The Mariposa Community Health Center (MCHC), which has offices in Nogales, Patagonia, Rio Rico and Tubac, has instituted a series of changes in response to the coronavirus pandemic to implement best practices to protect patients and healthcare providers with the goal of slowing the spread of the disease.

A patient waits to be screened for coronavirus symptoms before being allowed to enter the Health Clinic in Patagonia.  Photo by Robert Gay

Dr. Molly Anderson, the family health practitioner at the Mariposa Clinic in Patagonia, reported that the clinics set up an entry area tent at all their locations on March 17 to screen patients. People are asked questions about their travel history, any symptoms of fever or cold or if they have been around someone with symptoms to determine their potential to exposure.

If someone has respiratory symptoms but no fever, they are asked to wear a mask. If there have both fever and respiratory symptoms one of the nursing staff will evaluate them (outside) and, if needed, a doctor or a physician’s assistant will also assess the patient outside. If a care provider determines that you fall within the criteria to receive a test you will be recommended to go to MCHC in Nogales, according to Dr. Anderson. 

The strict criteria to receive a test at MCHC is largely based on Center of Disease Control’s (CDC) recommendations. If a person has a fever, cough, shortness of breath in combination with a known significant exposure to someone who has a documented case of covid-19; someone who has symptoms and works in a high-risk profession such as medical worker, grocery store cashier, jail guard and someone who is living in a nursing home and/or jail they will be tested. 

As of March 25, there has been one person assessed at the Patagonia clinic who was sent for testing to Nogales. In Nogales approximately a dozen people have been tested. To date, all those have come back negative. There have been two confirmed cases in Santa Cruz County.

Anderson said it is not ideal that there are not tests readily available. She said “testing becomes less useful when disease is rampant, it is most useful when the numbers are small.” Jeff Terrell, the Director of Environmental Health Services in Santa Cruz County, said “we are trying to get more tests and replicate the drive-through testing that has started in other places but there is a nationwide shortage on tests. We are doing our best, but I have no timeline at the moment.” Currently, test kits are available at MCHC, Holy Cross Hospital and   Nextcare Urgentcare in Nogales. Desert Stream Clinic in Sonoita has put in an order for tests but has not received them yet.

Anderson explained that Covid-19 is “spread by moist droplets.” In terms of the outbreak in Arizona she said there is “plenty of evidence that people have the virus with no symptoms or mild symptoms and we are not testing them, which means the number of people infected or contagious is quite a bit larger than the [confirmed] positive cases.” As of now Anderson said, “we don’t know if the virus is maintained in the air for any length time,” but we do know it can be passed on through surfaces. “Being in a rural area is a protective measure, people are more likely to be exposed in a high-density area”, she said. 

 “People are calling frantically because they can’t get tested,” she said but it’s important to remember that “testing a person who is sick is not going to make a difference in their treatment.” Testing widely has been shown to be an effective way to curb the disease in other countries.  

Recommendations in place for people with symptoms of fever and cough is to stay home if they are not critically sick. At home try to isolate yourself from others in the family and wear a mask. Masks are most useful if you have respiratory symptoms and want to avoid spreading it to others, said Anderson, but masks are not very effective in protecting you from getting the virus. If you are feeling significantly ill call ahead before going to see your healthcare provider. If someone is showing signs of significant illness and if they meet the criteria, they will get tested for covid-19. 

MCHC has instituted a policy for all staff to be screened for a fever before entering work. Any staff person who is not feeling well is asked to stay home. MCHC also decided to cancel all non-urgent appointments for people who are considered high risk (those who are elderly or immunocompromised) and has switched to telemedicine during this time. You can call (520) 281-1550 to make a telehealth appointment with a variety of providers. 

There is still no specific treatment for the virus. If one feels sick, he or she can have Tylenol or a cough syrup, said Anderson. Drugs are being tested around the world, said Anderson, “but we don’t have any information that they work.”

For now, Anderson reiterates the recommendations from CDC to help avoid contracting or spreading the virus. These recommendations are to stay home, stay away from groups of people, avoid any gathering of ten or more people, stay six feet away from other people, wash hands frequently and don’t touch your face. During this physical distancing you can take time to go outside and are encouraged to take walks, said Anderson. “You can bike, you can take a scenic drive, just stay away from people.”