Dr. RC Trotter, physician advisor for the Ford County Health Department in Dodge City, Kansas, has had a busy couple of weeks.
Positive cases of COVID-19 have been climbing in southwest Kansas since early April. According to the Kansas Department of Health and Environment, Ford County’s first case of coronavirus arrived March 17 with a traveler from Oregon. It was later counted elsewhere. Another positive came April 3. Numbers steadily ticked up with new positives added every day since April 8. As of April 27, numbers have reached 519 positives.
“It's kind of a strange deal,” Trotter said April 22. “We knew what was supposedly going around and people wonder why the big surge.”
Trotter’s office, Family Practice Associates, didn’t have any test kits, but the local hospital did.
“We started testing and everything exploded since then,” Trotter said.
The lack of testing supplies was troublesome, and, finally, on April 20 the state of Kansas sent Ford, Finney and Seward counties in southwest Kansas and Lyon County in central Kansas 7,000 tests. These areas have large meat packing plants with employees who tested positive. Trotter said the Ford County Health Department was able to acquire the rapid test system and started testing.
“We're all just trying to get a handle on this situation,” he said. “The intent is since it's hitting those counties that have the beef packing—let's get in there and find out what's going on.”
Trotter said he’s encouraging plant employees who are suspected to be positive to go to the Ford County Health Department and be tested. Extra staff has been added by KDHE at the county location because every one of the positives has to be contact traced.
“They brought in staff to do the testing and if they get into trouble there, our local hospital has technicians that are set to go and they could come out and help. So we will find the resources to take care of this problem,” Trotter said.
National Guard’s help
There are also plans to have quarantine housing available at a couple places around town. The National Guard is stationed in Dodge City to help with testing and the housing. Trotter hopes those who need the housing will take advantage of it.
“I hope that some of this will be culturally relevant. I hope these people can see that as we're not trying to do something bad to them if we can find them places to go outside their own home,” Trotter said.
He’s advised those patients who have tested positive at his clinic to stay home. Not everyone has followed the directive.
“We’re having trouble when we tell people ‘go home and stay home and don't,’” he said. “We've had other people go to a church gathering. We've told them no, you go home and you stay home.”
Once tested, the case is called presumptive and the person is a “person of interest, or PUI,” he said.
“That means you stay home and everybody that lives with you stays home until we know,” Trotter said.
Test process is quicker
The lab his clinic is using has a 48-hour turnaround. The Ford County Health Department is concentrating on the beef packing plants and has a faster testing system. Trotter hopes the increased testing will help get a handle on the number of positive cases.
“So we can keep that up and running, both for those who produce the beef that goes to the plants and then for the consumer,” he said. “So we don't start having runs on beef like we had on toilet paper.”
He hopes the testing will figure out where the disease is going, and April 22, he wanted to say he’s seen a slight drop, but he can’t say that just yet.
“Because it will very much depend as we maybe changed the demographics of the people we see because more from the plant of going out there,” he said. “We'll see. We're technically just about a week into this. It's just exploded on us.”
National Beef and Cargill have implemented changes in production and are offering employees additional personal protective equipment, and some have even slowed the lines down. Trotter believes these actions should help reduce exposure to employees.
“It’s got to be helpful. I've been in these plants off and on for 30 years. I have worked with a number of issues,” Trotter said. “I can talk Cargill particularly because I do their work comp. I had to get checked going in just like everybody else. So they did a real good job of checking you coming in.”
Trotter, however, is finding the 100.3 degree temperature reading is not a good indicator.
“None of our positives were at that level,” he said. “They're always lower. So I said get rid of that. I don't know who came up with it, but in Kansas it doesn’t work.”
Trotter said people are taking Tylenol on the way in to the plants, so screeners are better off asking, “Do you have a cough, fever, headache, backache any of these other symptoms?”
“Then you go get tested. That's the standard that we started with,” Trotter said. “In terms of testing, we just lowered the bar right down to—you have some symptoms.”
In the cases he’s seeing, people who are not necessarily working at the plants, but maybe have a spouse or is in close contact with someone who does. Trotter suggests doing the recommendations to protect yourself, especially the masks.
“You wear your mask to protect the guy in front of you,” Trotter said. “Now, if the guy in front of you is really infected and doesn't have a mask, you're gonna get his stuff whether you wear a mask or not.”
The cloth masks do protect you from spreading your germs to someone else.
“I don't want to see you in Walmart without a mask on. I don't want to see you anywhere,” Trotter said. “I know I was a late adopter until our numbers blew up and then I said, ‘Look, I've got to model.’ Now, mine's a bandana with a cowboy hat.”
As of April 22, Trotter was only aware of one hospital admission, and there hadn’t been any recorded deaths in Ford County because of COVID-19.
“So I know we don't look like New York, but we could,” he said.
Smaller communities surrounding Dodge City—Jetmore, Spearville, Cimarron and Minneola—need to be on guard as many people work in Dodge City, but live in the smaller surrounding communities.
“They’re at risk,” he said.
He’s been in touch with hospital staff in Hodgeman County and said they’re having staffing issues because of concern about COVID-19 when a spouse of an employee at their healthcare offices works in Dodge City. As of press time there’s only one travel restriction to and from Ford County, and that’s for residents of Trego County, according to their health department.
“We've had some other smaller entities in town that have had some exposure early on,” Trotter said.
And since testing was limited at the time, Trotter said businesses still operating need to be cognizant of the recommendations and practice social distancing.
“That's what I'm concerned about—we're going to have some bleed from the plants, as we get what we call crossover into other industries as somebody who works in the plant,” he said. “Now, the wife or husband works in another plant and we can start, you know, getting that crossover.”
Trotter has experienced other disease progressions like COVID-19 during his years in the medical field, and he believes people need to pay attention.
“I'm not much of a doomsday person. But I can see these numbers and we need to listen to these numbers,” he said. “I'm kind of a late adopter on all of this, but it's here.”
Trotter asks people to stay home and wear your masks if you have to go out.
“I'm seeing tons of people out walking. That's awesome. You know they're out with their kids and they're going for walks and riding the bicycle and that's fine,” Trotter said. “Go do it; if you come up on another person maybe scoot over to the side.”
Being cognizant of the people around you is important, he said.
“It's showing respect for the other person,” Trotter said. “They don't know you and you don't know them. So show them some respect.”
Trotter is no stranger to agriculture, growing up in small towns and working various jobs in the industry.
“I understand it enough to know,” Trotter said. “I could assure those out in the beef world, just hang in there, we're doing OK. We're not in New York. I can't predict when this is gonna pass, but, you know, I think we'll be back on track.”
Trotter is also president of the Dodge City Roundup, Inc., which produces a 5-day Professional Rodeo Cowboys Association rodeo during late July and early August.
“Yes, a lot of things will change—I'm thinking rodeo,” he said. “But how can I put on a rodeo safely. Actually I've been in conversations with the PRCA, with my medical expertise talking to them about how things could be done differently with contestants, at least in the short run and maybe in the long run.”
Kylene Scott can be reached at 620-227-1804 or email@example.com.
Listen to Kylene's interview with Dr. Trotter on the HPJ Talk podcast below.