through action, St. Charles leadership zeroed in on Gov. Kate Brown’s plan to place paid and volunteer contact tracers in each Oregon county. Ensuring adequate contact tracing, Brown has said, will allow the state’s public health system to effectively identify and treat new cases of COVID-19, trace contacts to identify those at risk of infection and contain new outbreaks before community spread can occur.

“Throughout this pandemic, our health system has been buoyed by an outpouring of community support,” said Dr. Jim Guyn, senior vice president of population health. “Offering some of our caregivers to help with contact tracing felt like one way we could give back to Central Oregon. We want people to stay well and for local businesses to stay open.”

After discussions with public health officials in Crook, Deschutes and Jefferson counties, St. Charles identified six Community Health Educators from family care clinics in Bend, Madras, Prineville and Redmond to take the Oregon Health Authority’s online contact tracing training. Those six caregivers have not yet started working with the counties – that’s expected to start in July, after a few final details are nailed down – but they’re ready when the call comes, said Maggie O’Connor, manager of community health strategy for St. Charles.

“Everyone on this team was so willing to sign up for the training session and to get going,” she said. “It’s definitely a great opportunity for us to serve the community in a new capacity.”

The CHEs who’ll take on contact tracing work are Nancy Burham in Redmond, Molly Christopher in Madras and Sisters, Catalina Gibson and Molly Olheiser in Prineville, and Gabrielle Gilmore and Rachel Nelles in Bend. The six are uniquely qualified to do contact tracing because of the parallels to their normal daily duties, which include serving as an extra layer of social support for patients who are struggling with housing, food insecurity, transportation, finances, domestic safety and so on.

“If our providers or behavioral health counselors have a concern about a patient, we get pulled in to help wrap around them in the context of those social needs,” said Olheiser. “The really cool thing about our job is that we’re able to establish relationships with people, and we’re with them through some of the most stressful times of their lives as a resource and a source of support.”

CHEs work with patients both in the clinic and at their home, and they are trained to communicate with patients in a way that makes them feel comfortable talking openly about their lives. That skill should translate seamlessly to contact tracing, said Gilmore.

“We’ll be getting names of people who have come into contact with someone who has COVID-19, and we’ll interview them and follow up with them to make sure they understand the disease and what they should be doing,” she said. “That extended interaction with them will give us an opportunity to assess their resource needs and make sure they’re being met. And that’s obviously something we’re used to doing on a daily basis.”

In other words, both community health education and contact tracing require not just specific health-related knowledge, but also people skills, cultural competency, compassion and empathy.

“It’s a little nerve-wracking because I know COVID-19 can be a really scary thing for people, but we’re trained to deal with delivering that type of news and information,” Olheiser said.

Burham concurred: “You need to be able to think on the fly and to know what resources are available. We’re all highly trained and well-connected within Central Oregon.”

No one is sure how long the CHEs will assist the counties with contact tracing, but the aim is to have them in place well ahead of flu season, when COVID-19 could surge, O’Connor said.

Until they are asked to stand down, contact tracing will be the CHEs’ top priority, she said. And that’s OK with them.

“I’m excited because I really think that this is a way our team can help the community by helping to curb the spread of the virus and keep it contained,” Burham said. “We know COVID-19 spreads from one person to another to another, and if we can cut off some of those connections and slow the virus, that’s a great thing to be a part of.”

Physicians who treated Central Oregon’s first COVID-19 patient to receive a transfusion of convalescent plasma cannot say with certainty how much the blood product helped 53-year-old Liliana Locke, who is now recovering at home.

But anecdotal results and early findings by the Mayo Clinic, which is coordinating the national expanded access protocol used to provide the plasma, are positive enough to encourage recovered COVID-19 patients to consider a donation, said Dr. Anna Dolezal, a pathologist with Central Oregon Pathology Consultants and acting medical director of the St. Charles Blood Bank.

“Among the first 5,000 patients who received convalescent plasma through that program, the incidence of serious adverse events was very low,” Dolezal said. “So what we can take from that is that infusing COVID-19 patients with convalescent plasma appears to be a safe procedure, and this initiative will continue nationally.”
In fact, the American Red Cross recently expanded its criteria for who can donate convalescent plasma. Until late April, donors must have tested positive for COVID-19 and fully recovered. (People who have fully recovered from the virus have antibodies in their plasma that can attack the virus and may help people fight the disease.) On April 27, however, the Red Cross began allowing people who don’t have a positive test but are certain they had COVID-19 to donate plasma. Those donations are tested for antibodies, allowing the Red Cross to simplify the eligibility process and qualify more potential donors.

