Category: Health

Dear Tulalip Clinical Pharmacy customers: Several patients expressed concerns about medication shortage due to supply chain issue in China (China supplies a significant amount of drug ingredients to the world).  I want to assure you that we are currently very well stocked on most medications.  It’s our standard operating practice to overstock pharmacy at the beginning of the year , partly to take advantage of volume discount and partly to protect us from situation like this.   I have no doubt we will be able to provide uninterrupted pharmacy service beyond this challenging situation.  

To reduce the chance of COVID-19 transmission at the pharmacy and to ensure safety for everyone, we have implemented the following precautionary measures:

•  Clean and sanitize all work surface at least once an hour
• Staff will wear masks and gloves during work hours until further notice
•  Staff in different departments will communicate primarily via phone, Skype and email.

• Sick patients are encouraged to wear masks inside pharmacy
•  Fill 90-days supply of maintenance medications whenever possible.   
• Delivery driver will check on elders to ensure they have all necessary supplies and report any issues immediately to pharmacy management and elder care program. 

What you can do to help: 

• Wear masks at the pharmacy if you are sick (coughing, sneezing, or having a fever)
• Consider ordering 90-days supply of your maintenance medications.  please do keep in mind our bigger workload as more patients want 90-days supply of their medications. 
• Arrange pick up for elders so they don’t have to worry about getting out. 
• For Medbox patients, we assure you your delivery will be on time every month just as they have always been for the last six years because on-time delivery is one of our highest priority and we do have plenty of your maintenance medications in stock right now. 

Please don’t hesitate to contact me or my staff if you have any concerns.  We will do our very best to accommodate your prescriptions needs. 

Kelvin Lee

klee@tulaliptribes-nsn.gov

www.tulalipclinicalpharmacy.com

Coronavirus Q & A

Disease: COVID-19

Virus:  SARS-CoV-2

With so much information about the novel coronavirus, it’s challenging to decide what is accurate and useful. The Tulalip Emergency Management Department, in collaboration with the Karen I. Fryberg Health Clinic and Snohomish County Public Health District, is committed to updating you about the virus regularly. We will plan to release our updates Mondays, Wednesdays, and Fridays, as well as when new information becomes available. For the latest accurate information, we encourage people to visit the following websites: CDC (Center for Disease Control) https://www.cdc.gov/coronavirus/2019-ncov/index.html, Snohomish County Health District https://www.snohd.org/, or the Department of Health https://www.doh.wa.gov/.

The following questions have come up in the last few days. Please let us know if you have additional questions you’d like us to answer—email questions and concerns to Ashlynn Danielson, Emergency Management, adanielson@tulaliptribes-nsn.gov.

Q: How do I know if it is COVID-19 or the flu?

A: COVID-19 and the flu have very similar symptoms. The COVID-19 includes cough and fever, particularly a fever that goes away and returns. Most people can overcome COVID-19 without medical intervention. If you suspect you have the COVID-19, please contact your regular medical provider via phone. If you are experiencing life-threatening symptoms, please call 911.

Q: What can I do to stay safe?

A: Wash hands frequently for 20 seconds with soap and water. Covering your mouth and nose with a tissue when coughing or sneezing, then throwing the tissue in the trash and washing your hands. If you develop symptoms, reduce the stress on the healthcare system and your risk of exposure by staying home and calling the doctor. Make it a habit to avoid touching your eyes, nose, and mouth. It is easy to transfer germs from surfaces to your body when you touch your face. 

Q: Are there any COVID-19 cases at Tulalip?

A: There are likely possible positive cases that have been identified at Tulalip. A possible positive case is a patient who exhibits the signs and symptoms and is presumed to have the disease. These patients are then tested if they show moderate to severe symptoms. Testing capabilities are limited, and patients with mild symptoms are generally not checked to protect the supplies for the most critical patients. The Emergency Management Team, in collaboration with Community Health, local Tulalip Bay Fire District 15 and Marysville Fire Department, and Tulalip Police Department, have a plan in place to track presumptive positive cases to keep our public informed and reduce the spread of the disease. Presumptive positive is a term which means that while local testing has produced a positive result for COVID-19, the sample is still awaiting confirmation from the CDC.

Q: Does handwashing work better than hand sanitizer?

