March 27, 2020

This evening the Governor of Alaska implemented 2 new health mandates. We are taking all precautions seriously and well be changing some of our processes. We have evaluated and decided, although we are considered critical essential services there are some positions within the clinic that can be done from employee’s homes. Beginning Tuesday, March 31, 2020 our billing department and some admin staff will be working from home. We have cancelled the onsite monthly services from our CFO and Behavioral Health Provider. Their services will be done via distance for the time being. The clinic is scheduled to be closed on Monday, March 30, 2020 in observance of Seward’s Day.

Beginning Tuesday, March 31, 2020 we will require more time between appointments to allow for though cleaning of the patient rooms and lobby. As we stated before, there may be appointments we would prefer to handle in the home. We want to protect everyone and there are situations when this will be a safer approach. We are asking all patients to not bring any extra family or friends to appoints unless medically necessary. All patients must call for an appointment as walk ins are not recommended, except for in the case of an emergency. At this point, the schedule is open, so appointments are available.

Some key points that came out of the frequently asked questions put out by the State of Alaska that we think are very important to understand and take into consideration.

Q) Should I wear a mask?

A) A mask will not necessarily prevent you from catching the virus, however, it will limit you from SPREADING the virus IF infected. There is a national shortage on masks and we, at Camai CHC, ask you to not use masks that may be needed later, if we have an outbreak here.

Q) How do I keep from getting the virus?

A) The science is definitive that maintaining six feet or more from other people will greatly diminish your risk of getting the virus. This, and washing your hands, not touching your face, and wiping down surfaces are the best public health guidance about preventing the spread of this virus. Since there are no current vaccination or antiviral treatments, the primary goal is to prevent getting the virus in the first place. Standing six feet away or more from others is the best way to do this.

Q) Can older people leave the house on essential errands?

A) The Centers for Disease Control and Prevention (CDC) recommends that older adults, age 64 and older, and those with underlying health conditions not leave home at all, even to run errands. The State of Alaska recommends that these more vulnerable populations order food or necessary items using available services from stores and restaurants, or ask for help from a relative, friend or neighbor. For the safety of everyone, stay home.

Q) Can I get groceries?

A) Yes, grocery stores remain open, but you must maintain six feet of social distancing. Take advantage of grocery delivery or pickup services. All Alaskans are encouraged to limit their number of weekly trips to the grocery store and to shop alone, do not bring the entire family into the store. If you MUST go to the grocery store, you MUST remain six feet away from anyone. Please keep at least six feet from others when you are out in public, wash your hands often and wipe down frequently touched surfaces. Do not go grocery shopping if you are ill with a respiratory infection; if you are ill, you should be isolating yourself at home, including from family members.

Q) What if I’m dating someone who lives in another household? Am I allowed to visit that person?

A) You must stay six feet away from anyone who is not a family member. Not doing so endangers the members of the dating partners’ families.

Currently, there is no case of COVID-19 in Bristol Bay Borough and it is our continued hope that these measures will help keep the virus at bay. All the staff at Camai CHC are here to help.

If you have any questions, we will help answer them. We are all in this together and together we will get through it.

Mary Swain

Executive Director/CEO

March 25, 2020

We have been asked several times, what will happen if I get sick and can not travel on a commercial flight out of Bristol Bay. Although we can not answer for the airlines, we do know if a situation is life threating, we are able to medevac a patient to Anchorage. We have been in contact with our medivac providers and they have begun taken extra precautions in cleaning their aircraft and decontamination. The providers are protecting themselves as well based on CDC guidelines.

Medevac insurance is a tool that can help you have peace of mind and not worry about a large medical bill for the flight. The 2 companies we work with are Guardian and Life Med. Guardian is $125 a year for your family and has a 15-day waiting period prior to utilizing. Therefore, you must have it in place prior to being ill or injured. LifeMed is $49 and you must have other insurance to apply for this one. It can be used instantly but other insurance is a requirement.

As a reminder, we are still in flu season and we have flu vaccine available for all age groups.

You may have heard in the news lately that the FDA is working on a new “rapid” test for COVID-19. Unfortunately, this is not a test Camai CHC will be able to do when it is approved. The test will require a lab to process it and our lab is not certified to do this kind of testing. We do not predict a test that can be used in our lab for months, if at all.