Earlier data available from studies indicated that a single 200 mL dose of convalescent plasma showed benefit for some patients, leading to improvement. And while the Mayo Clinic’s program isn’t a randomized clinical trial and is designed primarily to ensure safety, data from the first 5,000 patients enrolled in the protocol did show some promising results and also noted "with optimism the relatively low mortality in treated patients." This included a trend toward decreased mortality at seven days (14.9%) compared to average mortality for patients with COVID-19 in the hospital (15-20%) and ICU (57%).

Dolezal emphasized: “While there is still much work to be done to tease out the true efficacy of this treatment – as is true at this time with all treatments being explored for COVID-19 – the initial report from Mayo looks promising to me. If we can make convalescent plasma available to more COVID patients earlier in their hospital course, I’m hopeful that it can make a potentially life-saving difference in their outcome.”

Use of convalescent plasma has been studied in outbreaks of other respiratory infections, including the 2003 SARS-CoV-1 epidemic, the 2009-2010 H1N1 influenza virus pandemic and the 2012 MERS-CoV epidemic, according to the FDA.

Given the severity of the pandemic and lack of other available treatments for COVID-19, the U.S. Food and Drug Administration approved its use as an investigational new drug in late March. Since that time, blood suppliers have been working tirelessly to increase the pool of available plasma.

To schedule an appointment to donate COVID-19 convalescent plasma or other blood products, contact American Red Cross Blood Services at 1-800-RED-CROSS or https://www.redcrossblood.org/. More information can be found at the following links:

Eligibility requirements and a donor eligibility form

Frequently asked questions, including sections on COVID-19 and donating convalescent plasma.

For the past several weeks, I’ve been sending out an email on Mondays detailing St. Charles’ efforts to prepare for and respond to the COVID-19 outbreak and to care for our community through unprecedented times.

If you’d like to read those emails, here’s an archive. And if you’d like to sign up to receive future missives, you can do that here.

My Monday emails tend to be long and full of information, because there is a lot to say. I’ve written about our work to expand COVID-19 testing and our plans to handle a surge of patients. I’ve emphasized the importance of social distancing and urged people to follow Gov. Kate Brown’s stay-at-home order. I’ve shared the latest data models and discussed the development of a roadmap for recovery.

I also try to take an opportunity in each email to say “thank you” to whoever’s reading for whatever role that particular person has played in the fight against this dangerous new virus, whether they're working face-to-face with patients, ringing up groceries at the supermarket or simply staying home and helping to flatten the curve.

Here, though, I want to take a moment to be more specific with my gratitude. There certainly is enough to go around.

Thank you to our partner agencies, both locally and at the state and federal levels, with a special kudos to health officials in Warm Springs and at Crook, Deschutes and Jefferson counties, who have capably pursued the important work of identifying COVID-19 cases, conducting contact investigations and providing valuable guidance for our communities. And to the firefighters, emergency medical personnel and law enforcement officers on the front lines, thank you for putting your own health at risk for the good of Central Oregon as a whole.

Thank you to the St. Charles Foundation for quickly establishing our new Hero Fund, which will benefit frontline caregivers at St. Charles, and for making the 2020 Heaven Can Wait 5K a benefit for COVID-19 relief efforts. It is never easy to ask people for money, but ultimately, donating money is the best way to help our efforts and our caregivers. (Heaven Can Wait is going virtual this year, by the way. Sign up here.)

Thank you to the many businesses and individuals across Central Oregon and beyond that have donated non-medical items and services such as food and drink over the past several weeks. Yes, our caregivers need personal protective equipment, proper training, strong leadership and emotional support along the way. But I can tell you that when a stack of pizzas shows up at the hospital these days, it is greeted with open arms and giant smiles. Simple things matter.

Thank you to the essential workers who are out there risking their own health to ensure our society continues to function as normally as possible. Times of crisis tend to illuminate the occupations that play an indispensable role in the world as we know it, and that’s certainly true right now. To the delivery drivers, postal employees, cashiers, gas station attendants, garbage collectors, retail workers, those on the food-supply chain and all others doing jobs we depend on: We appreciate you and we value your work.

Thank you to the vast army of skilled sewists across the region who have been busily crafting cloth masks for caregivers at St. Charles and other health care providers. On April 1, we announced our 10,000 Mask Challenge in hopes of collecting enough masks to give our people two each. Just over three weeks later, we surpassed that goal, and we’re still going so we can share with others. What an incredible thing it has been to watch this group mobilize and focus its efforts on helping the folks on the front lines.

