Mahoning Public Health Prepares Nurses for Virus Tracing

YOUNGSTOWN, Ohio – As more businesses continue to reopen in Ohio, Mahoning County Public Health is preparing to use retired nurses and students in epidemiology to lend a hand contact tracing in an effort to contain the spread of coronavirus. 

“From our local standpoint, we are reaching out to public health nurses or they have reached out to us. There are a number of retired nurses that we could bring in if needed as well as students who have an epi [epidemiology] background or nursing background. We’ve even had calls with a sanitarian background,” said Ryan Tekac, Mahoning County Public Health Commissioner. “So when that time comes, we would either post for a position if were going to hire somebody or reach out to our local universities … for volunteers to help out.” 

Gov. Mike DeWine said during his daily press conference Monday that bars and restaurants largely adhered to the guidelines set forth by the state for reopening over the weekend. But not all venues followed the required social distancing guidelines, limiting groups to 10 people or fewer with at least six feet between each group. 

To ensure that all bars and restaurants follow the guidelines, DeWine announced the creation of a group composed of state health officials and law enforcement. The state’s Department of Public Safety Ohio Investigative Unit, working with local health departments, will lead the group. 

DeWine said among the potential penalties are administrative citations that could lead to the revocation of liquor licenses and, if local prosecutors agree, bring criminal charges, 

Tekac said the county’s public health received very few complaints about overcrowding in bars and restaurants, but has received complaints from larger chain stores about overcrowding. 

As far as the enforcement piece, Tekac the department works with local businesses to bring them into compliance. If businesses do not come into compliance, the health department contacts local police or the sheriff’s office. 

“What we’ve found is most local businesses are trying to do things the right way. If we come across someone who doesn’t comply then we contact police or sheriff’s office for the enforcement piece,” he said.

He said he doesn’t know of the state unit in place locally, saying that is a question for state officials. DeWine said it is the responsibility of the public as well as establishments to enforce social distancing policies. 

As far as treatment medicines being used locally on patients with COVID-19,  Dr. James Kravec, chief clinical officer for Mercy Health and medical director for Mahoning County Public Health, medical treatment is being done on a case-by-case basis for both hydroxychloroquine and remdesivir.

President Donald Trump announced yesterday that he is taking the hydroxychloroquine as a preventative treatment, adding that he’d consulted with his presidential physician about the drug. He has been an advocate for using hydroxychloroquine, used to treat or prevent malaria and is also used to treat Lupus and rheumatoid arthritis, as a treatment and preventive measure for COVID-19.

The Federal Drug Administration approved emergency use of hydroxychloroquine to treat patients who met guidelines and were hospitalized, but warned against using the therapy outside of clinical trials, citing potential “life threatening” heart problems.

Kravec, clinical director for Mercy Health said Tuesday that hydroxychloroquine as well as remdesivir have been used locally. 

“This is very individualized and done on a case-by-case basis. We haven’t used it as prophylaxis,” he said. “We have seen benefits in some patients and not in others.”

Local patients  have received doses of remdesivir, a drug used that has shown promise as a treatment, though testing continues. According to the National Institutes of Health, the drug has lessened the time of recovery from 15 days to 11.

“There has been a small amount of use of remdesivir during the past few months.  It is too early to tell if there has been a positive outcome. There are studies nationally that will give us better guidance on future utility of the drug,” Kravec said. “There does seem to be a short supply, yet the ICU and [infectious disease] physicians will use their best medical judgment to know what is the best use of the supply.

The state received a limited supply of the drug, but only enough to treat 100 patients. Kravec said Mercy did not receive any, but the hospital would be happy to participate.

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