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Union Gospel Mission staff members, from left to right, Danny Mullins, maintenance director; Justin Shewey, chief operations officer; and Mike Johnson, chief executive officer, are pictured outside of a tent the mission loaned to Virginia Mason Memorial on Sunday, March 15, 2020, in Yakima, Wash. Union Gospel Mission staff members, Camp Hope staff members and 24 resident volunteers from Camp Hope helped erect the tent at the hospital's emergency entrance.

Yakima County’s count for confirmed or presumptive positive coronavirus cases has increased to 10.

Of those cases, four are ages 30-50, and six are ages 60 and above, according to the Yakima Health District.

Counts statewide continue to climb, with 1,376 confirmed cases across 24 counties and 74 deaths statewide, according to the most recent data from the Washington Department of Health. Kittitas County had four cases and Klickitat County had two.

On Thursday, Washington Gov. Jay Inslee halted all elective surgeries to reserve medical supplies and equipment for those impacted by the virus. It’s the latest in a number of statewide mandates, including shutting down schools and some businesses.

Meanwhile, local clinics and hospitals are facing other challenges of their own, including the need to ration medical supplies. Local health care providers said sanitizer, masks and gloves — supplies needed by medical professionals — are becoming increasingly difficult to acquire.

Local clinics said they are still following guidelines established by the Centers for Disease Control and Prevention, the World Health Organization, and the Washington State Department of Health to keep health workers safe.

Those guidelines include that all health care staff who are interacting with patients who have confirmed or possible cases of coronavirus need to be wearing what’s called personal protective gear, or PPE, to limit their own exposure.

Universal guidelines

Jessica Baggett, spokeswoman for the Department of Health’s COVID-19 Response Joint Information Center, said the agency has issued statewide guidelines for health care providers.

DOH’s website contains an entire page of resources for health care providers, including links to proper testing protocol, correct use of personal protective equipment, and emergency preparedness checklists for providers.

Local clinics and hospitals already have implemented those recommendations, including limiting movement, maximizing the use of telemedicine rather than face-to-face encounters, and requiring health care staff to wear protective eyewear, gloves, face masks and isolation gowns.

The CDC recommends all health care workers practice proper and frequent hand washing, wear protective equipment when entering the room of patients who may be infected, and take swabs in an exam room with the door closed.

Dr. Michael Schaffrinna, the chief medical officer of Community Health of Central Washington, said staff are required to wear eye protection, isolation gowns and masks when testing patients for the coronavirus.

Astria Health also requires staff to follow the combined guidance from its own experts, state and national health experts, and the Washington State Hospital Association.

Leah Ward, spokeswoman for Yakima Neighborhood Health Services, said the agency has specific rules in place about when staff don personal protective equipment. Ward said Neighborhood Health also follows all precautions as recommended by the CDC, DOH, and Yakima Health District for testing patients.

“We are calling patients at home ahead of their scheduled appointments to determine if they have any COVID-19 symptoms,” she said. “When they show up at the clinic, they are screened for symptoms outside. If they are free of COVID-19 symptoms, they are given a mask and seen inside.”

If providers determine outside in the parking lot that the patient warrants a COVID-19 test, the testing is done from the patient’s vehicle as a further precaution, Ward said.

Tori Tarter, spokeswoman for Comprehensive Health, said that each residential and inpatient program is developing a screening process for employees at the start of each shift to ensure that staff are healthy.

Universal shortages

The CDC also notes that major distributors in the United States have reported shortages in personal protective equipment, particularly N95 masks, other face masks and gowns.

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State and local clinics said hoarding of supplies has become an issue, whether that’s people buying cartloads of water or stocking up on sanitizer.

“The public needs to understand that issues with supply are not due to the coronavirus but due to people buying more than they usually buy,” Schaffrinna said. “Anyone buying carts full of milk or water should be ashamed.”

Baggett said global medical supply chains have been interrupted since the coronavirus outbreak began. Factors such as a growing number of COVID-19 cases, panic buying, and members of the public hoarding supplies have led to shortages, she said.

“It is very important that we reserve personal protective equipment for our health care workers and first responders,” Baggett said. “Personal protective equipment is the main source of protection against illness when tending to patients.”

Schaffrina said supply issues at Community Health include the need for infrared temperature devices and COVID-19 testing kits.

Comprehensive Health’s Chief Medical Officer Dr. Frank Garner said staff have to ration gloves. Rationing also is happening at Astria hospitals.

Ward said Yakima Neighborhood Health staff also aren’t dealing with unlimited supplies.

“We are in the same boat as other community health centers across the country,” she said. “We are on the front lines of fighting the virus. But our resources are not unlimited.”

Ward said Neighborhood Health is supporting an emergency funding effort presented to Congress through the National Association of Community Health Centers.

Baggett said the Department of Health is working with state and local partners to purchase additional personal protective equipment when possible. The agency also has requested supplies from the federal Strategic National Stockpile.

“We received supplies, and are awaiting additional supplies,” she said.

Baggett said the department also is working with local and state partners to increase testing capacity.

Staying connected

Astria has centralized communication to provide real-time updates and clinical information to its medical teams. Comprehensive Health’s infection control committee meets daily to review information and monitor the status of the community. Yakima Neighborhood Health Services has an internal landing page to keep staff apprised of the required workflow.

Community Health clinics’ leadership staff keep up-to-date with the latest recommendations daily from the Department of Health, the CDC, and the World Health Organization, which they share with health care employees during daily huddles.

“Together with Virginia Mason Memorial, Yakima Neighborhood Health Services, and Yakima Valley Farm Worker’s Clinic, we are approaching this pandemic as one fight in support of our community,” Schaffrinna said.

Schaffrinna said Community Health has offered support to others also facing possible shortages.

“I have already told Virginia Mason Memorial that we will share N95 masks that we ordered back in January and February with them if they run out,” he said. “We believe that Yakima should be working to support all that need our help.”

He urged that same spirit of collaboration and cooperation for others as well.

“It is during times of crisis that the true characters of men and women are made visible,” he said. “Stand up to support the needs of our community. And remember, things are never as good nor as bad as people tell you. The numbers will rise, and all of us will be just a tad afraid, (but) together we will win this fight.”

Reach Lex Talamo at ltalamo@yakimaherald.com or on Twitter: @LexTalamo.