Covid update: reassuring hospital doctor, CEO walk QSJ back from the edge during pandemic fears

BAR HARBOR, Nov. 20, 2020 – Julius Krevans will pass on an item on his shopping list if he detects that another shopper near him was not properly masked. He also gives wide berth to individuals who are exercising and breathing heavily – as far as 12 feet away. He has favorite restaurants on MDI but he only does takeout.

Krevans is also “Doctor Krevans,” one of the frontline clinicians at Mount Desert Hospital who has seen Covid-19 up close and is learning every day on how best to treat the disease.

He gives MDI an excellent grade for its handling of the pandemic. “We’ve seen very few person-to-person transmissions here.” Compared with similar communities in states like Idaho, Wyoming or eastern Colorado, the rate of Covid on MDI is less by a “factor or 10 to 20,” said Krevans who worked as a rural doctor in Alaska for 20 years before coming to Maine. MDI also has had zero cases of in-hospital transmissions.

He attributes the low rate to the willingness of the citizenry to effect communal behavior in everyone’s interest. MDI has not reported a new case in almost a week, after a surge of cases in the first half of November.

In total there have been only 31 positive tests on MDI since March, six of whom were visitors from out of the county. At least 17 of the 25 Hancock County positive tests were of MDI residents. There was one admission to MDI Hospital and two patients transferred to other hospitals, one of whom who died. As of this writing, this may be the first week without a positive test in a month.

When asked about the current drug regimen to combat Covid, Krevans said, “The best drug is great nursing.” Nurses in rural hospitals must be the “Jack and Jills of all trades.” From proper application of oxygen to ensuring how patients lie in bed. – “You’d be surprised at how important that is,” Krevans said.

The subject of testing drew a different reaction from Krevans. “It’s our biggest challenge.”

“Starting with the place – where you test – to the person who gives the test, to what supplies are used, to even what part of the nose you swab,” Krevans described an unwieldy array of possibilities which sow confusion and possible mistakes.

The hospital possesses two of its own rapid testing machines but its supply kits are limited. Krevans is waiting for the promised delivery of 50 kits a week to stabilize rapid testing. The hospital is also awaiting shipments of antibody drugs which, he said, have proven to be the most promising drug treatment.

Christina “Chrissi” Maguire <br>CFO/COO

It was reassuring after talking Krevans and hospital CEO Chrissi Maguire this week about the state of the pandemic on the island.

With education and programs such as the Covid-19 task force testing of 200 frontline workers and the high school testing program underway, Maguire is confident MDI will turn the corner. “We’re in excellent shape,” she said.

But Krevans emphasized that it takes only one careless person to ignite a spread such as the breakout at the Kidspeace facility in Ellsworth which issued the following statement Wednesday:

“KidsPeace is happy to report no new cases of COVID-19 associated with the KidsPeace Graham Lake Campus since the last update. The total number of individuals that have tested positive is still at 26 (15 youth and 11 staff members) and 82 negative tests. We are exceptionally pleased to report that 12 of the 15 kids who tested positive are now officially recovered. Similarly, 5 of the 11 staff who tested positive have also recovered and have returned to work.” As of the last report Nov. 15, Ellsworth had by far the highest rate of positive tests in Hancock County with 43.

Right after Halloween, folks went indoors and could not contain their “aerosolized” behavior, Maguire said. Eating and talking are two extremely aerosolizing activities which were more forgiving in an outdoor environment.

For about two weeks after Halloween there was an unquestionable surge on MDI. “But it seemed to have plateaued for us,” Maguire said. There were specific pockets of a “family unit and another social unit” which contributed greatly to the surge on the island, she said.

Krevans is having the same concerns about Thanksgiving and urged residents to wear masks even when inside with friends and relatives.

Special care needed to be taken in break rooms, cafeterias and other congregate settings where people were likely to be unmasked and emitting fine sprays, Maguire said. She worries about the fatigue of the hospital staff who are performing exhausting work as both care workers and social resources for their patients.

QSJ readers may help by donating to the Covid-19 support fund at the hospital …

SWH town manager sounds alarm over staffing of ambulance service

SOMESVILLE, Nov. 19, 2020 – Bar Harbor is the only municipality on MDI with a full-time 24/7 professional ambulance service instead of volunteers mixed in with per diem workers such as that serving the communities of Tremont, Southwest Harbor and Mount Desert. The latter is now being questioned as whether it should be the model going forward.

This was the topic of a recent meeting of MDI town managers, so reported Southwest Harbor Town Manager Justin VanDongen to his selectmen board Tuesday night.

“I think something needs to be said to really push the Tremont/Southwest Harbor Ambulance Service into making a change and making sure that they’re going to be here in a year, in five years or ten years or come up with a plan if they don’t plan to be,” VanDongen said.

That was followed up by selectmen chair Kristin Hutchins who said, “We just can’t find people to do the work.

