Coronavirus Update

Updated June 29, 2020 at 9:30 p.m. PST.

HOT TOPICS
What are the visitor restrictions and how can I visit virtually?

Palomar Health is enforcing a NO PATIENT VISITORS restriction until further notice. This is unfortunate but necessary to ensure your loved one’s safety. There are some exceptions to this rule such as: child patients may be accompanied by one adult, one support person will be allowed during child birth, end of life patients may receive visitors on a case by case basis and patients with mental disabilities (meeting criteria) may have a support person under certain circumstances. Please call and speak with the patient’s care team before coming to the hospital. You must receive prior permission. Do not show up unannounced.

VIRTUAL VISITS
To increase access to patients during this difficult time Palomar Health is offering “virtual visits” through use of a loaner iPad provided by Palomar Health. To initiate a virtual visit, the patient (or loved one by calling the patient’s room) must ask their bedside nurse to set up the virtual visit. There may be a delay as there are a limited number of iPads available.

The patient’s charge nurse maintains the iPads and instructions for use. The iPads are Wi-Fi enabled and equipped with Apple FaceTime and Google Duo. The call must be initiated from the patient’s room on the iPad as an outgoing call; the loved one can only receive the call. Loved ones must have an internet-connected device with either FaceTime or Google Duo installed to accept the call. This can be a phone, tablet or computer.

The patient’s nurse or aide will establish the call for the patient using the loved one’s provided contact information. Once the call is established the patient will be able to see and hear their loved one and vice versa. Once the call is over, the nurse will make the device available for another patient. Virtual calls are also available using the hospital’s Wi-Fi guest network if the patient has their own device.

If you have any questions, please ask to speak with the charge nurse in the unit where the patient is staying.

Is Palomar Health resuming outpatient services?
In accordance with County guidelines, we have started to slowly resume outpatient services. As of June 1, Cardiac Rehab has resumed Phase 2 services and outpatient diagnostic imaging has resumed for critical cases. All patients will be screened and all required precautions will be observed including masks, social distancing and frequent hand hygiene.
 
Are gift shops and Starbucks open at Palomar Medical Centers?
The gift shop at PMC Escondido opened on June 1 with limited hours and the gift shop at PMC Poway will reopen once volunteers are able to return to the hospital. Starbucks will be reopening at PMC Escondido on Monday, June 8. All County guidelines for retail businesses will be followed at these locations.

Is it safe to come to the hospital?
Yes. Palomar Medical Centers in Escondido and Poway are taking extraordinary measures to ensure your safety during the coronavirus pandemic. Please don’t hesitate to access emergency services if you have cardiac issues, abdominal pain, chest pain, orthopedic injuries or psychiatric emergencies. Early treatment can result in drastically improved outcomes.
Here are some of the ways we are ensuring your safety:

  • Screening all patients at the door
  • Isolating potential COVID-19 patients from all other patients
  • Masking all patients and personnel throughout the hospital
  • Restricting visits of all non-patients 
  • Unprecedented cleaning and sterilization of all surfaces

Since the pandemic outbreak, Palomar Health has experienced up to a 50% decrease in patient volumes. Some of this is attributed to fewer people being injured due to stay at home orders but some is due to people unnecessarily delaying treatment. Our message is “Emergencies Don’t Wait.”

VISITOR RESTRICTIONS
Are visitors allowed at the hospital? 
To protect against the coronavirus spread, no visitors are allowed inside Palomar Medical Center Escondido, Palomar Medical Center Poway and The Villas at Poway (Villa Pomerado), per the public health order, until further notice. Exceptions may be granted for those visiting end of life patients and children, on a case by case basis. Anyone entering the hospital will have their temperatures taken (nobody with a temperature above 100 degrees will be allowed to enter) and screened for potential coronavirus exposuresure.
 
Are birthing partners allowed in the birth center?
Only one birthing partner will be allowed in the birthing room until further notice. The birthing partner must be at least 18 years of age and show no symptoms.

