LVMC Community Update, August 21, 2020

Dear Lompoc Valley Community:

I will tell you something nobody knows: the Lakers are 1-1 in the playoffs, and the Dodgers have the best record in Baseball. That’s not good for you Giants fans, but at least nobody is paying attention.

Today I will speak (write) in general terms about Covid, and stay out of the weeds. The good news is that the statistics continue to go in the right direction for Santa Barbara County. The number of hospitalized Covid positive patients continues to decline (55 as of today). The Positivity Rate continues to decline significantly. I won’t provide a specific rate because there are conflicting figures, but even if we use the highest figure, it is still a material decrease. The number of new Covid cases is coming down, as well, but it is the one metric that is not quite at the State benchmark.

Santa Barbara County is poised to meet all of the metrics needed to get off the County Monitoring List. However, once the County meets all of the metrics, in order to get off of the Monitoring List, the County needs to continue to meet the metrics over a 14-day period, with no more than 3 of the 14 days having one or more metric worse than benchmark.

Then, if the County of Santa Barbara miraculously accomplishes the above, what does it mean? Not much. It doesn’t mean that gyms, hair salons, restaurants, and other businesses can open. This can only happen by the State issuing a new order. (It is still important to meet the State metric benchmarks, because if and when a new State order is issued, allowing businesses to open, it may only apply to Counties that are not on the Monitoring List.) The only thing it means is that schools, particularly K-6 schools, will be more likely to have their Waiver Application approved, if they choose to submit one.

While the State’s benchmark for new Covid cases is “less than 100 per 100,000 population, over a 14-day average,” K-6 schools are permitted to submit Waiver Applications, if the rate is less than 200 per 100,000 (rather than 100 per 100,000). So, with that concession made by the State, Santa Barbara County meets the criteria for K-6 schools to submit Waiver Applications.

Before a school can submit a Waiver Application and request to reopen, the school must “consult” with the teacher’s union (if applicable), parents, teachers/staff, and other stakeholders, as well as have arrangements to Covid test all school staff every two months. The requirements of the “consultation” are not well-defined, but the implication is that the school must be able to demonstrate support from those groups. I am aware of at least one school in the Lompoc Valley that is preparing to submit a Waiver Application.

I thought you might like to read a brief article from the August 21 edition of the Santa Maria Sun, which provides excellent information from our own LVMC General Surgeon and COVID-19 Care Director, Dr. Chris Taglia.

Local doctors talk about how COVID-19 treatments have changed for the better

By MALEA MARTIN

Throughout the COVID-19 pandemic, the word “change” has overwhelmingly become laden with connotation of difficulty, confusion, and hopelessness. From lost jobs to missed rents to curves that won’t flatten, many of the changes happening around us are wrought with pain and hardship. But positive changes are happening, too, one being an in-the-works vaccine, perhaps the fastest ever developed.

And in the meantime, the medical community is making constant headway on how to treat the disease. Those treatments, Lompoc Valley Medical Center General Surgeon Dr. Chris Taglia said, look completely different today than they did five months ago.

“When things hit this community in Lompoc the hardest was probably at the end of March, beginning of April,” Taglia remembered. “That’s when they were seeing the peak of the disease in New York, so we got a lot of our protocols from the hospitals in New York, which is where I did my fellowship training. I had a bunch of buddies back there who were willing to share their treatment algorithms.”

At the time, Taglia said, treatment was heavily based on using hydroxychloroquine, an immunosuppressant, and azithromycin, an antibiotic used to treat infections.

“When all of that information came about—the different journal articles that were published showing the lack of benefit of hydroxychloroquine—we immediately threw that out of the protocols,” Taglia said. “We started using convalescent plasma.”

Convalescent plasma treatments, in which a recovered person’s antibodies are given to a sick patient, continue to be a strong part of treatment today. Dr. Lynn Fitzgibbons, director of quality and research and medical education at Cottage Health, wrote about the benefits in an Aug. 13 email statement and encouraged those who have recovered to donate their plasma.

“At Cottage Health, we are very interested in the potential of convalescent plasma as a tool for fighting the virus in the most severe cases when patients are hospitalized,” Fitzgibbons wrote.

Another positive change for Santa Barbara County came with access to remdesivir, an antiviral medication.

“We kind of always knew it was effective, we just didn’t have any,” Taglia said. Then in May, “Santa Barbara County got an allotment.”

At that, time Lompoc Valley Medical Center had “a ton of patients from the federal prison who were quite ill,” Taglia said, so the hospital got the highest allotment among local hospitals.

“It wasn’t a magic bullet,” Taglia said. “But there was a definite improvement.”

Another advancement came in June, when a U.K. study revealed the benefits of steroids, particularly dexamethasone, in treating critically ill patients.

“That’s something that was frowned upon when this all started,” Taglia said. “Then the data came out from the U.K. study, and now everybody’s using steroids and they seem to make a definite impact.”

For a small community hospital, Taglia said that most patients will be treated in accordance with the set guidelines coming from the larger medical community. But, he added, there are rare times when “you have to throw the kitchen sink at someone.”

“Even before steroids were popular before that U.K. study came out, we had a few patients who were not in a good way, and we used steroids and saw the benefit,” Taglia said. “Certainly that was off-label use, and that’s maybe one small example of when we didn’t follow the set guidelines that were out there.”

