Front Line Heroes

As the COVID-19 health crisis continues to threaten populations around the world, the true “essential workers” in our community continue to show up for us every day despite the perilous risk to their own lives.

Photo courtesy of Florida Department of Health in Marion County

The number of confirmed cases of COVID-19 in Marion County has risen to 135 in recent days, with three confirmed deaths attributed to the virus. The most recent death was that of a 49-year-old Ocala woman on April 12th. The other two were an 88-year old Ocala man and a 55-year old Ocala man with underlying health conditions, which were both reported on April 5th.

The continued risk to our healthcare workers and emergency service personnel, especially amid some of the public’s desire to break confinement, is one of the greatest dangers to our community during an epidemic like this one. While the majority of us restlessly shelter in place and practice social distancing, these men and women are called upon to be our better angels. We can choose to be safe in our homes, but for literally thousands of those on the front lines in Marion County that is simply not a choice.

These individuals are not only doctors, nurses, medical professionals, hospital staff, paramedics and EMTs, but also our law enforcement community and firefighters,—many of whom must remain isolated from their own family members because of the risk their exposure creates.

“In my lifetime, I’ve never seen a situation like what we are experiencing with this pandemic,” offers Joe Johnson, President and CEO of AdventHealth Ocala. “There are terribly difficult priorities and painful realities that everyone is facing. Some are in a personal fight with COVID-19 or have lost a friend or loved one to this virus. Virtually all are facing some degree of loss due to the closure of businesses and services. Through this darkness, however, I am also seeing signs of light and hope. I am inspired by the courage and skill of our physicians, nurses, and our entire team, along with our first responders who run to help those who are suffering.”

Photo courtesy of Ocala Health

Every hospital group in our area is facing the same challenges. Officials at Ocala Health also point to the human factor as the key to how they are dealing with the current crisis, “In the face of a threat, we don’t panic, we prepare. At Ocala Health, and across our HCA Healthcare network, what we’re made of is incredible people. Passionate people who care without reservation or limits. Courageous people who show up ready to face new challenges daily.”

“Who’s scared?” Dr. David Kuhn, CEO and founder at Trinity Clinic in Ocala, asked his staff during their morning meeting on March 16th.

“I’m scared for my kids,” one staff member replied.

“I’m scared for my grandmother,” another expressed, looking slightly shaken.

This was before any case of COVID-19 had been identified in Marion County—before any deaths. Kuhn had decided to film daily updates to give the public a firsthand and behind-the-scenes look at what it’s like for healthcare workers during these unprecedented times. He also made it clear that he intended to be an active participant in getting information from as many sources as he could on the pandemic, acting as a kind of documentary filmmaker.

“This is history. This is going to be the biggest event maybe in our lifetimes,” he replies after hearing his staff’s concerns. “The last time the world had to deal with something this big was World War II. Think about it.”

While the videos are an interesting chronicle of Kuhn’s deep dive into what is happening in relation to the COVIID-19 outbreak here in Marion County, in which he manages to access key officials and local healthcare administrators, what it also reveals is the real toll the virus is taking on local healthcare workers. On April 14th, Kuhn shared news of a local nurse, who had contracted the virus, on behalf of April Tony Crenshaw of Belleview.

Photo courtesy of Ocala Health

“My sweet friend, Patty Case, is currently in the hospital battling COVID19. Patty is a nurse at The Villages Hospital and has been on the front lines treating COVID patients since the outbreak began,” Crenshaw shared via a GoFundMe page she created for Case. “Patty is just 44 years old, a wife and a mom to three amazing kids. She is the most caring, selfless, giving person I have ever met. To meet Patty is to love her. She would literally give anyone the shirt off her back, which in part is what lead us to where we are today. Patty’s underlying health issues should have kept her safely at home, but her love of her job and caring for others led her to continue working thru this. Unfortunately, Patty developed a cough which got so severe that she had to go to the hospital via ambulance on April 6th.”

Through updates Crenshaw advised that Case had been moved from The Villages Hospital to UF Health Shands Hospital in Gainesville, where she was placed on a ventilator and sedated. On April 19th, the latest update read, “Patty is out of ICU. Doing well but still in recovery, she has about a week at Shands and then possibly three more to full recovery.”

Crenshaw further explained that she started the GoFundMe page with a goal of raising $10,000 to ease the financial burden on Case and her family, as well as relieve the stress of everyday financial worry for the family to “allow everyone to focus on fighting this battle with Patty.”

So far Crenshaw has raised $13,772 through donations from the community and exceeded her initial goal.

But there have also been other cases among healthcare workers that have not reached the public.

“There are healthcare workers, doctors and nurses that are infected. I can tell you that I know for certain of one doctor and three nurses,” Dr. Kuhn reveals of some of the other cases here in Marion County. “It is common knowledge among the medical community when one of our own becomes infected. The fear is real among healthcare workers. It is scary for us and raises the fear, especially for those who are working in the hospitals. They are our last line of defense and they have the highest anxiety level.”

