SCBHS continues to prepare for a potential surge of COVID-19 cases in Swift County

By Reed Anfinson
Publisher
Swift County Monitor-News
Each time the numbers are posted they are almost instantly wrong as new COVID-19 cases are identified and more people die from the deadly coronavirus.

As of Tuesday morning, Minnesota’s Department of Health had confirmed 301 deaths in the state with 4,181 cases identified.

For now, western Minnesota has only seen a handful of cases. Swift County has had just one case of COVID-19 while Pope, Stevens and Grant counties have yet to record a single case. Chippewa County has had two cases. But to our east, Kandiyohi County has seen its number of cases rapidly jump to 64.

A second positive test of COVID-19 in Swift County was confirmed by the Minnesota Department of Health Tuesday morning.

There isn’t wide community spread of the coronavirus locally because people are not out and about, Co-CEO Melissa McGinty-Thompson said. “They are observing social distancing that has helped keep the spread of the disease down.”

Medical staff at Swift County-Benson Health Services know that it is just a matter of time before more cases show up in the community. They have been working steadily to prepare for a surge of cases while at the same time taking extraordinary steps to ensure that anyone coming to the clinic or hospital does not expose others to the virus.

At Monday night’s SCBHS governing board meeting, conducted with all its members joining via conference call, McGinty-Thompson said that staff can now test a person and have results back in less than an hour. SCBHS will follow the Minnesota Department of Health’s (MDH) guidelines when evaluating who to test.

Because testing capabilities are still very limited, MDH has set the following guidelines for who gets tested:

- Symptomatic patients (hospitalized patients, health care workers, patients and staff in congregate care settings, dialysis and other patients including outpatients).

- Persons in a setting where an outbreak is occurring (as recommended by MDH).

- Priorities as defined by facilities (patients who are those being transferred to other facilities or congregate settings, patients being admitted in labor and certain pre-operative patients)

“We still have to be conservative and use those tests wisely because likely we will only get 24 tests at a time. They are not sending out thousands of kits,” McGinty-Thompson said. SCBHS is hoping it can continue to order them in the days and weeks ahead.

As of Friday, SCBHS had only conducted 19 COVID-19 tests. Those tests were being sent either to MDH or the Mayo Clinic. SCBHS was seeing results from the tests it sends out returned in 24 to 72 hours. However, lately, the tests seem to be coming back more quickly, she said.

SCBHS staff participates in daily calls with incident command teams of CentraCare Health of St. Cloud and Carris Health of Willmar, McGinty-Thompson said. In the calls, there has been a lot of discussion on strategies in dealing with a surge of COVID-19 patients.

Co-CEO Dan Enderson and McGinty-Thompson also continue to participate in a weekly call with the area hospitals that were pursuing creating a Tri-county COVID-19 Medical Center (TCMC) at the Prairie Correctional Facility in Appleton. The group includes hospitals in Montevideo, Appleton, Madison, Dawson and Benson. Even though the state has said that PCF can’t be used,  SCBHS is talking with area medical facilities on how they can create partnerships to address the COVID-19 threat with their current facilities.

SCBHS has no ventilators in-house. However, it does have a machine that can function as a vent. It is currently used as a CPAP-bypass-ventilator. It is not used that often as a ventilator, but one of the physicians or the SCBHS certified nurse anesthetist could do it.

Patients who need to be intubated could also be sent to the Montevideo hospital under an agreement reached through the TCMC discussions. Under the agreement, SCBHS has said it is willing to take on non-COVID-19 patients from Montevideo.

Local COVID-19 patients needing a ventilator could also be sent to the Carris Health facility in Willmar or the CentraCare Health hospital in St. Cloud. If those facilities are overloaded, the state’s plan is to send COVID-19 patients to a regional facility in Marshall.

SCBHS is looking at using its pre/post operattion rooms as patient rooms for non-COVID-19 patients and then using regular inpatient unit for COVID-19 patients if there is a surge.

Also, as part of  its planning COVID-19 patients it has converted one of its patient rooms to a negative air pressure room.
Working with Countryside

SCBHS has been seeing patients showing symptoms of COVID-19, and in those cases, it is also reaching out to Countryside Public Health. If the patient signs a consent form, their medical information is shared with CPH, which will then offer medical resources to help with the patient.

If a person’s test comes back positive for COVID-19, they are quarantined to their home for 14 days. “They are strictly instructed – do not leave the home for groceries; do not leave the home to go to the pharmacy,” she said. If the person does not have family or friends who can run errands for them, Countryside  staff has people who can find those resources.

When a patient signs the release form for Countryside, it can speed up the partnering process by as much as 24 hours. However, Countryside Executive Director Liz Auch points out that the Minnesota Department of Health is the primary contact when a person is confirmed to have COVID-19.

The degree of follow up on cases where a COVID-19 positive person is in self-quarantine will likely depend on the severity of the symptoms. Many people recover without having to be hospitalized while others develop severe respiratory problems. 
Personal Protective Equipment

Across America, one of the major concerns of medical facilities that are seeing high numbers of COVID-19 patients is the lack of PPE.

“We are actually sitting very well with our personal protective equipment,” McGinty-Thompson said. There have been a lot of donations of masks from the community. While some have been homemade, others have been the N-95 masks that medical staff need to stay safe when working with COVID-19 patients.

Several businesses in the community have donated goggles or gowns, she said.

Benson businessman Steve Hastings, owner of Captain Clean, gave SCBHS two boxes of N-95 masks. Andy Abner of Abner Sales donated a case of goggles. The Starbuck Bakery brought down a bunch of treats for the staff thanking it for what it has been doing. A veterinary clinic outside the area sent a bunch of waterproof gowns.

Kerkhoven-Murdock-Sunburg Schools donated masks and shields. SCBHS received 50 face shields that St. Thomas Academy in the Twin Cities made using 3-D printers.

“It has really been overwhelming,” McGinty-Thompson said of the donations SCBHS has received.

SCBHS has to monitor daily the amount of personal protective equipment (PPE) it uses. “So, we are monitoring it pretty closely,” she said. At the moment, they are going through a lot of their PPE.

In non-patient areas, homemade masks can be used, and hundreds have been donated, McGinty-Thompson said. “Anybody in a patient-facing position, floor nurses, clinic nurses, they are using a medical grade mask whenever they are dealing with patients.”

The volumes of normal types illnesses or problems that people display that would bring them to the clinic or hospital are down.