Please know that Camai CHC is working very hard to prepare for this virus. Staff has spent hours working on several contingency plans and training. If you have any questions, please do not hesitate to contact us.

March 23, 2020

Patient confidentiality is as important to us as safety. Safeguarding patients’ rights regarding personal health information is an ethical and legal obligation for the clinic and everyone who works at Camai CHC. This can be challenging at times in everyday situations, but when we are in a crisis it is even harder. All patient information is protected by HIPPA, Health Insurance Portability and Accountability Act, legislation that assures every patient’s health information is protected. We are not able to disclose who has been at the clinic, what they are here for or if any test was done for a patient. Privacy is a right of patients to keep information about themselves from being disclosed. Deciding who, when, and where to share their information is the right of patients. As staff at Camai we are obligated to treat patient information confidentially.

You may hear in the news that HIPPA rules have been waived. This does not mean they have been suspended. Certain information may need to be shared to assist a nationwide public emergency. The Secretary of the U.S. Department of Health and Human Services (HHS) Alex M. Azar exercised his right to waive certain aspects of the HIPPA Privacy Rule. These include:

  • the requirements to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b).
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a).
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520.
  • the patient’s right to request privacy restrictions. See 45 CFR 164.522(a).
  • the patient’s right to request confidential communications. See 45 CFR 164.522(b)”

This means a health care provider /clinic/hospital will not be fined if we do not give you all the privacy information we normally would if you were coming to the clinic for a regular visit. However, it does not allow us to disclose patient information to any member of the public that the patient has not approved in writing.

March 20, 2020

Beginning the week of March 23rd, we will offer a new schedule for the benefit of our patients who might be more susceptible to infection {Elders, Pregnant women, and patients with chronic health issues}. Tuesday and Thursday mornings from 9-11am will be reserved for these patients.

We have also begun to ask patients who have a fever, cough, or shortness of breath to wait in the outer entryway of the clinic so a staff member can come out to them with a mask or other necessity prior to entering the clinic. It may become necessary to use the back entrance for patients if we have concerns for patient safety. If this happens you will be told in advance of your appointment which entrance we would like you to use. Patient safety is our number one concern so please be patient with us as we work through all the changes.

Camai CHC has been contacted a couple times regarding self-quarantine procedures after travel and what we would recommend. Here are our recommendations based on the current recommendations by the State of Alaska; all the recommendations are for 14 days.

Although the current guidelines issued March 17th do not specifically address in State travel we would recommend the following:

  • Keep your distance from others (about 6 feet).
  • You can go to work if you are able to maintain a safe distance from those around you. However, many employers have stricter rules, so please check with your employer.
  • Avoid crowded places and limit public activities.
  • Monitor your health.

If you are traveling from out of state, you MUST:

  • Keep your distance from others (about 6 feet).
  • You can go to work if you are able to maintain a safe distance from those around you. However, many employers have put in stricter rules, please check with your employer.
  • Avoid crowded places and limit public activities.
  • Monitor your health.

If you are traveling from out of country, you MUST:

  • Stay home and avoid contact with other household members .
  • Contact your employer and do not go to work or school for 14 days after you return home.
  • Monitor your health.

See the blank monitoring sheets for an example of what to monitor and record that we posted yesterday.

March 19, 2020

Due to requests from those traveling, we decided to share this tool to help you monitor yourself during self-quarantining. We hope you find it helpful.
Don’t forget to wash your hands.
Don’t touch your face.
If you feel sick, please do not go to work.

March 18, 2020 Update

Camai Community Health Center staff is part of an ongoing task force with processors and industry leaders from the Bristol Bay area. Yesterday we discussed at length what preparation everyone is taking, questions about supplies needed and other general ideas and questions. Everyone on the call has been preparing for quite some time. Many fishing communities are already doing things because they are currently actively fishing. We are building our preparations around what is working and what is not working. We are lucky to have them for support.  Most are internal processes and business decisions but here are a few highlights that I hope will help everyone.