What are the vendor and contractor visitor restrictions?
In accordance with CDC guidelines, all non-essential vendors and contractors are barred from entering all Palomar Health facilities. The exceptions to this policy (essential care vendors and contractors) are those who provide services directly to medically necessary patient care and essential equipment or facility processes. This policy is effective immediately and until further notice. All vendors and contractors must check in at the front desk upon arrival and those meeting the criteria will be given a badge for that day only. Please see the attached letter on our vendor restrictions at this time. 

INDIVIDUAL ACTIONS
How can I protect myself?
Here are the best ways you can protect yourself and others.
- Wash your hands with soap and water often for at least 20 seconds
- Keep six feet of distance from anyone not in your immediate household
- Avoid close contact with people who are sick
- Do not touch your face
- Stay home if you feel sick
- Properly cover your cough/sneeze
- Disinfect highly touched areas
 
What should I do if I believe I am infected with COVID-19?
Call your primary care physician. If you do not have a healthcare provider, please call 2-1-1 or visit 211sandiego and they will connect you with a provider. Stay home until instructed to leave by your healthcare provider. Do not visit the Emergency Department unless you are having an emergency situation. Read our steps to follow for more information.  
 
What should I do if I am told to isolate at home?
The County of San Diego has issued a specific set of directions for anyone who is being evaluated or has confirmed positive for the coronavirus. These instructions also cover anyone who has contact with the coronavirus carrier.
 
How will the coronavirus affect pregnancy and breastfeeding?
The CDC has issued guidelines for pregnancy and breastfeeding. There is a lot we don’t know so pregnant and breastfeeding women should do what the general population is doing to protect themselves from getting the coronavirus.

TESTING PROCEDURES
Should I get an antibody coronavirus test? 
Palomar Health’s Chief Medical Officer and the Medical Director of Infectious Disease are suggesting you wait until a more valid antibody test is developed. The vast majority of antibody tests are not FDA approved and in the opinion of many medical experts are not yet accurate. Scientists are currently working to create a reliable test and are hopeful they will get FDA approval in the future. The most accurate current tests being conducted by hospitals nationwide, including Palomar Health, is called a polymerase chain reaction (PCR) test which examines a sample of mucus taken from the nose or mouth.


Is Palomar Health testing all patients for COVID-19?
Beginning Monday, May 18, Palomar Health is testing all inpatients, including those who are asymptomatic, for COVID-19.

What is the testing recommendation for new patients?
In accordance with California Department of Public Health recommendations, we will start testing all admissions from the Emergency Department and any patient directly admitted from the Operating Room on Monday, May 11. Tests results are expected within a few hours.

Are we testing people without symptoms for COVID-19?
Following CDC guidelines, and due to the low number of test kits available, we are only testing people who show symptoms. Since incubation periods after exposure differ for each person, testing someone without symptoms could produce a negative result and a false sense of security for the individual and those around them. Anyone who believes they may have been exposed to the virus, but isn’t showing symptoms, should wear a mask and remain in quarantine.

What are the odds I am COVID-19 positive, but I received a negative test result? 
The sensitivity and specificity of the COVID test is greater than 98%, which means the rate of false negative test results is very low. You should feel confident that anyone who has been ruled out for COVID has no indication of being a carrier.

How much is a COVID-19 test?
We treat everyone regardless of their ability to pay. As is the case with any treatment, we collect insurance information. Your insurance company is best to answer any payment related question.

How is Palomar Health screening patients for the virus?
All patients are screened at the entrance to the Emergency Department and their temperature is taken. Those who meet the criteria for possible coronavirus testing are immediately masked and sent to the triage tent erected near the Emergency Department to isolate them from other patients. Inside the tent, patients are evaluated and those suspected of carrying the virus are tested and sent home with medical instructions or tested and admitted to the hospital for treatment, depending on patient condition.  

What is the process for testing?
First you are screened to meet CDC testing requirements. Then a practitioner swabs your nose and/or mouth to collect a specimen. If you need hospital care you will be checked in and treated as necessary, otherwise you will be sent home and asked to self-quarantine. 

What should I do once I have been swabbed for the coronavirus?
If you have been tested for COVID-19 at a Palomar Health hospital and sent home you will be contacted by a Palomar Health employee immediately when your results are in. If you are home waiting for results, stay home and away from other people as much as possible.