“Until this spring we had adequate staff … we’ve lost three of our per diem paramedics. November is particularly difficult because some people have gone hunting.”

Multiple times this year there was no ambulance staffing and the Quietside went uncovered, VanDongen said.

The situation in Mount Desert is not as dire because the ambulance service has opted to pay for an extra backup in case the pandemic wreaked havoc with the scheduled shifts. But it too is looking al all options, said ambulance service chief Basil Mahaney, including adopting a Bar Harbor model someday or consolidating with Southwest Harbor and Tremont.

Mahaney pointed out that Bar Harbor has more than three times the call volume than that of Mount Desert. Mahaney, who is a paramedic in Bar Harbor, said it has about 1,000 calls a year compared to 300 for Mount Desert. The volume also means Bar Harbor has a richer revenue source for ambulance payments from users and insurance reimbursement to support a professional staff.

Paramedics from MDI ambulance services with new heart monitors in 2017. From left, Margaret Houghton of the Northeast Harbor Ambulance Service, David Buccello of the Southwest Harbor-Tremont Ambulance Service and Basil Mahaney of the Bar Harbor Fire Department. MDI Islander photo

Mount Desert has had a separate volunteer ambulance service since 1938, a non-profit which is supported mostly by donors. It receives only about $10,000 a year in support from the town plus use of facilities to house the ambulances.

Southwest Harbor and Tremont also has a non-profit service but it gets $72,000 a year from SWH and $50,000 from Tremont which make up about half its revenue.

“What do we need to make sure that the ambulance service is going to be successful in the future? And we need to know the realities of it, VanDongen said. “It just can’t be the general request for money again this year. We really need to take a look at what the investment this community needs to make to provide ambulance service to its residents.

“I think there is frustrations on a lot of fronts as far as staffing, funding, billing,” he continued. There needs to be some changes … “

Hutchins added, “I’m extremely concerned about it … I think it’s appropriate to turn up the heat a bit. If we’re not pushing, I don’t think it’s going to get solved.”

Michelle Kaplan no longer at her job at MDI Hospital

SOMESVILLE, Nov. 19, 2020 – Michelle Kaplan not only lost her race for the 132nd House seat in the Maine legislature, but she also no longer has her job at Mount Desert Island Hospital. Hospital officials confirmed today that Kaplan has submitted her resignation. She posted on Facebook she left for another opportunity.

Kaplan made statewide news when the emergency room physicians assistant went to work after appearing at a Trump rally without a mask and came in contact with White House chief of staff Mark Meadows, who later was diagnosed with Covid-19.

The following article appeared on The Quietside Journal in late October:

MDI Hospital staffer (GOP candidate) quarantined after mingling without mask at Trump rally

This image has an empty alt attribute; its file name is image-15.png

SOMESVILLE, Oct. 27, 2020 – Michelle Kaplan, an MDI Hospital emergency room physician’s assistant, has begun a 14-day quarantine after a photo appeared on Facebook showing her at the Trump rally Sunday in Levant, Maine, along with several prominent Maine Republicans, includingcandidates in both Congressional Districts. Kaplan is the Republican candidate for the 132rd House seat in Maine.

She was in at least two photos with Dale Craft and Jay Allen who are running against Democrats Jared Golden and Chellie Pingree. One included Mark Meadows, White House chief of staff. Allen is a family physician in Waldoboro.In response to a question from QSJ, Kaplan stated she is “voluntarily self quarantining for 14 days out of an abundance of caution. I will use this time to catch up on some household projects, perhaps produce a painting or two, and make some homage goodies.If I display any symptoms whatsoever I will be sure to get tested.”

She clearly failed to comply with Maine CDC guidelines where she appeared unmasked at the rally. Facebook posters said she worked at least one 12-hour shift at the hospital after the rally.

Kaplan did not answer a QSJ question of whether she worked a shift after the rally and before the quarantine.

An MDI Hospital spokesperson said, “While we cannot discuss individual personnel matters, we can assure you that any employee known to have acted in a manner that does not follow proper health and safety protocols in accordance with our policies and the guidance of the MaineCenter for Disease Control and Prevention will be required, at a minimum, to quarantine for 14 days, receive mandatory education and training, and be subject to disciplinary action.

This image has an empty alt attribute; its file name is 122716788_369425984407536_1533876732372141711_n.jpg

“MDI Hospital follows all Maine CDC guidelines for distancing, masking and screening in order to provide a safe environment for patients to receive care and needed services.We take the health of our community very seriously and will take every appropriate action to continue to provide our region with safe, responsible care in accordance with CDC guidelines and our health and safety policies and procedures.” The 132rd seat is held by DemocratNicole Grohoski.

Tuesday night the Bangor Daily News reported that the owner of the orchard which hosted the Trump rally publicly regretted allowing the event to be held saying and that its attendees did not practice good social distancing or mask-wearing in the middle of a pandemic.

Here is the link to the statement