COVID-19 Update

COVID-19 UPDATE CONVERSATION WITH DR . MATT YOUNG BOWIE COUNTY HEALTH AUTHORITY

T E X A R K A N A M O N T H LY

Dr. Matt Young, owner of Texarkana Emergency Center, and practicing emergency medicine physician of more than 20 years, serves as the Health Authority for Bowie County. He works closely with local hospitals and city and county leaders to make recommendations and share information about Texarkana’s COVID-19 status. Texarkana Monthly asked Dr. Young a few questions to help provide updated information regarding current conditions in the community. TEXARKANA MEDICAL FACILITIES Are Texarkana hospitals at capacity? Are sick Texarkana residents still being admitted locally?

MISINFORMATION From the beginning of this pandemic until now, there have been constant changes and new findings. Is there any topic of significance that you continue to notice causing confusion for the people of Texarkana? If so, please take this opportunity to clear up those areas with the most current understanding of information. “It is a true disease process that we are seeing locally, and it is affecting people in a significant way. It does cause death, and it does cause illness. We just need to make sure people are aware that it is a problem in our community. Just because somebody may feel well, that does not mean that they couldn’t be passing COVID-19 around. There are carriers who do not have symptoms. So, that’s why it’s important for us to follow the guidelines that are set out by the CDC and also both the Arkansas and the Texas Governors, as far as wearing a mask.”

“They are both very full, but they are not at capacity at the current time. It’s a dynamic situation, but for now they are able to handle both COVID and non-COVID related illnesses. There are beds available currently, but that changes hourly and daily. We, at the Emergency Operations Center, keep in constant contact with our hospitals to make sure that we can handle the cases in the Four States area.” Are there enough ventilators locally? Will that be a problem? “Currently it’s not a problem. They have had large usage of the ventilators, but there are extras that we could potentially bring in to use if needed. We can borrow from sister facilities as well.” “If the hospitals do get full, after the patient is seen and evaluated at one of the local emergency departments and the request for admission is needed, then the hospitals will work together to get that patient a bed at the nearest and most appropriate facility. That’s only if they are full. They are doing everything they can to make sure that they have beds for all our neighbors and friends in the four states area.” If the local hospitals get full, what will happen to newTexarkana cases needing admittance?

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T E X A R K A N A M O N T H LY

PREVENTION Beyond social distancing and hygiene, are there preventative steps that we can take? For example, are there vitamins or supplements that might be effective to keep us from getting sick? “I think a lot of times we overlook what we should be doing on a daily basis, and that is: making sure we are getting the appropriate amount of sleep and rest, which is very, very important; making sure we get the appropriate amount of exercise; and having a good stable diet that includes all food groups. Water is also our friend, so we need to make sure we are hydrating. Then, some extra vitamins and some over-the-counter medicines may be appropriate, such as vitamin C, zinc and vitamin D. Just remember, that’s all in moderation, because your body will eventually get rid of what you don’t need. So, we’re just trying to optimize what our body needs to make sure that we can fight off any infection, be it any virus or bacteria that we may come across.”

TESTING If a person has COVID-19 consistent symptoms, how important is it to have the diagnosis confirmed by testing? Is it safe to assume a positive diagnosis and simply begin self-isolation and symptom treatment at home? “Really, if you’ve been exposed to a known positive case for greater than ten minutes, the treatment is quarantine. You can get tested many times, but the treatment is still quarantine for 14 days, because what we do know is that it might take up to 14 days for you to start showing symptoms and being able to spread the virus yourself. Just getting a negative test result in the first few days after exposure does not mean you are negative. There are some specialists that even say you may show symptoms or spread the disease much further out than 14 days, but if you are exposed, 14 days is what current literature and current medical practice is going by from the CDC guidelines. If

you do show symptoms, absolutely get tested to make sure, and then you need to isolate. That means basically being by yourself and not even around family members. You want to make sure you are protecting them from yourself, if you actually get the disease.”