How many days does it take to get coronavirus results back?
If you are admitted to the hospital (become an inpatient) your results will be returned in less than 24 hours. If you are tested (swabbed) and sent home to self-quarantine, your results may take 7 days or longer. You will be contacted immediately by a Palomar Health employee when your results are completed.
 
Is Palomar Health operating drive through coronavirus testing?
No. The tent outside the Emergency Department is not a drive-through testing site. It is being used to pre-screen potentially contagious patients. Unless you have an emergency situation, please contact your doctor first before coming to the Emergency Department.
 
PALOMAR HEALTH ACTIONS
When will elective surgeries begin again?
Government agencies loosened surgery restrictions to allow those that are “time-sensitive” and essential to the health of the patient. Although surgery volume is vital to our business, it’s important that we resume surgeries in the safest way possible to protect our patients and staff. Since we have a limited number of COVID-19 testing kits, we will not be able test all patients and OR staff prior to surgery. This means proper levels of PPE will be of utmost importance as we expand procedures. We must be mindful of the number of surgeries and PPE we use so we do not run into critical shortages. We are resuming time-sensitive surgeries while monitoring safety and PPE use closely. All other elective surgeries will continue to be suspended at this time.

What types of treatment and testing is Palomar Health doing? 
e are continuing to review advanced treatment options for COVID-19 which include: Actemra, Convalescent Plasma and Remdesivir (Click herefor more information about each treatment medication). We are not currently doing any anti-body testing as the only FDA approved test is not reliable and does not specifically test for COVID-19.

Why did we take down the surge tents? 
Since there has been a large decrease in the number of patients seen in our surge tents, we took down the tents at PMC Escondido and one of the two tents at PMC Poway. A modified treatment process has been established for patients coming to the emergency room with COVID-19 symptoms. Designated areas have been identified to treat symptomatic patients to reduce the risk of exposure of patients under investigation (PUI) to others. Should the surge tents be needed again for any reason, they can be made operational within a matter of hours.

How are we celebrating COVID-19 patients who leave our facilities? 
Every patient who recovers from COVID-19 is a true testament to the determination of the patient, but most importantly to the dedication and exceptional patient care provided by our employees and physicians. When a COVID-19 patient leaves our hospitals, it is something to celebrate. Each time a patient is discharged, a “Code Rocky” will be called overhead and all available staff are asked to meet in the lobby to send them home with smiling faces and cheers. View the PMC Poway Code Rocky here, and the Escondido video here. (Code Rocky is named after the theme song from Rocky.)
 

What is the status of the Field Medical Station?
Items for the Federal Medical Station (FMS) were delivered this weekend and setup on the 10th and 11th floors will take place this week. The delivery included 200 beds with the additional 50 beds coming sometime this week. It’s important to remember this is not a Palomar Health project and will be fully funded by the County. It is still undetermined when/if the FMS will open and what patients (COVID, non-COVID, both) will be cared for at this location. These decisions will be made by the County based on community health needs, and we will remain prepared to work with the County on staffing and other needs as directed.

Why did we lay off 317 workers?
The COVID-19 pandemic has greatly affected our business practices causing us to reduce our patient population by up to 70% in some areas with an overall drop of 45-50%. The drop in patients has led to a corresponding drop in revenues. We are forecasting a slow increase in the number of patients over time but don’t see a full return of patients in the foreseeable future. Therefore we were left with staff without patients to care for. In the best interest of all Palomar Health stakeholders we had to take the painful step of a workforce reduction. For more information, please read the CEO’s press conference remarks.

Have any patients at The Villas at Poway tested positive for COVID-19?
Not a single patient at The Villas has tested positive for the coronavirus. Due to the increased risk of exposure of this vulnerable population, we are retesting any patient transferred to or from another facility.

