As the coronavirus pandemic subsides, Petaluma ponders its path forward
Pedro Toledo remembers the fear and uncertainty that gripped him more than a year ago.
After a Petaluma Health Center employee tested positive for COVID-19 on March 15, 2020, marking the first case of community spread in Sonoma County, health center officials like Toledo, the chief administrative officer, scrambled to brace for what was to come.
“We didn’t know what the impact was going to be,” Toledo said. “But we knew what we were seeing in Washington state and New York.”
The health care network closed and fully sanitized its Rohnert Park facility where the infected employee worked because officials didn’t know how contagious the virus was. It partnered with the county to establish a military-style field hospital across vast swaths of the Sonoma State University campus because health leaders thought a surge of coronavirus patients was imminent.
It tapped into its stores of PPE, a fortunate December 2019 purchase, to protect its workers, but Toledo said there was ongoing worry about their ability to protect the health care agency’s 45,000 patients, many of whom belong to traditionally underserved groups.
“The whole reason we exist is to eliminate health disparities,” Toledo said. “We knew this disease was impacting people of color and low-income communities. We knew it would be our patients that would be disproportionately hit.”
They were right. In the throes of the COVID-19 pandemic, the virus swept through nursing homes, killing vulnerable seniors, and zeroed in on the county’s Latino population, which accounted for three-quarters of all local infections last summer.
As Petaluma, and Sonoma County, wobble toward recovery from a virus that has killed 312 and infected 29,807 while closing down civic life and cratering the local economy, leaders in health care, education, housing, commerce, senior care and transportation are working to envision what’s next in part by examining the lessons of the past 13 months.
“I think that we’ll never be the same,” said Wendi Thomas, director of nursing for Petaluma Valley Hospital. “Those that have been through this as health care providers are always going to be worried about the next new virus.”
In early April, when Thomas recounted the initial stages of the pandemic at Petaluma Valley Hospital, the details came in raw, unflinching surges.
“What kept me up at night was making sure…was doing everything I could to make sure we could care for the community and not make our nurses collateral damage,” she said. “They were frightened. I was frightened, but I couldn’t show that. My major focus was to show them that I was so on top of everything, that I could get them all of the PPE they needed.”
As with most U.S. hospitals at the start of the pandemic, Petaluma Valley Hospital was forced into a precarious balance of resources, conserving or over-using some of the most effective personal protective equipment that for years was cycled through via “just-in-time” delivery to cut back on waste.
“We always thought, ‘let’s not fill our store rooms with stuff that might expire,’” Thomas said. “I think that’s going to change forever. I don’t think any hospital right now will want to be in a position where they don’t have at least two weeks of PPE.”
Thomas, who recalled a bustling pre-pandemic Petaluma Valley Hospital filled with vendors, patients and visitors, staff birthday parties and more, said hospitals like hers likely won’t ever go back to having a fully open campus again, either due to patient safety or because visitors are more fearful themselves.
Restrictions on hospital visits led the health care industry to pivot quickly to tele-health.
Petaluma Health Center, which operates in south Sonoma and west Marin counties, areas home to 80,000 residents, offered remote doctors’ visits to patients isolating at home, or to those working multiple jobs who couldn’t take time to visit a health center. Toledo, the chief administrative officer, said the effect was greater access for people who might not normally visit the hospital.
Some of the biggest post-pandemic shifts, said Toledo, are dependent on government action, including continued waivers for remote medicine and greater funding for primary care.
“That’s one thing we’re hoping we’ll be able to maintain,” Toledo said, referring to tele-medicine strategies. “There are strict insurance requirements that prevent us from being able to do that.”
Even with tele-health on the table, Thomas said health care providers may be forced to grapple with disparate health crises in the coming months and years. Residents delaying preventative care could face sobering diagnoses, and a burgeoning mental health crisis is evident in local emergency rooms, Thomas said.