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To say it’s been a busy year for the Ravenswood Family Health Center and MayView Community Health Centers would be an understatement.
Just as the pandemic was breaking out in March, the East Palo Alto-based Ravenswood Family Health Center was in the midst of wrapping up its acquisition of the MayView Community Health clinics, adding its staff members and working through contract details, and learning the nuances of running clinics across the border in Santa Clara County. The combined facilities, now part of the Ravenswood Family Health Network, are responsible for about 25,000 patients at the Ravenswood Family Health Center in East Palo Alto and the MayView clinics in Palo Alto, Mountain View and Sunnyvale. The Palo Alto location is temporary closed.
From there, it’s been a whirlwind of learning and adapting to serve communities upended by a coronavirus that has hit patients like theirs disproportionately hard, said Ravenswood Family Health Network CEO Luisa Buada.
One of the first problems in the early months of the pandemic was acquiring enough personal protective equipment for employees. In the first three months, she said, about 80% of their PPE was donated from various sources, including corporate leaders who leveraged connections with international markets to track down needed supplies.
Staff members have also had their own challenges some are themselves medically vulnerable and unable to work closely with patients, and others have had to cut back their hours due to limited child care options.
The system has hired a number of nurses to do testing for patients and staff, and has developed protocols to minimize the risk of spreading COVID-19, Buada said. The network provides free testing for its patients at the East Palo Alto and Sunnyvale locations. Access more information here.
Ravenswood Family Health Network is one of the beneficiaries of the Mountain View Voice’s Holiday Fund. Because the Voice and its partner the Silicon Valley Community Foundation cover all the administrative costs, every dollar raised goes directly to this year’s 10 nonprofit organizations. Donations to the Holiday Fund can be made at mv-voice.com/holiday_fund.
Both COVID testing and preventative actions, Buada said, are necessary.
“A test today is only a test today,” she said. “If you go out and partied tonight, you could get COVID and five days later be in the hospital.”
“Testing is not a cure,” she said. “It is a snapshot in time. It’s not something that should reassure you such that you do not practice preventive measures.”
Now, clinic visitors are screened at the entrances and called in advance to find out if they are symptomatic, she said.
For patients who do test positive, the clinics conduct telehealth visits to make sure they are OK and not at risk of exposing many people. For COVID-19 positive patients who have asthma, the clinics have also been providing free pulse oximeters so that patients can check their oxygen levels at home, she said.
While COVID-19 has hit especially hard in the communities the clinic serves in East Palo Alto, Menlo Park’s Belle Haven neighborhood and North Fair Oaks, clinic staff is also seeing increases in anxiety, depression and financial hardship among patients, Buada said. Many patients have lost jobs and some were not eligible for aid due to their immigration status, she said.
Another challenge for the Ravenswood clinic was figuring out how to conduct dental care safely. The team spent a lot of time researching it and ended up purchasing aerosol filters and defoggers, and requiring dental patients to be tested for COVID-19 three days in advance of an appointment and get a negative result, Buada said.
“No one’s gotten COVID from patient care,” she said. “We’re doing all the right things.”
On top of all that, the clinics switched their entire electronic medical records systems midyear.
“It’s extremely helpful for continuity of care,” she said.
Future challenges
As of late November, two challenges that the health clinics faced were a glove shortage and concerns, leading into Thanksgiving, that employees would travel for the holiday and be required to quarantine, impacting the availability of workers in the clinics, Buada said.
Clinic employees are part of the community, and some are dealing with the same factors that create temptations to break with pandemic guidelines, she said. Some may have cultural beliefs that can be somewhat fatalistic, along the lines of “If God wants me to get COVID and I die, that’s just life;” pressure from family members to visit; and pressure from friends to hang out or face isolation and ostracism, she said.
“It’s really hard to say no to people who are around you,” she added.
Looking ahead, another challenge will be making sure people feel safe about getting vaccinated. She expressed concerns that some people may fear the vaccine and opt out. “If not enough people get vaccinated, we face a situation of COVID continuing endlessly for a very long time,” she said.
COVID-19 is still a young disease, and it’s still not clear what the long-term impacts will be to those who are infected, even after they recover, though the clinics are keeping a close eye on the emerging research, Buada said.
“We’re going to be managing the long-term effects of COVID for a very long time in health care and trying to figure out the best way to help people once they recover as well,” she said.