I have the impression there aren’t enough healthcare staff to treat patients. Is that true? 
Unlike other parts of the country that are being shown in the media, San Diego County is not experiencing a high number of hospitalized COVID-19 patients. Palomar Health hospitals, and many others in the county, are currently operating 50-60% below normal. Emergency rooms are slow and hospitals are currently half-full due to the cancellation of all elective surgeries. Additionally, there are very few hospitalized COVID patients in the county (420 total since 3/7). This decrease in patients has resulted in a drop in revenue and the need for fewer staff caring for patients. This unfortunate and unforeseen situation led to a 21-day temporary layoff for some employees while patient volume is down. Hospitals, like many other businesses, have had to make difficult decisions as a results of this pandemic to ensure they remain solvent. The only way we can ensure we are able to continue serving the community during and after this crisis is if we make the right decisions for the organization at the right time. We understand how tough this is on our employees and are very empathetic to their situation. The health and well-being of all our employees is important to us and we expect to bring our Palomar Health family back to work as quickly as possible.

How has this healthcare crisis affected hospitals?
The COVID-19 worldwide pandemic has caused unforeseen challenges and extreme difficulties to healthcare systems across the county. The process of balancing what state and local offices are expecting in the coming weeks and the realities we are currently facing have caused hardships on many companies, Palomar Health included. Unfortunately, hospitals and healthcare systems, like many other businesses, are faced with tough decisions to ensure we are able to balance our finances and ensure we can continue serving the community during and after this crisis. As usual, we adjust staffing levels to patient volume, which is significantly below average in hospitals countywide right now. Elective surgeries and outpatient services were suspended on March 18 due to COVID-19 safety precautions. While these were absolutely the right actions to take, we have seen a 50-60% reduction in patient volume and a significant loss in revenue.

How will the Federal Medical Station (FMS) impact Palomar Health’s business practices?
The announcement of the Federal Medical Station (FMS) is a partnership with the County of San Diego should the region need more patient care capacity. The FMS is NOT related to Palomar Health patient volumes, which are significantly below average in hospitals countywide. While we are proud to help the region ensure our community is prepared for a surge, the FMS is not a Palomar Health decision or funded project. Simply put, we are providing space on the unused 10th floors at Palomar Medical Center Escondido for the FMS. The County determined these shelled floors were an ideal location since it is inside an already fully functioning hospital. The shelled space was built to be able to grow with the needs of the community and are being temporarily loaned to the County for use during this pandemic.  It is important to know that the federal government will be fully funding the FMS, including staffing, supplies, equipment, etc., in the event it opens. The County will determine when/if the FMS is needed and what patients will be treated there.

Will the Federal Medical Station be staffed by Palomar Health employees? Who will pay them?
As part of the partnership with the county, Palomar Health will be prepared to assist the federal government in staffing the FMS with travelers and temporary staff as needed to support these additional surge facilities. All staff working in the FMS will be paid directly by the federal government.

Why is the governor asking people to come out of retirement to work in health care if we have been able to “flatten the curve”?
The process of balancing what state and local officials have been expecting and the realities we are facing today (low patient volumes) have caused hardships on many healthcare systems. Since the COVID virus has so much uncertainty, last month the state and San Diego County began preparing for a surge in patients and worst case scenarios by asking people to come out of retirement and be put in the pipeline to work if needed. At this point, these surge plans have not been enacted.

Does Palomar Health have enough hospital-grade PPE? 
Yes. Palomar Health has been able to maintain use of all proper hospital-grade PPE. We always have and always will provide the necessary PPE required by the CDC for patient care. In many cases we have exceeded the requirements.

What is happening with the downtown hospital?
Some have been asking why the former Palomar Medical Center in downtown Escondido has not been used to treat COVID-19 patients. It currently functions as a lab, acute rehabilitation unit and behavioral health unit. The response to the COVID-19 pandemic is coordinated on a regional level by the County of San Diego Health Department under the direction of the State of California following guidelines established by the Centers for Disease Control. The response team also includes local hospital systems, including Palomar Health. The response team has determined the best location for the Federal Medical Station (FMS) is the top two floors of Palomar Medical Center Escondido for various reasons. Palomar Health has been working diligently to prepare the downtown Escondido facility in the event the response team determines additional bed spaces are necessary beyond the FMS.

