Update Monday, Mar 23, at 9:48 pm. Dr. Ming Lin continues to post on his fb page from South Dakota. He returns to work tomorrow, Tuesday, Mar 24. And he says a local company is able to sell the N95 face masks - the scarce but desired ones - to PeaceHealth. This could be good. Here is his post of this evening.

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I WOULD BE UPSET

A father asked for my help. Her daughter’s COVID test 9 days ago is still pending from the emergency room. She showed up to registration clerk which is in the waiting room UNMASKED with cough and fever.

Also a dozen others of her acquaintances are quarantined and CANNOT work awaiting her results.

As of today Peacehealth will be sending some of their COVID to UW.

Finally!

Message me if u choose to remain anonymous. I will keep it confidential.

Please pass on our message and please feel free to share any peacehealth story

Tomorrow I return to work to see if I still have a job hahaha

Pass the word, call someone. We can make a difference and get over this

Please push on

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Update Saturday, Mar 21, at 12:23 pm. The W ashington Post this morning is reporting that health care workers in hard hit states are saying, “... the battle to contain the virus is lost and the country is moving into a new phase of the pandemic response.” The hardest hit states are New York, Washington, and California - in that order. And our local St. Joseph hospital is still dragging its feet, according to Dr. Lin. Meanwhile, Dr. Frank James, our former Whatcom County Public Health Officer, has joined the discussion on Dr. Lin’s facebook page with supporting comments and further information.

Lin posted this morning: “I just want the general public to remember that the covid virus is for the MOST part a virus with symptoms indistinguishable from the cold or flu. If you are not too short of breath you do not need to come to the local emergency room. The only treatment is oxygen should your level be low which we can check in seconds with a portable machine. Coming INTO the hospital to be tested is like walking into a room of people coughing away with a cold.

PRACTICE GOOD HYGIENE and keep away from your love ones if u show signs of the cold. Most of us will do fine but it’s the healthcare workers who are battling this war with minimal gear.

No and I don’t want pizza and donuts!

Stay tuned and be careful

Skagit ( 20 min away) set up their tent over two weeks ago. Where’s our tent Chuck?

James commented: “Yes being a recommendation and implementing it are very different. Ming Lin is absolutely correct when a flood of ill elders hit the hospital there will be more healthcare worker and EMS workers both exposed and off line due to exposure or actually getting the disease, this is not good or bad it just is. We should be developing ways to suport the in place initially as much as possible like has been done in Seattle once they had to deal with it. These folks are fragile. Within in a week two at the most, with exponential growth of cases we will not be able to admit anyone to the hospital.”

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Update, Mar 19, Thursday evening at 10:15 pm. Dr. Lin has posted a third piece on his FB page - and there is reason to hope his suggestions are being implemented at St. Joseph Hospital. Again I am posting his statement here to render useless the hospital pressuring him remove the post from his FaceBook page. You can visit his FB page to read the many expressions of thanks from local folks. And he suggests we may finally have decent supplies of test kits.

The Seattle Times has this evening posted a comprehensive article on Dr. Lin and his whistle blowing on the poor practices at St. Joseph Hospital. This will make it even more difficult for Dr Lin to be fired as was threatened. He was told earlier this week to take down his FaceBook post or resign. He did neither. Now with regional attention on St Joes and their stubborn refusal to protect their staff and patients and their slowness to prepare for more testing, they may be forced to come up to the standards that all other hospitals in the Puget Sound area are practicing. Well, lets hope. We thank Dr Lin. It took much courage to post and then leave it posted. He has served our community.

Here is Dr Lin’s third post, with the second below and the first at the bottom.

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Wow! Great job everybody for passing the word out and show of support. This is not a good time to be bashing my employer or the hospital as we have MORE serious work to do and we need to do it expediently.

We have to realize that this is a LEVEL 3 biohazard (google it) which means anything short of PPE outfit is pretty much useless in an enclosed environment. We need to be covered completely. A mask alone (surgical or N95) will still give you a 7-9 percent chance of catching influenza in a hospital setting (JAMA 2019). COVID is much more infectious than Influenza.

We also have to presume everybody is COVID positive until proven otherwise. We need to open up outside ventilated tents like Skagit so we can spread our staff and patients apart and continue social distancing at the hospital.

Some good news is that I have been in communication with EMS concerning supplies and lab corp to help expedite testing (potentially 1500 test a day with 2 hour turn around) and they both have some great ideas. I NEED great logical ideas from everybody on how to get more safety equipment and making our workplace safer.

These are unprecedented times and we will be in for the long ride. Please everybody save the kind words ( too much for me to read), but share your ideas. I may need your help later to pressure the right people to make the necessary changes.

- - - End of third post by Dr. Lin

Update, Thursday, Mar 19 at 10:20 am. Dr. Lin has posted a followup of “good news and bad news” - and we have posted it above his original letter. Scroll down for his letter, first posted on his facebook page. I have learned from sources at St. Joseph Hospital that Dr. Lin was pressured to remove his letter from FB - before I posted it here on NWCitizen. Indeed, part of the reason for posting it here is so it cannot be removed from the public record. This is a major shortcoming of FB because everything can be removed, not just misinformation. I went to considerable lengths to confirm Dr. Lin was and is an emergency room doctor at St. Joseph Hospital and also that he wrote the letter on FB, before I posted it here. Now, we post his latest FB post here, as he is again under pressure to either resign from his position as an emergency room doctor or remove his FB post - as he informs us below.