What’s the truth about wearing masks? How effective are they at prevention? “Well, masks help us protect each other. The person who wears the mask is actually protecting their germs from getting to other people, in the sense that if you sneeze or you cough inside your mask, at least it’s not free flowing out into

Are tests still readily available?

“Many of the nasal swabs, which they call

the community. If the other person you come close to also has a mask on, that adds prevention of anything that might slip through your mask, getting into their respiratory system or their mouth. The majority of the time the mucous membranes, your eyes, your nose or your mouth, are where this disease gets into our system, so masks do help. Nothing is 100% effective and what we say today may change tomorrow, but we do currently feel that using the mask both protects us and those around us.” Do you recommend a certain type of mask? “I recommend most of the ones that are FDA approved. Again, not all of them are going to be 100% effective at preventing every illness. Some of these viruses and bacteria, and other types of illnesses that we may come across, are so minute that they aren’t going to catch everything. They will catch most of what we need them to, though.”

the PCR test, are still long in coming back with results. The standard of care that both the Arkansas and Texas Departments of Health currently consider the gold standard are the PCR nasal swabs, so it’s taking anywhere from two to ten days to get those back because labs are stressed.” Are test results reliable? “Test results need to be considered with the exposure of the patient. The gold standard currently is the Nasal Swab PCR send out test that is taking anywhere from 2-10 days depending on the labs’ volumes. The rapid tests are not 100% so each of these tests also need to be considered with patient exposure. If you have been within 6 feet for more than 10 minutes of a positive patient quarantine is the key even if you are not having symptoms. It is recommended to quarantine for 14 days.

If symptoms occur during that quarantine time it is absolutely necessary to see your provider to be evaluated.”

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T E X A R K A N A M O N T H LY

COVID FROM HOME According to the most current data, what are the most effective ways to treat COVID symptoms from home? As far as treatment, is there anything specific that should be avoided? “Again, what we say today might change tomorrow, but currently we feel that Acetaminophen, which is Tylenol, and Motrin or Advil, are still appropriate to treat for fever and body aches. Over-the-counter cough suppressants are still fine to use. Again, make sure that you are resting, drinking plenty of fluids, mainly water, and also eating an appropriate diet; these are all important.” “That’s a good question. What we do know is that the virus kind of tends to affect some of the dependent parts in our lungs. So, they’re talking about putting some of the patients on ventilators in a prone position so that areas that are usually gravity dependent are not just getting attacked by the virus. The same thing might hold true for you at home. Potentially sitting up in a chair could have a positive effect, so that we’re ventilating all portions of our lungs and the parts that are gravity dependent aren’t being continuously attacked by COVID.” There is a rumor that sleeping in a more upright position could help. Is there any truth to that? When is it necessary to go to the hospital? “When our symptoms are not improving if we are taking over- the-counter medications and especially when we are experiencing shortness of breath or difficulty breathing with chest pain. Those are some of the hallmarks, when you add fever, sore throat, body aches, headaches, lack of taste or smell, with COVID type symptoms, that’s when we need to go to the hospital, clinic, or the ER to get evaluated.” COVID-19’S EFFECT ON MINORS/ “We are very fortunate that COVID has not created the need for hospitalization for most minors. They still get ill with it, but we see their symptoms are a lot less and their illnesses are not nearly as severe. Remember though, they are still out and about in public so they could still be carrying the virus and many of them are probably without symptoms or what we call asymptomatic. So, that’s the importance of us wearing masks, and them wearing masks, because they can spread it very easily.” THE START OF SCHOOL How is COVID affecting minors?

Updated 7/20/20 at 3:06 p.m.

Bowie County COVID-19 Status Total Positive Cases in Bowie County 493 Bowie County Patients Hospitalized 19 Bowie County Active Cases 238 Bowie County Patients Recovered 225 COVID-19 Deaths in Bowie County 30 Non-resident Patients Hospitalized 27 Total Hospitalizations 46 Bowie County Positive COVID-19 Demographics Males 220 Females 273 0-18 41 19-29 80 30-39 79 40-49 82 50-59 63 60-69 64 70-79 58 80+ 22 The Bowie County/Texarkana, Texas Joint Operations Center is still conducting contact tracing on positive cases, so if you test positive for COVID-19, or are a healthcare provider that conducts COVID testing, please notify the Local Health Authority at (903) 255-5560.