There is no public data available on these cases or those involving first responders in Marion County and we were advised that such information is protected by the HIPAA regulations (the Health Insurance Portability and Accountability Act, designed to protect individual privacy of personal health records).

“Per HIPAA, we are limited in the type of information that we can share on individual cases,” explains Christy Jergens, public information officer for the Florida Department of Health in Marion County. “Any places of employment of COVID-19 positive individuals is considered protected health information.

“But we know that, since the start of the coronavirus pandemic, first responders are facing the same risks that their healthcare counterparts are subject to.”

Ocala Fire Rescue firefighter Kelly Owens

“The Ocala and Marion County first responders are the most committed group of emergency personnel,” asserts Ocala Chief of Police Greg Graham. “I am proud to work alongside these men and women. They have remained dedicated to protecting this community during the spread of COVID-19, despite the many challenges. The nature of calls have changed and present unknown risk factors. We are used to the unknown when responding, however this brings a whole new element of uncertainty to the table. Some of these challenges are mitigated by the personal protective equipment (PPE) that is provided for frontline first responders.”

While the police department has not had any members contract the virus to date, which they attribute to the dedication of personnel wearing PPE and following the appropriate protocols, the shortage of personal protective equipment and testing in Marion County places all agencies and medical facilities at a high risk level.

“This is a great time of need for a lot of people. Our job allows us to play a vital role in being there for our community when they need us the most,” Ocala Fire Rescue firefighter Kelly Owens explains of her drive to continue working amidst the pandemic, despite concerns for her family’s health. “There are risks regardless of virus or no virus. I think that the character inside most firefighters does not focus on ourselves. We are wired to care for others first, she continues. “When I walk in the door, I have a fixed attitude of ‘faith over fear.’ My husband and I teach our two children to be the same way. It is a career that is built full of unknowns. It is also a career built upon teamwork. I am incredibly proud of my crew and our department. We are taking impressive measures to limit our exposure. Our training has always focused on health and safety for everyone, and I trust it completely. Together, we can positively make a difference and ease fear for those who are struggling.”

Cpl. Calvin Batts of the Marion County Sheriff’s Office

Cpl. Calvin Batts of the Marion County Sheriff’s Office acknowledges that it is a similar sense of duty that drives he and his fellow law enforcement personnel.

“We show up to work knowing we are at risk because it is our job and our responsibility. Our job is already high risk, the COVID-19 Pandemic just adds another layer,” Batts offers. “We signed up to protect and will do so day-in and day-out through whatever challenges, outbreaks or disasters that are presented to us.”

Even in an absence of information of infection rates, it is largely accepted that these essential workers are among the most vulnerable during this health crisis.

“As COVID-19 impacts our local community, Marion County’s healthcare workers and first responders are facing a challenge unlike any that has been seen locally in 100 years,” Mark Lander, administrator for the Florida Department of Health in Marion County commented. “Their hard work in combatting the virus and in testing and treating those who are sick is vital in keeping our residents safe, particularly those who are most vulnerable.”

Jamie Ulmer, CEO of the Heart of Florida Health Center (HFHC), echoed that sentiment while detailing the work of his own team.

“These last few weeks have been a true testament to the commitment and dedication that every one of our Heart of Florida Health Center employees have to this organization and community. We have provided necessary access to healthcare including dental, as well as screening and testing HFHC and non-HFHC patients for the coronavirus, ultimately ensuring our hospitals can stay focused on COVID-19 patients,” he offered. “We are proud to be a part of the incredible team of healthcare providers, organizations, and local officials caring for and keeping the residents of Marion County well and safe.”

Photo courtesy of Heart of Florida

While Gov. Ron DeSantis’ Re-Open Florida Task Force debates when and how it will be safe to change restrictions, the difficult work continues for our medical professionals and first responders and as we, as a community, grapple with projections from experts like Centers for Disease Control and Prevention Director Robert Redfield that a second wave of the coronavirus will emerge in the fall or winter with the start of the flu season.

Dr. Kuhn has joined forces with the newly formed advocacy group, the Marion County COVID-19 Medical Task Force, composed of local physicians, who are trying to be heard by releasing their recommendations for mitigation measures.

“We have drafted an official statement of intent and recommendations. There are over a dozen doctors listed on the executive committee,” he explains. “We are going to use that document to supply recommendations to any official whose hands we can get it in, from the county level to the mayor. Any day now restrictions may be relaxed. We, as a group of doctors, are worried that the stay at home order is going to be lifted early. I don’t feel like our county is going to be a hot spot, but we have a lot of nursing and retirement homes, as well as long-term health facilities here. Those are the places that we are most worried about. That is the concern, that by lifting the restrictions there is the potential for additional infections.”

And while Kuhn acknowledges the economic impact of social distancing, he cautions that relaxing those restrictions too soon could put our community at unnecessary risk. “Businesses are closed down right now and a lot of people are out of work. It is a sad thing,” Kuhn admits. “But I don’t want to lose the opportunity that we have to get as much work done as we can get testing done while we are under the stay at home order.”