Here is his second post, with the original post now further down the page.

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Hi Everyone… thanks for your support

Some good news and bad news

Good news is there is some movement by the hospital to implement some of the things I have recommended.

1. the hospital is to implement a health screen and temperature check for staff and care givers ( although it made no mention of visitors and other non health care employee) or when.

2. the hospital is asking that elective surgery and procedures be reevaluated by the specialist for postponment( although I am a bit skeptical of this plan as I heard there were 17 cardiac cauterizations today). I know some specialist have been asking the hospital to cancel all elective surgery since last week to no avail.

3. There is finally talk of setting up emergency triage tent to release the potential pressure from the ED in case the volume picks up. Unfortunately the hospital does not plan to implement it yet as they feel volume is down. The point is not the volume but staff and patient safety in which triage of COVID risk patients can be more safely done outdoors in full protective outfit.

skagit, swedish, evergreen, wenatchee locally and numerous ED around the country with much less risk does it why not us. why wait?

4. Social Distancing is being advocated in the hospital, including cancellation of meetings.

I would like to take credit for opening up some of these actions but I am sure the hospital was planning this all along :). I won’t hold my breath but these are some positive signs

Now the Bad News

1) potential COVID patient are on the rise in the hospital and I have heard that nursing homes are sending patients to the ED refusing to take them back unless they are proven negative ( which may take 2-6 days). We should consider ourselves a petri dish for the coronavirus and warn people to come only for emergent condition.

2) Sensitivity for COVID test is probably around 70 percent so don’t be fooled with a negative test and keep your guards up.

3) US GOV just recently labeled people from endemic areas and health care workers as the most likely to get corona virus. We need to be more aggressive than the current policy of patient visitation.

4) Lastly I have received some pressure from some unnamed superiors to retract, repent or consider resigning. Unless I am terminated and not wanted I will continue to show up to work in the Emergency Room to continue to serve.

I do not want to sound gloomy and as a general population we will get over this. However the potential damage to the health care staff is catastrophic. We need to be pro active and stand up and speak for each other’s safety. PLEASE SHARE my message.

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End of second FB post by Dr. Lin.

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Wedesday, Mar 18, at 5:24 pm - post of Dr. Lins first letter.

Doctor Ming Lin, who works in the Emergency Department at St Joseph Hospital in Bellingham, wrote a letter to Chief Executive Officer (CMO) Charles Prosper of PeaceHealth, the corporation that owns the hospital. As he suggests at the beginning of his letter, his first letter went nowhere. So he sent the second letter below - slightly expanded from his original - to his immediate director at St Joseph Hospital, with words that direct the letter to the CMO. Dr. Lin also posted both letters to his facebook page. I copied the letter from there. I also confirmed that Dr. Lin actually wrote the letter.

His concerns impact the safety and health of our Bellingham and Whatcom County community. Dr. Lin raises questions and issues about how St. Joseph Hospital is dealing with the Corona Virus and COVID-19 epidemic. These should be public questions and issues and they demand responsible answers from St Joseph Hospital.

Here are his words and his letter.

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This a letter I sent to my director today

Unfortunately I don’t feel the CEO or CMO wants to hear from me unless it’s thru a chain of command

I have to say I am quite disappointed in the one hour phone in session we had yesterday with administration CEO and CMO. Couple of points I find concerning.

1. We have no line to express our concern about our safety other than thru you. The impression I get is that they are not interested in our concern.

2. We have been told over and over again that we are looking into outside testing, we are looking into outside screening, we are looking into getting more test but the fact is when outside walk in clinics are allowed to order more tests with less restriction and doing it more safely, we like to know specifically know when and why. We shouldn’t be requesting, we should be demanding for our own safety.

3. We are the greatest risk of spreading coronavirus. We have the highest concentration of Covid and Covid potential patients in the county. Would you feel uncomfortable flying in an airport today, than you should feel nervous about going to work. We should be screening patients, visitors and STAFF with questionnaires and temperatures before they enter the hospital.

4. We should request that ALL elective procedures and surgery to cease at the hospital. That is why they are called elective. It should not be at the discretion of the surgeon. If bars and restaurants and non essential stores are closed, so should elective procedures.

5. Its somewhat concerning when administration is not aware that other hospitals which have much less exposure are also implementing outdoor screening. i just find out my old hospital in a tiny town of Cobbleskill has been doing outside screening since last week

6. I will also be altering my practice not to do strept test, influenza test until we have covid capability wo restrictions, Sensitivity of the former is questionable. I also recommend doing portable cxr on all patients to decrease exposure to patients and staff. I have also asked that scribes to have the option of not showing up on my shift. I encourage my colleagues to do the same.

7. To say that giving patients information on our testing availability and its indication up front is a violation of EMTALA is ludicrous. Would you rather have patients in the ED coughing for hours and waiting to be told that we cannot test them. EMTALA has been around for over 40 years and even lawyers cannot agree on what constitute a EMTALA violation. Its a bit of a vague to say anything that deters a patient from seeking medical help is consider EMTALA violation.

note that on one of the image at an GOVERNMENT facility, they are also checking everybody’s temperature and warning patient of Covid prior to entering the ED.

Would you consider asking people to wipe their shoes prior to entering a deterrence?

Thanks for hearing my concern and would appreciate it if you can relay my concerns to the CEO and CMO

Regards