Just stay home. That’s what the Montana Nurses Association is asking Montanans to do for the next few weeks as coronavirus cases continue to surge and strain the state’s health care system. YPR News’ Nicky Ouellet spoke with MNA Chief Executive Officer Vicky Byrd over Zoom about the mitigation efforts they’re asking the public and elected officials to take now to save lives.
Nicky Ouellet: Vicky, thanks so much for taking time to chat with me today.
Vicky Byrd: Thanks for having me.
Nicky Ouellet: The Montana Nurses Association has released a suite of recommendations that you say if followed for the next four to five weeks will likely lead to a huge decrease in COVID-19 infections, hospitalizations and deaths by the New Year. Walk me through what needs to happen.
Vicky Byrd: The only way to combat this virus is not to get it in the first place. And that comes with wearing a mask, social distancing, limiting people and washing our hands. That is all we got right now. Even though a vaccine might be around the corner, that's going to be weeks to months before that gets to everyone, if not until the middle or the end of next year. But we know that by doing some mitigation efforts, it takes four to five weeks after those efforts are employed for it to be realized. So, we're coming up on Thanksgiving. We're coming up on cold weather for Montana. We're coming up on school break for Christmas. Let's take advantage of it. Everybody stay home. Try to limit your travel. And I know it's going to be painful, but if for three to four or five weeks pause right now, and after the New Year, we see these cases significantly drop, we're just all the better for it.
Nicky Ouellet: You mentioned staying home as much as possible and closing schools through the New Year. Schools in some communities in Montana have not seemed to be a big source of spread of the virus. Why make that broad scale recommendation now?
Vicky Byrd: It only takes one case in those rural areas to completely devastate the health care system there in our very rural areas like Cutbank or Forsyth. We know that what makes our communities whole is the school and the healthcare facility. And we know that in-person learning is the best for these kids, but it can't truly happen safely because even though it might impact the kids at a lower level, we've got teachers, support staff, janitors that are not of those school age, that won't be as protected. And until we get the community surge under control, we are going to continue to recommend taking advantage of this holiday season and just stay home from school.
Nicky Ouellet: What makes you confident that following these recommendations will indeed flatten the curve?
Vicky Byrd: Because we've seen it before and it's been proven in other states and even in our own state. Look at what happened way back when this first started. I think it was around March when the governor shut it down, our cases were so low. And then, you know, we get more lax and there was a call to open up the economy. But if we don't take care of the public health pandemic first none of our economy will rally from this. We have got to take care of our health first. Then we can invest in our economy.
Nicky Ouellet: In your recommendations you write that after a four to five week pause, we need to gradually reopen bars, restaurants, schools and businesses. What does that gradual reopening look like?
Vicky Byrd: I think it looks like a lot of how they actually opened Montana in the first place, you know, at the 25 percent, and then 50 percent. I believe schools were like, let the parents choose online and/or in person. But if we just get that big dip in the daily cases and we can do that every couple of weeks, and then you reevaluate to see where those cases are.
Nicky Ouellet: For people who hear these recommendations and are picturing barren downtowns, local businesses shuttering because everyone is staying home. What's the picture that forms in your brain when you imagine Montanans following these recommendations to keep their healthcare workers and neighbors safe?
Vicky Byrd: I imagine the businesses, which many of them are doing now, they're doing takeout order and delivery. Pop your trunk. I'll put it in the back of your trunk. That's awesome. I'll go to the bookstore and order books from the local bookstore, pop my trunk and have them put it in the back. That makes jobs for other people as well. Everybody wear a mask. I order my stuff to go from the local restaurants around town, because I want to support them. These are our recommendations based on everything. The governor gets to lay down the law, 50 percent capacity, only gather in groups of 25. We're just saying don't even go to the restaurant and gather because we know by not doing that, the virus has no way to spread.
If you give the virus a way to spread, it just laughs all the way to the ventilator. The only way we have to combat it right now is not to get it.
The Montana Nurses Association's recommendations follow:
Montana Nurses Association (MNA) is asking all Montanans to embrace science, data, and public health experts and work together on every possible safety precaution noted below. These mitigation efforts will not be realized for at least 4-5 weeks from implementation to flatten the curve. There is a unique opportunity now, to take advantage over these holidays to significantly decrease the number of infections, hospitalizations, and deaths we are experiencing as a state. MNA is asking our citizens and communities for help with and to comply with these mitigation efforts to save lives now.