Dr. David Kuhn of Trinity Clinic

During a presentation to the Marion County Board of County Commissioners on April 21st, Lander reinforced the importance of both mitigation practices and testing.

“We continue to promote [the] mitigation step—social distancing. We have to continue with that message. That message has been effective when you look at the numbers,” he asserted. “Our numbers are where they are and are going to continue to increase, but we’ve been able to do such a good job in our community with the mitigation practices, that we are seeing a rise that does not impact our hospital system and—to date—has not impacted it. That is just the message to keep putting out there when it comes to the social distancing piece. Everyone has to do their due diligence. That’s what is going to keep this virus from spreading.”

While a relatively small number of individuals have actually been tested in Marion County—around 3,374 of the reported 353,717 residents—he highlighted the department’s efforts to leverage testing capabilities.

“We have our drive-through sites where we do it by appointment at the Health Department,” he explained. “The Heart of Florida is doing drive-through and Langley. Rainbow River in Dunnellon is doing drive-through—they are just drive-up. You don’t need to have an appointment with them. We have Ocala Fire Rescue working with us and they’re doing some stuff over at the E.D. Croskey/Hampton Center site on Tuesdays and Thursdays. They’ll be testing over there. And then we have several other providers in the community that are doing testing in their facilities. It’s going to help us get a better picture of what is happening in Marion County.”

Dr. Kuhn’s Trinity Clinic is one of those facilities that has been providing testing at their offices and currently is making strides to open a larger drive-through test site to provide even more testing, with an emphasis on access to testing for healthcare workers and first responders.

“We believe there should be no obstacle to any healthcare worker or first responder to get testing done, if needed,” says Kuhn, who has already tested over 40 of these individuals. “That is our priority.”

The Ocala/Marion County Chamber and Economic Partnership (CEP) also has been actively involved in helping the community. The CEP website offers information relative to the business community and also to the populace at large, such as a recent webinar with Kuhn and Lander. Visit www.ocalacep.com/covid-19-updates/  for details and to view that video.

Marion County officials are cautiously optimistic when assessing the local coronavirus picture, but Marion County Board of County Commissioners Chairman Kathy Bryant wants residents to recognize the positive outcomes so far.

“Our citizens have done a really great job of listening. Obviously, it shows in the results we have had,” Bryant stated of social distancing, before addressing the call for all Marion County citizens to be tested. “There are limited resources when it comes to testing. Out of the over 3,000 that we have tested, for the most part, these have been people that have presented with symptoms or contact history or travel history that would make us highly suspicious that they have COVID-19. And yet, we have still remained at 4 percent to 5 percent positive [results].”

Photo courtesy of the Ocala Police Department

Lander stated that this is a low rate compared to the average 9.9 percent seen in other Florida counties.

And even as health policy experts and government leaders across the country are looking ahead on how to best ease coronavirus social distancing, what can we do to keep ourselves and others safe during this pandemic? While it is tedious to hear…We can wash our hands often, often, often. We can stay home as much as possible. We can remain positive and help spread the word about good works and good information. We can pray. And we can support the efforts of those on the front lines.

“I am inspired by the generosity and gratitude of our community who are finding creative and thoughtful ways to bring resources, hope and praise to these healthcare heroes. There is light through the darkness as I see our community unite to heed precautions, pour out prayers and display appreciation, and generously donate what they can to support this fight,” Johnson shares. “I am profoundly saddened by the devastation of virus but I am encouraged as I see continued selfless acts of courage and generosity. I pray for our healthcare professionals every day. I invite you to join me in holding them in your thoughts and prayers as well. Together, we will get through this, and find a way to be even better.”

Photo courtesy of Heart of Florida

Kuhn says that one of the most rewarding elements of this journey for he and his staff has been reading the comments on his videos.

“It’s been a lot of long days and nights. It’s often at midnight before I get to read the comments,” he reveals. “It’s easy to get emotional, but it keeps us all going, to know that we’re helping.”

To all of you on the front lines, we offer our heartfelt thanks and hold you in our thoughts. Even for a veteran wordsmith, it hardly seems possible there could be words enough to express our collective gratitude. We know that your service to our community it is not just a job, but your choice to be there for all of us in this vital time.

If you would like to give a social media shout out to these community heroes, please visit our post on Facebook or Instagram.

For Marion County-specific information, call the local hotline (352-644-2590), follow the Department of Health in Marion County (DOH-Marion) on Twitter at www.twitter.com/FLHealthMarion and visit http://Marion.FloridaHealth.gov. For the most up-to-date information on COVID-19 in Florida, visit floridahealthcovid19.gov. For general questions about COVID-19, call the state hotline (866-779-6121) or email COVID-19@flhealth.gov. For other general health information about COVID-19, visit cdc.gov/coronavirus/2019-ncov.html.

Residents can be screened for testing by DOH-Marion by calling the local COVID-19 Call Center 24/7 at 352-644-2590. If you qualify for testing, staff will schedule an appointment for drive-up testing with you.

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