  • Processors are requiring employees returning from Level 2 or 3 countries to self-isolate for 14 days to ensure they are symptom free before coming to work.
  • Some industry and processors have already hired companies to do health and temperature screens at airports, so employees are screened prior to coming to King Salmon in addition to the screening or quarantines they are requiring prior to travel to Alaska.
  • Visitors will be limited or not allowed in plants and surrounding areas.
  • Temperature checks before and after shifts and breaks.
  • All processors are developing contingency plans.

One thing we must keep in mind is that this is a very fluid situation. One day can be drastically different from the next. During our staff meeting this morning we went over new ideas and how we would handle some scenarios.

Please know that everyone at Camai Community Health Center is taking this very seriously. This is new for everyone and, one thing we do not want is panic. If there are questions you have that we have not addressed, please let me know. If I do not know the answer, I will find out for you.

Mary Swain

Executive Director/CEO

March 17, 2020

In our continuing effort to keep everyone up to date with the latest information regarding the COVID-19 virus we thought sharing how tests are treated would be helpful to everyone. Here is the latest as of today, March 17, 2020.

In order to have a test performed you must meet the criteria set by the State of Alaska/CDC. The criteria changes rapidly so these can change at any time. Following is a list of criteria:

  1. Had close contact to a laboratory-confirmed case of COVID-19
  2. Travelled (not airport transit) within the last 14 days to a location where community transmission of COVID-19 is occurring {this list is on the CDC website and is rapidly changing}
  3. Hospitalized
  4. Lives in a long-term care facility
  5. Health Care worker (negative influenza test)

Once a patient has had their nose swabbed by a health care provider they need to self-quarantine until they have the results.

The swabs are sent to the state lab in Anchorage. Tests are run 7 days a week by the State of Alaska. Specimens need to be tested within 72 hours from the time they are taken. Currently, specimens are gathered at the Anchorage lab and sent to Fairbanks for testing. They send the tests to Fairbanks at 2pm every day and they are tested the following morning. Fairbanks can process 100 at a time. On Sundays, the lab in Anchorage does the tests; their capacity is 24 tests at a time and does take a bit longer to process. At this time America does not have a test available for testing for antibodies, this means we cannot test to see if someone thinks they had the virus, only active cases with symptoms.

Prior to today, states had to have their first 5 cases confirmed by the CDC; this is no longer the case. If the state lab comes back with a positive then it will no longer be presumptive, it will be positive. You will then move into self-isolation. This means you need to separate yourself from other people in your home and limit your contact with pets and animals. You will be instructed to self-monitor. This means taking your temperature twice daily and monitoring for a cough or respiratory issue. Instruction will be given to you at the time of your confirmation call.

Once you have tested positive an epidemiology investigation will begin. You will be contacted by an investigator. They will ask for information regarding who you have had contact with beginning 48 hours prior to symptoms. They will then talk with the contacts and recommend that they to go into self-quarantine and self-monitoring. They will also decide if the contacts will need to be tested as well. They may decide a test is not warranted. This will be handled privately and on a case by case basis.

Because this information is rapidly changing, we cannot guarantee that it will always be handled this way. Protocols within the state/nation can change without our knowledge.

We hope this information will help you with the unknown. Camai Community Health staff are here to help you during this time of unsettling times. As we learn more, we will update everyone. Please, if you have any questions, do not hesitate to call us.

March 16, 2020

Camai Community Health Center is committed to taking precautions and preparing for the potential that the COVID 19 virus may come to Bristol Bay Borough. We have begun reviewing and updating our protocols. In the next few days, we will have processes in place that may change what patients have come to expect when making an appointment. We will have specific screening questions prior to making an appointment. We may also ask you not to come to the clinic and ask you to allow us to come to you for treatment. However, these are all items in the works and may change as we review and test our processes.

We will have the ability to test for the virus but there are protocols in place as to who gets tested. Each case will be handled individually and privately.

We have also been in contact with most of our industry partners in the community. Tomorrow, March 18, 2020 we will participate in a newly formed task force with key leaders and experts in the field and community. Our goal is to have the most up to date information and ensure that everyone is on the same page with procedures and processes.

This is an ever-changing situation and we will update our website/facebook at least every other day {Monday, Wednesday and Friday} and at other times as the situation warrants an update. Our priority is to keep everyone informed and protected as much as we can.