A: Soap and water are better than hand sanitizers at removing specific kinds of germs, especially on dirty hands. However, for people who have mobility issues or lack of access to clean running water, hand sanitizer is useful in a pinch.

Q: How do I decide whether to stay home from work, go to a clinic, or go to the hospital? 

A: If you have a fever and cough, as well as any flu-like symptoms, please call your regular health care provider. They will do a phone triage, or a series of questions to determine if it is likely that you have contracted COVID-19. Based on your doctor’s recommendation, you should self-isolate and limit your exposure to others, visit a healthcare facility, or, if you are experiencing life-threatening symptoms including shortness of breath or chest pain, call 911.

Q: I need to be seen, but my doctor told me to stay home. Why are they treating me like this?

A: Your doctor may ask you to self-isolate, or stay home and limit your exposure to others, to protect you and the people around you. In many cases, patients are putting themselves at risk for contracting the disease by going to a medical facility when they do not need to. In other cases, you may risk infecting others. Lastly, in situations like this, health care facilities can become overwhelmed with minor illnesses, which reduces their ability to take care of those patients who do experience life-threatening symptoms from the disease. 

Q: What is Tribal Government doing?

A: Tribal Government administration has briefed managers about the situation and is encouraging staff to be diligent about sanitizing high-touch areas, including keyboards, doorknobs, and handrails. Tribal government is encouraging staff who have COVID-19 symptoms to stay home from work for at least seven days and/or 72 hours after symptoms resolve, whichever is longer. The Pharmacy will be holding a seasonal influenza clinic at the Administration building to provide staff with a seasonal flu vaccine. This is a protective measure. This vaccine does not protect against COVID-19. When a person contracts seasonal influenza, it can raise their risk of contracting COVID-19, so flu vaccines are being recommended. Some policies are being temporarily relaxed to allow employees to take sensible precautions. For example, supervisors may waive the requirement for a doctor’s note before returning to work. We are doing this to reduce the non-emergent workload for medical facilities. 

Q: What are our casinos doing?

A: Leadership is putting strategies in place to both sanitize the facilities more thoroughly and protect staff and clients by encouraging team members who exhibit symptoms of COVID-19 to stay home from work based on current medical recommendations. Leadership will be flexible about employee leave to take care of the health of our community. 

Q: Will our health clinic close if it gets worse?

A: Staff at the Karen I. Fryberg Health Clinic have been involved in planning and are putting precautions in place to make sure that staff stays healthy, and the clinic remains operational. As you enter the clinic, a staff member will ask you to sanitize your hands. If you show any signs of a cough or upper respiratory infection, you may be provided a mask and asked to wear it to contain your cough. Another new procedure is phone triaging. This means that patients who exhibit symptoms of COVID-19 will be asked a series of questions to determine if it is likely they have contracted the disease. Patients with mild symptoms will be advised to isolate, to protect them from contracting the illness if they do not have it, and to prevent them from spreading the illness if they are ill with COVID-19. Patients with moderate symptoms may be asked to come in and call when they arrive. At that point staff will **

Q: Why do emergency personnel need masks if they don’t work?

A: Masks will not stop you from contracting COVID-19 since they do not cover your eyes and do not filter out viruses. However, if you are already sick, a mask can limit the distance that droplets travel when you cough or sneeze. Medical professionals ask patients exhibiting symptoms to wear a mask. 

First responders and emergency personnel will wear full personal protective equipment if seeing a client suspected of or infected with COVID-19. They wear both masks and goggles to protect the eyes, nose, and mouth. They may also wear disposable gowns and foot covers that can be disposed of in a medically safe manner to reduce transmission of COVID-19. 

Q: COVID-19 isn’t the flu, why should I get a flu shot?

A: Although the seasonal flu shot will not protect you from COVID-19, it can reduce your risk of getting the flu. Coming down with any illness can increase your risk of catching a second illness, which is why we recommend people get a seasonal flu vaccine if they have not already.

Q: What is the incubation period?

A: This virus is new; we are learning more about it every day. The current medical recommendation is that if you show symptoms to isolate yourself. Encourage family members to stay six feet away to reduce the transmission of the disease. Do not return to work or school for seven days or 72 hours after all symptoms have resolved, whichever is longer. 

Q: How can I talk to my kids about COVID-19 when I am scared that it won’t be all right?

