The Miller Report: May 19, 2020

The Miller Report: May 19, 2020

AHMC_Miller Report_reduced
The weekly pandemic update from Mendocino Coast District Hospital and the City of Fort Bragg:

Healthcare Heroes and Lessons Learned
By William Miller, MD, FACP
Chief of Staff, Mendocino Coast District Hospital
I am happy to report that as of today we can conclude, with a high degree of confidence, that we have no evidence of community spread of COVID-19 here on the Coast and certainly no outbreak in Mendocino Coast District Hospital. We have tested 153 people; 124 staff and 29 patients. So far, 139 are negative, zero positive, with 14 still pending. Our testing strategy was based on doing internal contact tracing and identifying individuals who might have had a moderate or high-risk exposure. This is what we recommended, but we went a step further and expanded testing to include low risk exposures as well. Community staff and patients who had no exposure were not tested. Equally important, I am happy to report that the initial staff member who did test positive is recovering well. We learned several things from this experience.

First, we learned that the processes we have in place at the hospital to prevent transmission of COVID-19 worked very well. Having everyone, including staff, patients and others, all wearing a mask really was effective. I believe that our hospital is a very safe place to work and to get healthcare. I encourage people who need our services to not be fearful and to come forth and get the care that they need.

Second, the majority of the 153 are local residents. This sampling, coupled with the 80 or so negative tests done previously for other reasons, including those done as screening tests through MCC, are a sampling of the Coast. While we still desire to do more broad screening, these negative results, coupled with the fact that we are not seeing any patients sick with COVID, reinforces that we have a very low prevalence. This is useful information to help guide public health decisions for our city and county leadership as to how and when to begin to roll back shelter-in-place.

Next, it was good practice for us on how to investigate a potential outbreak and perform contact tracing. That is not something that we get to do every day and from an infection prevention standpoint, is valuable experience. Also, it helped us to examine our policies and procedures around screening of staff, including those that may travel here from farther away. We have made changes to such procedures as a result.

Lastly, we learned that the old adage that times like this bring out the best of people and the worst of people is true. The majority of our community has been wonderfully supportive of our hospital and our healthcare workers. However, we also experienced a few of our travelers receiving threats from members of the community. This is a sad note and I know that is not the face of our community that we wish to present to the rest of the country.
I feel that there is a lot of misunderstanding around having staff, including physicians, who work for us while calling somewhere else home. The simple reality is that most rural hospitals in the US are not able to draw from their own communities to completely staff highly specialized roles. Since only a small percentage of the community is currently trained in healthcare, we draw from staff that live elsewhere while we recruit to meet our local needs. Yes, that comes at a premium, however, the benefit is beyond just filling positions. Travelers bring a breadth of experience from having seen how things are done elsewhere that is extremely valuable.

These people travel here, leaving behind their homes and families, to help us out. At a time like this, with the challenges of COVID constantly looming over us, all of our staff are heroes, regardless of where they call home.

Tabatha Miller
City Manager, Fort Bragg

I heard a report this week that television executives are panicking because this is the time of year that they announce the new fall TV shows and start selling advertising. There is some concern that we will “run out of TV” over the summer. One substitute program I suggest is the regular and special meetings of the Fort Bragg City Council or the Mendocino County Board of Supervisors meetings. I realize that this may not be on everyone’s top-ten list, but please consider the following.

There are a lot of reasons to be angry, frustrated or even scared these days and I hear and read the emotions directed at local government and its officials. Participating in those meetings makes you a part of the process and lets you tell those folks what you think. The meetings can be viewed in real time on Channel 3 through Comcast and are also live-streamed. Past meetings are archived and available on the City’s website. In normal times, you can even be part of the live audience; attend in person and sit in uncomfortable chairs. Unlike the Rachel Ray or other talk shows, you do not have to be invited or wear bright colors to make the audience look happy (or so I have been told). Unlike Rachel, the City Council doesn’t get to pick their audience.

Public participation is important and part of the process. Agendas and staff reports are published in advance of the meetings, so that you have an opportunity to understand the issues. The responsible staff member’s email address is on the staff reports, so you can reach out ahead of time to ask questions. Even during the time of COVID-19, you can tell the City what you think of an agenda or action item.

One easy way is to submit comments by using the eComment agenda module. Visit the City’s website then select the “Agendas & Meetings” icon to see a listing of all City meetings. For upcoming meetings with eComment enabled, you will see a link on the far right-hand side of the page which allows you to comment on all agenda items. You will need to register the first time you use this feature, but you don’t need to provide your name, just an email. You can simply indicate whether you Support, Oppose or are Neutral on a particular agenda item, without leaving a comment. This is not quite like Facebook with emoji but it offers Councilmembers information on how many people are for or against an issue. Or you can voice your opinion and the reasons why. If you need help, or just want to email a comment, contact the City Clerk at You can tell Councilmembers what you think of an action before it is decided.

These days, most of what the City Council is deciding is related to COVID-19, which is why your participation is so important. This is the issue most on our minds these days. Sometime Wednesday (May 20th), the Agenda for the May 26th regular City Council meeting will be published and include links to documents and staff reports.

This upcoming agenda includes a request for City Council to approve an Urgency Ordinance which allows businesses to apply for no-cost temporary Use Permits or temporary waiver of zoning requirements to facilitate business operations affected by the Shelter-in-Place Order. The goal is to help businesses survive by giving them more flexibility in how they are allowed to conduct business. Also COVID-19 related is a request to use HOME grant funds for rental assistance for low to moderate income households adversely impacted by COVID-19. Council will be asked to approve the salary adjustments resulting from the recent staff reductions and the City’s applications for CDBG Funding. The CDBG program applications focus on post-COVID recovery and include a request for $750k in Business Assistance Loan funds, $117 in Microenterprise Assistance funds, $100k to finish the Mill Site Planning, $204k for design of the Fort Bragg Fire Station Rehabilitation and $217k for Code Enforcement activities. Non COVID-19 business includes the approval of the PG&E On-Bill Financing program that will allow the City and CV Starr Center to replace the old lighting fixtures with LED fixtures and use the monthly bill savings to finance the improvements interest free. I encourage you to get involved in your local government.