Does Palomar Health have enough ventilators?
We are preparing for a surge in patients who need ventilators and are continuing to increase our supply. We have a proof of concept that will allow multiple patients to share one ventilator, further increasing our capacity.
 
What is Palomar Health doing as far as preparedness?
Palomar Health has been preparing for the coronavirus for several months. Our infection control team has instituted a series of measures to isolate infected patients and prevent cross-contamination. We are following all federal, state and local recommendations to restrict visitors, disinfect surfaces, cancel elective surgeries, mask patients showing symptoms before entering the hospital and increase the number of rooms with special filtration systems.

Will Palomar Health be cancelling elective surgeries?
Beginning Wednesday, March 18, Palomar Health cancelled all elective surgeries and will reschedule them for a later date. Emergency surgeries will continue.
 
Is Palomar Health cancelling events?
Yes, per the CDC recommendation to limit gatherings, all Palomar Health-sponsored community activities and events have been cancelled in March and April and will be made available online, if possible. This includes education classes, tours, symposiums, awareness events, ALL support groups (including breastfeeding support groups), etc.
 
DONATIONS
How has the community helped Palomar Health through giving?
One of the most inspiring parts of this pandemic has been the tremendous outpouring of support we have seen from our community. In the last month alone, we have received 47 donations of food, 42 supply donations, 20,000 homemade masks and $450,000 in donations. A special $200,000 gift was made by jazz artist Richard Elliot and his wife Camella in honor of all of our physicians, nurses and staff, in the hopes that it will inspire others to give.

Why did Palomar Health ask for mask donations? 
Palomar Health asked for mask donations, and we are happy to announce we reached our need for cloth masks. 

What should we do with donations other than masks?
We are receiving many donation offers from generous local companies and residents. We are grateful for their generosity and ask all hospital supply donations be sent to Heather.Woodling@PalomarHealth.org in Supply Chain. Donation offers for anything other than supplies should be directed to Alex.Arana@PalomarHealth.org at the Foundation.

Note: Due to the outpouring of support we are no longer accepting mask or food donations. Thank you for your support.

COMMUNITY RESOURCES
Where can I get the latest data on the spread of the coronavirus?
The County of San Diego Public Health Department updates coronavirus statistics every day around 4 p.m. 

Where can I get good information about community resources such as child care, etc.?
The County of San Diego operates a website and information line that contains local resources, sorted by zip code that has been vetted by professionals. You can call 2-1-1 or visit their website to learn more about these resources.

Do you sell N95 masks? If not where can I purchase them?
No hospital sells N95 masks, but they are available from third party vendors. Please be careful of scams and price gouging as some are taking advantage of the pandemic. Your best defense against contracting the coronavirus is to stay at least six feet away from other people and wash your hands regularly.
 
COVID-19 FACTS
What is COVID-19?

COVID-19 (also known as coronavirus) is a respiratory disease first identified in Wuhan, China causing an illness not previously seen in humans. The fact that it’s a new virus with little information is why it’s getting so much attention.

How does COVID-19 spread?
The virus mainly spreads between people in close contact with each other and/or from a cough or sneeze. People are most contagious when they are feeling sick. However, it might be possible for the virus to spread before symptoms occur. Although unlikely, the virus could spread by touching an infected surface and then touching your face.

What are COVID-19 symptoms?
The following symptoms may appear 2-14 days after exposure:
- fever
- cough
- shortness of breath

Where can I find the best information?
Centers for Disease Control
San Diego County Health & Human Services Agency
 

Flu Vaccinations

Each year, the Centers for Disease Control (CDC) (www.cdc.gov) recommends a new flu vaccine to protect against the upcoming strains of influenza. The 2019 - 2020 flu vaccine will protect against the three influenza viruses that research indicates will be most common during the season. It will not prevent illness caused by other viruses. It takes up to two weeks for protection to develop after the shot, and protection lasts six-months to one year. Palomar Health, working under national guidelines provided by the CDC, is prepared to vaccinate as many individuals as possible, age 9 and older, through its community flu shot clinics. Palomar Health nurses will provide the influenza vaccine by injection to persons 9 years of age and older.

 

 
There are no more community flu shots this season.