A: Viruses have been around for all of human history. We can work to limit our exposure and contain it. COVID-19 doesn’t appear to have the high fatality rates of viruses like Ebola or Hemorrhagic virus. Most healthy people have mild symptoms, and their immune system deals with the virus. We can take care of ourselves and the people around us, especially elders and those with compromised immune systems, by letting people know if we are sick and staying away from others who are sick. We care about one another, and even though this is a scary time, we’ll get through it together. 

By Kalvin Valdillez, Tulalip News

“It’s so widespread, but the societal norm is that it’s not accepted as a disease,” said Tulalip Problem Gambling Counselor, Robin Johnson. “A lot of people who come and see us will say that they feel like they don’t have a real problem, so this is raising awareness about the fact that problem gambling is a disease and also of the detriments that it causes in real life. There is help. You are not alone.”

The Tulalip Tribes Family Services Problem Gambling Program invites you and yours to a special soiree on the evening of March 7^th. A popular community event, and highly anticipated within the recovery circle, the annual Problem Gambling Awareness Gathering promotes healing, education and awareness about an addiction that nationally affects approximately six million individuals and their families each year, according to the National Council on Problem Gambling.  

“In most Indigenous communities there’s higher risk of acquiring a gambling disorder,” explained Problem Gambling Coordinator, Sarah Sense-Wilson. “That’s because of co-occurring disorders, mental health, addiction, proximity to gambling establishments and trauma issues. Those things all factor into why Indigenous populations tend to have vulnerability for a gambling disorder.” 

For half a decade, the Tulalip Problem Gambling program has actively taken part in a countrywide initiative, Problem Gambling Awareness Month, by hosting local events and providing support to those in need each March. The campaign originally began over fifteen years ago in response to the amount of sports betting surrounding the NCAA March Madness college basketball tournament. Since Tulalip’s involvement in the awareness month, recovering gambling addicts who live at Tulalip, or in nearby cities, have found a sense of community and people who they can relate to and confide in during their journey to recovery.  

“The theme for this year’s Problem Gambling Awareness month is ‘Seeds of Hope Through Recovery.’ That comes from the problem gambling recovery community, they’re the ones who conceptualized the theme,” Sarah said. “It impacts everybody in the community at some level, especially in our tribal communities, because we’re so small and tight knit. When I first started here, there was a real void in any collective effort to promote health and wellness around this issue of problem gambling, throughout the region not just at Tulalip. And really, there are no collective efforts or campaigns in Indian country to spotlight this as illness or disease.”

As a people, Native Americans are at the highest risk of developing a gambling habit. A 2019 study conducted by the National Institute on Alcohol and Related Conditions showed that 2.3% of the entire Indigenous population are currently battling the gambling addiction, one of the highest percentages in the nation. Recognizing that this is an issue affecting our tribal people, several Northwest tribes are addressing problem gambling by developing programs to help their people from within the community. Many of those nations, whose programs are still in the infancy stage, often send representatives to participate in events at Tulalip to get a better understanding of how the tribal people are interacting with the program.

Sarah explains, “Our program is a national model program because of the comprehensive services we provide and the expansive work that we’ve created here developing not just treatment, but also prevention, education, community outreach, all of those aspects. Usually, you don’t see that continuum of support services in any other addiction field program. This is also a great opportunity for cross-cultural understanding because we serve non-Natives too. In fact, our services are free and we work with everybody.”

The 5^th Annual Problem Gambling Awareness Community Gathering takes place Saturday March 7, from 5:00 p.m. to 8:00 p.m. at the Hibulb Cultural Center. Medicine will be offered all evening in the form of laughter provided by comedienne Adrianne Chalepah, traditional drum circle led by Terrance Sabbas and family, personal testimonials from recovering gambling addicts, as well as soothing tunes from Native violinist, Swil Kanim, who also doubles as the event’s Master of Ceremony. 

“We’re trying to keep the same formula, bringing healing through comedic relief and raising awareness, trying to destigmatize the illness so that people are more open to receiving help or seeking services. We want people to understand that this is a disease, a disorder just like diabetes, high blood pressure, there’s no shame in it. We just want to see people get well and live healthy. It really does take a community to make it happen and that’s our goal. These events are not just about calling attention and centering on those in recovery; it’s also about reaching those who are still suffering.”

For more information, please contact the Problem Gambling program at (360) 716-4304.