SAR & COVID19 – Part 1

The following 2 posts were originally sent as emails to La Plata County (CO) SAR, which Dr. Durkin is the medical director. They are shared here for educational interest of other rescue professionals in formulating their COVID19 response. This is not medical advice for use outside of LPCSAR. The COVID19 situation is highly dynamic and recommendations and guidance are changing incredibly frequently. Any policy or procedure regarding COVID19 should be thoughtfully prepared and frequently reviewed with the input of a physician advisor taking into account the most current information and recommendations from local, state and national public health authorities. This is a highly dynamic situation with a very contagious and potentially fatal disease.

Teammates:

The leadership team has been very engaged with planning & discussion regarding the novel coronavirus pandemic. These discussions have included other agencies in the area and our public health department. I want to thank Ron, Tom, Leo, & Dr Brainard for their proactive support in this area. 

As you are aware, we are postponing or cancelling all but the most essential of in-person team activities. This will help keep our organization healthy and ready to respond, as well as reduce transmission of this disease in our community. As this situation is unprecedented, I would like to share with you some summary thoughts, since the tremendous amount of information in the media is overwhelming. 

The COVID19 coronavirus is a new illness not previously detected by medical science. It is spreading rapidly around the globe since first being detected late last year. It can be spread by infected people before they feel or show any signs of illness. While some people will have no or minimal symptoms (but can still spread the disease) or have a flu-like experience, others will become critically ill with the virus attacking the lungs and other organs. This can lead to weeks of severe illness, death or permanent disability when recovered. While the chances of severe illness increase with increasing age and pre-existing medical problems, the disease can sometimes cause severe problems in young and healthy people. COVID19 can be easily spread when someone sneezes or coughs nearby, or if a person touches their face after touching something with virus on it. 

While as of this writing there are few confirmed cases in our area, do not get a false sense of security. Many people will spread this disease without getting sick, others will not seek medical treatment (usually unneeded unless you have breathing difficulty, severe weakness, fainting or other symptoms more extreme than a typical flu) , the medical tests are being rationed and may not have the accuracy of more established tests. People can be infected and possibly spread the illness for up to 2 weeks before they get sick. It is only a matter of time before we have more confirmed local cases, and there are almost certainly undetected cases in nearly every community. 

With this in mind, one can begin to understand the rationale behind “social distancing” and cancelled team events. The major objective for everyone right now should be to slow the spread of this illness. The best way to do this is to limit contact with others to the extent reasonably possible. Obviously, many of us will need to goto work to afford to live and/or provide essential services as well as obtain food at the store. Other activities are not as essential and should be critically evaluated. Avoid crowds and large gatherings. When visiting with people, avoid handshakes, hugs or other intimate contact that could spread illness. Conversation should be at a longer than usual distance – 6 feet is the current recommendation. 

If you are feeling ill (coronavirus or common cold) stay at home. Similarly, if you have been around ill people, known COVID19 patients, or visited an area with widespread cases, then you should self-quarantine. The current recommendation for this is 14 days.  

In addition to social distancing and avoiding unnecessary interpersonal interaction, another key tool to keep yourself healthy and prevent spreading illness to others is to frequently and thoroughly clean your hands, either with soap and water, or with hand sanitizer. This is especially important after touching anything that is frequently touched by others like door handles, credit card keypads, money, gas pumps, elevator buttons and the like. Be sure to not touch your face until you clean your hands after touching any frequently used surface or item. 

While it may seem obvious, I encourage everyone to review the CDC information on hand cleaning, at https://www.cdc.gov/healthywater/hygiene/hand/handwashing.html

By limiting our activities and giving careful attention to hygiene, we as a team, community and nation can slow the spread of this disease. This will save thousands of lives by preventing the health care system from becoming overwhelmed. This is the case in Italy where they have an excellent modern healthcare system but are leaving many for dead as there just are not enough people and equipment to care for the number of critically ill patients. Take a moment and consider how horrible that situation is for the patients, their families and the hospital workers who are unable to save them. We may be able to prevent this with aggressive action before there is more extensive spread. 

As this email is already plenty long, I will discuss some mission considerations in a follow up message. 

Keep yourself healthy & thanks for being on the team

Timothy Durkin, DO, FAAEM, CAQSM

Medical Director

La Plata County Search & Rescue 

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