Please visit www.coronatxk.org for more information.

In light of that, what would your advice be to parents of school-age kids for this upcoming school year? In your opinion, will kids be safe in classrooms?

congenital heart disease. That particular pediatric population and those with other medical problems, might need to use a virtual type of learning. Most others in the pediatric population should be safe in their environment as long as they are wearing masks and following other CDC guidelines.”

“We would recommend for those who don’t have any contraindications to wearing masks, to wear them and follow the other CDC guidelines. Some pediatric patients may have lung disease such as asthma or

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A Message to Our Community: Texarkana hospitals and county health authorities actively managing COVID-19 and counting on the community’s help to reduce the spread

The number of COVID-19 patients in the Texarkana and surrounding region has increased significantly in the past weeks, resulting in rising hospitalizations. Like area residents, we are concerned about this trend. First, we want to assure our community we have been and will continue to work together to respond to this pandemic. Both hospitals have worked diligently to ensure safe and accessible healthcare for all in need. We communicate regularly and are confident in our abilities to provide safe care to all with compassion and professionalism. However, we need your help. Reducing the spread of COVID-19 requires everyone to participate in safe practices throughout our daily lives -- every day, every time. It is proven people wearing face masks in public, social distancing by maintaining a physical distance of at least six feet from others and practicing frequent hand hygiene reduces the spread of the virus. We are writing this unified message to ask the people of Texarkana and surrounding counties to do these three simple things to help us save lives and prevent further surge of COVID-19. Face masks are required upon entering both hospitals in order to keep staff, physicians, patients and essential visitors safe and healthy. Screening is also required of all who enter. We appreciate the understanding and adherence to this important effort to help minimize exposure. We applaud businesses as well as individuals who have supported and practiced the proven measures as a means of being part of the solution. Our citizens and neighbors have been resilient throughout the history of our community, unifying to overcome challenges, and now we need each and every one of us to step up again. The initial efforts on both sides of the Stateline were successful in flattening the curve in the number of cases. The reopening of the economy undeniably has been critical but has added challenges, and we have witnessed increasing COVID-19 cases. It is important we continue to work together to prevent the spread of COVID-19 for our health and our economic situation. We strongly believe the people of this community can, and should, be able to continue the practices needed to earn a living and support our economy. But, for future success, we need everyone to engage in all of the needed steps to limit your risk of exposure as well as protect those around you. Masking, physical distancing and hand washing - these things work and can help impact the current trend of increasing COVID cases . Thank you for your support. We stand together to serve you and your family today and always.

Jason Rounds

Thomas Gilbert

President

President

CHRISTUS St. Michael Health System

Wadley Regional Medical Center

Matt Young, M.D.

Jerry Stringfellow, M.D. Miller County Health Authority

Bowie County Health Authority

COVID-19 PARENTING 5

Keep Calm and Manage St ress

This is a stressful time. Take care of yourself, so you can support your children.

You are not alone

Listen to your kids

Millions of people have the same fears as us. Find someone who you can talk to about how you are feeling. Listen to them. Avoid social media that makes you feel panicked.

Be open and listen to your children. Your children will look to you for support and reassurance. Listen to your children when they share how they are feeling. Accept how they feel and give them comfort.

Take a break

We all need a break sometimes. When your children are asleep, do something fun or relaxing for yourself. Make a list of healthy activities that YOU like to do. You deserve it!

Take a Pause

Step 1: Set up • Find a comfortable sitting position, your feet flat on the floor, your hands resting in your lap. • Close your eyes if you feel comfortable. Step 2: Think, feel, body • Ask yourself, “What am I thinking now?” • Notice your thoughts. Notice if they are negative or positive. • Notice how you feel emotionally. Notice if your feelings are happy or not. • Notice how your body feels. Notice anything that hurts or is tense.