If we pause over the next 4-5 weeks we will see a huge decrease in infections, hospitalizations, and deaths by the New Year. Then we can GRADUALLY open up our bars, restaurants, schools, and businesses in a safer manner while sparing our nurses, frontline healthcare workers, and facilities from becoming overwhelmed. Our frontline nurses and healthcare workers are exhausted, reusing and conserving personal protective equipment (PPE), and hospitals are either nearing or are currently at capacity. Our hospitals are making “COVID surge” plans NOW as they worry about the weeks and months to come.
Ø Recommend stay at home, only go out for essential needs, and limit travel for emergency only
· On 11/22/2020 Montana was the 9th in the nation (top 10 spread) as covid cases in last 7 days are at 116.4 cases per 100,000 population. (https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days)
· November 22, 2020 covid cases in MT = 1138
· A joint letter issued by the American Medical Association, American Hospital Association, and American Nurses Association recommends people still planning to host or attend a Thanksgiving gathering to follow every possible safety precaution.
"We — the physicians, nurses, hospital and health system leaders, and public health professionals on the front lines of this pandemic — strongly urge everyone throughout our country to celebrate responsibly, in a scaled-back fashion that limits the virus' spread, to help reduce the risk of infecting friends, family and others you love," the letter states. They caution that hospitals may not be able to accommodate a similar mid-December COVID-19 infection spike if too many Americans spread the virus at Thanksgiving get-togethers. (https://www.nwitimes.com/business/healthcare/national-health-groups-beg-americans-to-scale-back-thanksgiving-celebrations/article_424da9c5-a673-5380-83e6-8d2c89a63306.html)
Ø Recommend keep schools closed until after the New Year (take advantage of the Holiday breaks)
· “You can only open your school safely if you have COVID under control in your community.” (Benjamin Linas, MD, MPH Associate professor of medicine and epidemiology at Boston University School of Medicine).
· While COVID-19’s light impact on K-12 schools so far has spurred calls to fill classrooms, coronavirus infection surges in many parts of Montana and poses a growing threat. In recent weeks, outbreaks have forced some schools to close and revert to distance learning.
· The goal of having children attend school in person--which is how they learn best--will only be safe when our communities have the virus spread under control. And then, when it is possible to reopen a school for in-person learning, a layered approach is needed to keep students, teachers and staff safe. (https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Return-to-School-During-COVID-19.aspx)
Ø Support Mandate: If you go out, Wear a Mask at all times, socially distance, and wash hands
· US coronavirus hospitalizations and new cases break record for second straight day Friday, November 20th 2020, with over half of the country is now in the "red zone," according to Dr. Deborah Birx, a White House Coronavirus Task Force member told CNN Chief Medical Correspondent Dr. Sanjay Gupta in an exclusive interview, warning that this surge was unlike those in the past. (https://www.kten.com/story/42941820/us-coronavirus-hospitalizations-break-record-for-second-straight-day)
· Masks are primarily intended to reduce the spread of droplets, which is especially relevant for asymptomatic or presymptomatic infected wearers who feel well and may be unaware they are infected. This asymptomatic or presymptomatic population is estimated to account for more than 50% of transmissions. (https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html)
Ø Recommend supporting local businesses utilizing take out, drive through, or delivery-don’t dine in
· Indoor businesses, particularly restaurants — where larger groups of people spend long amounts of time together — could be the cause of most COVID-19 super spreader events. (https://www.nrn.com/operations/indoor-dining-major-cause-covid-19-superspreader-events-stanford-led-study-suggests)
· Hospitals such as St. Peter’s Health are implementing surge plans as covid cases spike with more than 60 staff not working due to covid related issues. Nurses are resilient however, staffs are strained. (helenair.com)
· At another hospital facility the hospital has gone into contingency staffing as their nursing staff have been picking up extra and are becoming very fatigued due to Covid admissions daily increase reporting that today 42% of their inpatient are Covid positive. (Communicated to MNA 11/23/2020)
If we put in the effort now, Montana’s health, healthcare infrastructure, and economics will benefit greatly in January 2021. We cannot improve the economics, jobs, and businesses without FIRST taking care of this public health crisis, the COVID pandemic.
Public Health officials also ask please get a FLU shot if able.
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