Today - a guest post from my friend and colleague from the San Diego community clinic world, Gary Rotto. Gary's the Director of Health Policy for the Council of Community Clinics - San Diego's equivalent to our clinic consortium. As policy director down there, Gary's been tracking some of the same issues we've touched on recently - including the swine flu response and the debate over public health services to undocumented immigrants. I thought it'd be interesting for our readers to see how these topics are playing out at the other end of the state.
Mexico is Swine Flu Ground Zero, but San Diego and Imperial Counties are only a step away. Call us Ground Zero Plus 1.
By now of course, the steam's gone out of the media coverage, but for a while its feverish reports were spreading concern faster than the virus was spreading actual fever.
As the hysteria radiated out, schools overreacted by requiring students to see a doctor for even a runny nose, needlessly exposing healthy students and their families to those who had the virus. As three local high schools closed and the school boards prepared the public for continuing the closure until May 18th, parents and their children swamped our clinics. One reported a 70% increase in walk-in visits. Another had to keep staff at its location until 11pm. Another, working closely with the local emergency rooms, opened on Sunday to see patients. By Friday (5/15/09), clinics had prescribed 40 courses of Tamiflu - including pediatric doses.
Just before the media attention peaked, one San Diego television reporter showed up unannounced after service hours in front of a local clinic and started talking about how the clinic provides screenings to undocumented workers.
Actually, the clinic provides services to patients who speak 18 different languages and focuses on the intercity communities. But in San Diego, the issue of “services for undocumented workers” is an attention-grabber. Couple that with the H1N1 outbreak, and you have an unfortunate ratings hit for the 6pm news.
But beyond its fixation on the spread of the virus, the media to its credit did spotlight the close working relationship between our clinic consortium and the County. Since San Diego County does not have a public hospital and does not fund its own clinics, our community clinics are truly on the front lines of public health. As you did in Contra Costa/Solano, we worked collaboratively to harmonize testing protocols, refine the system for pickup and testing lab specimens, etc.
The H1N1 outbreak was San Diego County's health system stress test. We saw the impact of breathless media attention, a perhaps overly pre-cautious school district, and a justifiably concerned patient population. And the system - largely made up of community clinics on the front line - held fast. In the process, we learned a lot about what to do next time.