Lakes area hospitals have been busy preparing for a possible influx of COVID-19 patients since mid-March, and Crow Wing County’s two hospitals continue to diligently plan so they are equipped to serve the community.

“Yes, I feel confident we would be ready and have the pieces in place to care for the patients who arrived here,” Jessica Herron, director of inpatient surgical care at Essentia Health-St. Joseph’s Medical Center in Brainerd, said Friday, April 17.

One of the leaders on the hospital’s Surge Planning Team, Herron said the situation is fluid and plans remain a work in progress as hospitals work with the Minnesota Department of Health and projections on patient numbers.

Essentia Health-SJMC relocated its infusion therapy and oncology clinic from the hospital to the Brainerd clinic for the safety of those patients and to clear those spaces should a COVID-19 surge arise, Herron said.

SJMC is licensed for 162 patients, and the number of patients the hospital could handle varies depending on where the team is at in its preparation, Herron said, noting on April 17 the hospital was set up to accommodate 113 patients.

That number can go up as they get more space ready, she said, and plans are in motion with equipment scheduled to arrive in early May to open more areas to house patients.

“We’re definitely working to get equipment and staffing to our licensed number of beds,” Herron said. “After that, it's a little bit of a moving target with projections and anticipated surge.”

Cuyuna Regional Medical Center in Crosby said in an email that the modeling the state of Minnesota is using currently anticipates the peak of COVID-19 cases may come in late June or early July.

CRMC usually has 25 beds. During a potential influx, 38 COVID-19 patients would be on a special unit at CRMC. All other medical, intensive care unit and obstetrics patients would be in a separate area.

“We have identified arrangements to double our bed capacity and provide more negative pressure rooms when an influx occurs,” the email said. “Physicians, nurses and staff are receiving training to support an influx of COVID patients. Extensive remodeling has occurred in the hospital.”

CRMC’s emergency department and ICU corridors were converted to negative pressure; two medical/surgical rooms were remodeled into negative pressure ICU rooms; patient care rooms were converted to a telehealth structure to allow for additional access to providers for patient needs; and a decontamination staff shower was built in the ICU.

In addition, barriers were constructed and added to all hospital, clinic and nursing home entrance screening stations and registration desks for patient, resident and staff safety. COVID-19 positive or suspected patients are isolated and staff caring for them are using appropriate personal protective equipment precautions.

If CRMC were to need even more beds for COVID-19 patients, it would consider increased use of surgical areas and considerations of other campuses for management of non-COVID patients.

The Essentia Health team has not looked at facilities outside the hospital to serve patients, but it has been communicating with Essentia Health partners and a coalition of central Minnesota hospitals on how they can help each other.

While the hospital doesn’t have a huge influx of COVID-19 patients now, Herron said they always operate on the premise that that could change at any time, so everything being done is in the realm of being ready.

Leaders continue to fine-tune the plan, make sure staff is ready and educated, and make sure everybody within the facility understands the plan and how to put it in motion, if need be.

Patient numbers

The average census is now in the 40s for all patients at SJMC, Herron said, noting that is lower than usual because elective surgeries and procedures are not being done.

Staff from Essentia Health clinics who have had decreased volume are being educated to work at the hospital during a potential COVID-19 surge. Surge planning has included cross training and credentialing doctors to serve in areas they may not have served in previously.

CRMC has created a labor pool and is shifting employees who are on low need to areas that continue to have needs. The hospital is also cross-training employees with specific skill sets to cover specific needs in the event there is a surge of suspected or confirmed COVID-19 patients.

Seasonal influx

The annual return of tourists and seasonal homeowners is part of both hospitals’ planning processes. Herron said that traditionally, as the lakes area’s summer population jumps, so do visits to emergency rooms and admissions to the hospital.

“So we definitely have taken that into consideration,” she said of COVID-19 planning.

CRMC is asking people who come to the area from anywhere outside of Crow Wing County to quarantine for 14 days before scheduling a non-emergent appointment or test.

Testing

Regarding testing people for COVID-19, hospitals are following MDH guidelines, which change frequently, said Kathy Sell, marketing manager at Essentia Health-SJMC. Those guidelines currently say to test people in long-term care settings, those at greatest risk and healthcare workers.

“For current guidelines, we’re confident we have enough,” Sell said of tests.

CRMC said the nationwide shortage of testing supplies is limiting the hospital’s ability to do testing. But the capacity to perform the testing is slowly improving and CRMC anticipates it will continue to improve to allow tests more readily.

“We’re doing planning every single day to prepare and know that we’ll be ready for whatever the community needs,” Sell said, adding a thanks to the community for supporting healthcare during this time and for donations.

Donations welcome

Area hospitals continue to seek donations of personal protective equipment, including masks for staff and others. Following is a link to make masks:

https://www.essentiahealth.org/covid-19/ways-to-get-involved/

Gov. Tim Walz and Lt. Gov. Peggy Flanagan launched a week-long statewide homemade mask drive to encourage Minnesotans to create homemade masks for donation and highlight the importance of workers on the front lines of the COVID-19 pandemic.

From 10 a.m. to 2 p.m. Saturday, April 25, Minnesotans can deliver homemade masks to their local fire department. Fire departments will then deliver the masks to local congregate living facilities for their employees and residents to wear.

The Centers for Disease Control recommends wearing cloth face coverings to protect others from COVID-19. Cloth face masks can help prevent the wearer from infecting others, especially in situations where they may spread the virus without symptoms. Cloth face masks are not a proven way to prevent COVID-19 from infecting the wearer.

COVID-19 numbers

As of Tuesday, April 21, Crow Wing County had 20 confirmed cases of COVID-19, including 12 men and eight women; two are health care workers. Four need hospitalization, with three requiring intensive care. Half of those confirmed to have the disease in Crow Wing County no longer require isolation.

Cass County has four confirmed COVID-19 cases.

Nancy Vogt may be reached at 218-855-5877 or nancy.vogt@pineandlakes.com. Follow her on Facebook and on Twitter at www.twitter.com/@PEJ_Nancy.