Last but certainly not least, thank you to the 4,500+ caregivers at St. Charles Health System who have worked tirelessly over the past few months as we engage in an uncertain fight against an invisible enemy that doesn’t seem to play by the usual rules. My full-hearted gratitude goes to the doctors and nurses, of course, but also the pharmacists, respiratory therapists, medical techs, lab scientists, food services workers, environmental services staff, facilities crew and so many more in other support areas who keep our hospitals running smoothly. Thanks also to the administrators at St. Charles, who have spent countless hours setting up new services, honing policies, updating processes, pursuing solutions to new problems and otherwise supporting those on the front lines. We are not done yet, but for now, please know that I could not be more proud to lead such a terrific organization.

Finally, if you’ve read this far, thank you for taking the time to understand what’s happening at St. Charles and how our operation intersects with Central Oregon in this challenging time. It is vitally important that members of this community get their information from trusted sources so we’re all working from the same page and pulling in the same direction.

I’ve said it in my Monday emails and I’ll say it here: We are truly all in this together. Thanks for doing your part.

Sincerely,
Joe

It was after 10 p.m. on Friday, March 27 when Dave Beermann pulled into the parking lot of St. Charles Bend. Before he could even open his door to help his feverish wife, Barbara, out of the vehicle, he heard someone shouting instructions.

“We arrived at the Emergency Department and they said, ‘Don’t get out of the pickup!’” Beermann said. “I said, ‘OK,’ and they took Barb and put her in a wheelchair and wheeled her off into the dark.

“And that,” Beermann said, “was the last time I saw her for six or seven days.”

Barbara Beermann, 71, is one of handful of people who has recovered and been discharged from St. Charles Bend after testing positive for COVID-19. She spent six days and nights in the hospital’s Progressive Care Unit, where caregivers worked around the clock to lower and stabilize her temperature, which hovered near 100 degrees before finally reaching 101.8 on the night she went to the ER.

By that time, Beermann had awoken soaked in sweat several nights in a row. Just a couple weeks removed from a knee-replacement surgery, she was concerned about an infection and was in touch with both her surgeon and her primary care physician. The possibility that she had contracted the novel coronavirus known as COVID-19 never crossed her mind.

“They thought it had to do with my incision at first,” Beermann said. “But they said if my temperature went over 100.4, I should go to the ER. So that night, I was getting ready for bed and all of a sudden I was just out of energy. I couldn’t even get undressed. I took my temperature and told my husband, ‘We need to go right now.’”

Beermann hadn’t experienced any of the other symptoms commonly associated with COVID-19, including cough and shortness of breath. But she said the St. Charles ER staff tested her oxygen level and found it was very low. They also scanned her lungs, she said, and tested her for the virus by inserting a swab deep into her nasal cavity. At 3 a.m. on Saturday, March 28, she called Dave and said she wouldn’t be home that night.

Dave Beermann, 72, was also experiencing symptoms consistent with COVID-19, though his weren’t as severe as his wife’s. So he hunkered down and self-isolated at home.

“I pretty much became a hermit,” he said.

Barbara Beermann couldn’t have visitors at all because she was isolated at the hospital to protect caregivers and other patients from the highly infectious virus. Her nurses were “awesome,” she said, constantly updating and encouraging her. She had one conversation with a doctor – a “gloom and doom” talk about ventilators and the possibility that she might not survive the situation, she said – that upset her, in part because it highlighted the fact that she couldn’t have her family at her side.

“It was petrifying thinking, ‘Oh my God, I want to do this and I want to do that. I want to see all my grandkids grow up,’” Beermann said. “It was pretty devastating, but I could see (my number on the screen) every time they took my temperature. I could see that I was getting better.”

After her second night in the hospital, Beermann’s night sweats subsided, and four days later, she was allowed to go home to her Bend home. There, she decided to make a donation to the St. Charles Foundation in honor of her nurses, who she called “so nice and kind.” Just last week, St. Charles announced a new Hero Fund to benefit caregivers on the front lines of the battle against COVID-19.

“My son is a nurse in California, so I had great respect for them when I went in there,” Beermann said. “And I have even greater respect for them now. They took good care of me, and I just hate to see the loss of life over this. I didn’t give a huge amount, but I hope it can help somebody.”

Now, both Beermanns are feeling much better. A veteran of the agriculture and trucking business, Dave is urging acquaintances far and wide to take COVID-19 seriously.

“I tell them they need to use common sense and be very vigilant about not only their own well-being but also the people around them,” he said.

As for Barbara, her three kids and 10 grandkids are scattered across the country, so she hasn’t gotten a chance to hug them yet, though she did video chat with them to assure them that “grandma is OK.”

She feels lucky – or more precisely, blessed – to have beaten COVID-19.

“I had good care at the hospital and I had a lot of people praying for me,” she said. “By the grace of God, I’m home.”