Luckily, knowing when to try something outside the box is not a decision that doctors in Northern Santa Barbara County have to make alone.

“There’s a bunch of pulmonary critical care specialists who are down in Santa Barbara. I have a good relationship with all of them, and so we constantly have group emails back and forth,” Taglia said. “If I had a difficult-to-treat patient, I’d call one of them and say, ‘Hey, what do you think about this?’ or, ‘I’m thinking about steroids, is that a good choice?’”

Occupational Medicine Service

LVMC is in the process of launching its Occupational Medicine Service Line. It is located at the Lompoc Health North H Center. The services provided include pre-employment physicals, drug screens, treatment of workplace injuries, Workers Compensation

Evaluations, and others. If you are an employer potentially interested in this service, please feel free to contact me, and I will connect you with the right people at LVMC.

Official Welcome to Dr. Ira Felman

A few weeks ago, I mentioned the impending recruitment of a new Hematologist/Oncologist. Now, I can say “recent recruitment” rather than “impending recruitment,” as Dr. Ira Felman began treating patients at the Lompoc Health Oncology Center on August 10. Dr. Felman is working alongside Dr. Donna Walker, and in conjunction with Radiation Oncologist and LVMC medical staff member, Dr. J. Ben Wilkinson. Dr. Felman can be considered “a local”, having earned his undergraduate degree from UC Santa Barbara (back in the day), and doing his residency and fellowship in Hematology and Medical Oncology at Los Angeles County/USC Medical Center. Dr. Felman has previous practice experience on the Central Coast and is liked and respected by those who know him. Welcome, Dr. Felman!

LVMC Mural Restoration

On July 18, 2005, the ribbon was cut, dedicating the mural at the entrance to LVMC. 15 years later, with funding and oversight by the Lompoc Hospital Foundation, the mural is being restored. The restoration, which began in early July, is being done by Ann Thompson, the curator of the Lompoc Mural Society. The restoration is expected to be completed near the end of the year. It is fascinating to watch Ann “do her thing,” as there is a lot more that goes into a restoration than most of us would think. Ann has said that there have been out-of-town visitors, homeschooling parents and children, and others who have stopped by to observe. Ann is working almost every weekday, please feel free to come by and take a look!

Donations

A huge thank you to the following businesses and individuals who have made donations of Personal Protective Equipment and supplies, food for our healthcare workers, and other acts of kindness. You are all very much appreciated!! (The ones in bold are new since the last update) Angela Wynne; Edward Maschke; Direct Relief; Albertson’s Store #3171--and those individuals who participated with Albertson’s; Northrop Grumman; Southwest Carpenters Union; INTO THE AM CLOTHING LLC-Matt Marchione; Kathy Milham; Kimberly Todd; Vons Market; Celeste Dugré; Subway; Sleep Center; Doreen Ross; Lompoc Pizza Hut; Superior Home Health; Miguelito Elementary School; Cajun Kitchen; La Purisima Mission Mask Makers; Advanced Performance Physical Therapy; SONOS; Pickle & Peanut Restaurants Inc.; Jordano’s; Lompoc Little Caesar’s Pizza; Victoria Perez; Diana Coronado; Firework Foundation; The Daily Grind; Industrial Eats; Vivid Financial Management; Christine Collier; David Carey DDS; The Church of Jesus Christ of Latter-day Saints; Sue McIntyre; McDonalds; Hilton Garden Inn; Anita Macias; a collaboration of 18 wineries--Alma Rosa, Ampelos, Chanin, Fiddlehead, Flying Goat, Garcia, Kings Carey, Kita, Longoria, Loring, Pali, Piedrasassi, Sandhi, Santa Barbara Winery, Sea Smoke, Sweetzer, Temperance and Transcendence; CoastHills Credit Union; CenCal Health; Dunn School; American Host; Kateri and Chris Kingsley; Katherine Milham; Sweet Bliss Sugar Scrubs and Co.; Carol Kirkland; Dr. Iris Radler; Donna Bommersbach; Patricia Henry; Nancy Manes; Annamie Lafferty; Marilyn Romine; Courtney & Mitch Barnham; Ida Kreds; Ingrid Kaper; Judy Carpenter; Space X; Lompoc Oral and Maxillofacial Surgery; Santa Barbara Foundation; Lompoc Hospital District Foundation; Lompoc Unified School District; Lompoc YMCA; Floriano’s Mexican Food; Circle K; Keller Williams Realty of Lompoc; Girl Scouts of Lompoc; Arbonne independent distributors; Orcutt Bakery; Northrop Grumman; L3Harris Technologies; Astrotech Corp.; Harbor Freight; Home Depot; Direct Relief; Heath Dental; CHC Dental; Mikowicz Dental; Kimberly Nails; Not Alone Plumbing; Artisan Uprising Winery/Azeo Distillery; Starbuck’s Store 496; Tom’s Burgers; Super Grill; Sign Gypsies Central Coast.

Our frontline healthcare workers, support staff, physicians, and allied health professionals have been doing an outstanding job, and we are very thankful and proud of them!! Thank you, Lompoc Valley Community, for your tremendous support of LVMC and our healthcare workers; it means a lot to all of us!

As always, please feel free to contact me at popkins@lompocvmc.com or (805) 737-3301. Until next time, be well and stay safe!

Steve Popkin
Chief Executive Officer