Step 3: Focus on your breath • Listen to your breath as it goes in and out. • You can put a hand on your stomach and feel it rise and fall with each breath. • You may want to say to yourself “It’s okay. Whatever it is, I am okay.” • Then just listen to your breath for a while.

1-minute relaxation activity that you can do whenever you

Step 4: Coming back • Notice how your whole body feels. • Listen to the sounds in the room. Step 5: Reflecting • Think ‘do I feel different at all?’. • When you are ready, open your eyes.

are feeling stressed or worried

Taking a Pause can also be helpful when you find your child is irritating you or has done something wrong. It gives you a chance to be calmer. Even a few deep breaths or connecting with the feeling of the floor beneath can make a difference. You can also Take a Pause with your children!

For more information click below links:

Parenting tips from WHO

Parenting tips from UNICEF

In worldwide languages

EVIDENCE-BASE

The mark “CDC” is owned by the US Dept of Health and Human Services and is used with permission. Use of this logo is not an endorsement by HHS or CDC of any particular product, service, or enterprise.

Parenting for Lifelong Health is supported by the UKRI GCRF Accelerating Achievement for Africa’s Adolescents Hub, the European Research Council (ERC) under the European Union’s Seventh Framework Programme and the Horizon 2020 Research and Innovation Programme, Oxford University Innovation GCRF Sustainable Impact Fund, UNICEF, the Leverhulme Trust, the Economic and Social Research Council, WHO, CIDA, the National Research Foundation of South Africa, Ilifa Labantwana, Rand Merchant Bank Fund, the ApexHi Charitable Trust, the John Fell Fund, the Evaluation Fund, the UBS Optimus Foundation, USAID-PEPFAR, the Wellcome Trust, Grand Challenges Canada and Wellspring Advisors.

Talking about COVID-19 COVID-19 PARENTING 6 Be willing to talk. They will already have heard something. Silence and secrets do not protect our children. Honesty and openness do. Think about how much they will understand. You know them best.

Be open and listen

It is OK not to know the answers

Allow your child to talk freely. Ask them open questions and find out how much they already know.

It is fine to say “We don’t know, but we are working on it; or we don’t know, ‘but we think’.” Use this as an opportunity to learn something new with your child!

Be honest

Always answer their questions truthfully. Think about how old your child is and how much they can understand.

Be supportive

Your child may be scared or confused. Give them space to share how they are feeling and let them know you are there for them.

Heroes not bullies

There are a lot of stories going around

Explain that COVID-19 has nothing to do with the way someone looks, where they are from, or what language they speak. Tell your child that we can be compassionate to people who are sick and those who are caring for them. Look for stories of people who are working to stop the outbreak and are caring for sick people.

Some may not be true. Use trustworthy sites: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public and https://www.unicef.org/coronavirus/covid-19 from WHO and UNICEF.

End on a good note

Check to see if your child is okay. Remind them that you care and that they can talk to you anytime. Then do something fun together!

For more information click below links:

Parenting tips from WHO

Parenting tips from UNICEF

In worldwide languages

EVIDENCE-BASE

The mark “CDC” is owned by the US Dept of Health and Human Services and is used with permission. Use of this logo is not an endorsement by HHS or CDC of any particular product, service, or enterprise.

Parenting for Lifelong Health is supported by the UKRI GCRF Accelerating Achievement for Africa’s Adolescents Hub, the European Research Council (ERC) under the European Union’s Seventh Framework Programme and the Horizon 2020 Research and Innovation Programme, Oxford University Innovation GCRF Sustainable Impact Fund, UNICEF, the Leverhulme Trust, the Economic and Social Research Council, WHO, CIDA, the National Research Foundation of South Africa, Ilifa Labantwana, Rand Merchant Bank Fund, the ApexHi Charitable Trust, the John Fell Fund, the Evaluation Fund, the UBS Optimus Foundation, USAID-PEPFAR, the Wellcome Trust, Grand Challenges Canada and Wellspring Advisors.

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