Minnesota health officials are confident the state has enough hospital beds to handle an expected surge of patients with serious COVID-19 infections, but there is growing alarm there may not be enough medical workers to provide care.
“All the beds in the world are worthless without skilled, experienced health care workers to staff them and to provide care,” said Kris Ehresmann, director of infectious disease for the Minnesota Department of Health.
COVID-19 patients needing serious medical care surged throughout October, and there are now roughly 740 hospitalized across the state. That’s roughly a 75 percent increase in hospitalized patients since the end of September. Minnesota set a record of 3,165 new infections Thursday, and as cases continue to grow, the surge is likely to continue expanding.
The growing amount of coronavirus circulating in the community means medical workers have a bigger chance of coming in contact with people infected with the coronavirus who don’t know they’re contagious. So-called community transmission — when someone gets sick without an obvious link to another infected person — is now responsible for at least one-third of new cases.
“We need to do what we can to protect our health care workers and long-term care workers from getting COVID from us while they are out in the community,” Ehresmann said. More than 14,000 health care workers — from hospitals to nursing homes — have tested positive for the coronavirus; nearly 500 were hospitalized themselves. Not all are exposed at work.
Ehresmann noted the number of “high-risk exposures” for health care workers grew by nearly 50 percent between June and September. Of the 393 acute care hospital workers with “high-risk exposures,” 58 percent were from household or social contacts, 21 percent from coworkers and 21 percent from patients.
Mary Turner, president of the Minnesota Nurses Association, says she often feels safer at work in the COVID intensive care unit at North Memorial Medical Center in Robbinsdale than out in her community.
“To anyone out there not wearing a mask: You never know when you are standing next to a frontline health care worker that you may get infected,” Turner said. “That health care worker may be the person who ends up saving you someday and if they get sick they are not going to be there to save you.”
PREPARING INVENTORY AND STAFFING
Early on, a big part of Minnesota’s coronavirus response was making sure there were enough hospital beds for a rush of critically ill patients.
Minnesota now has roughly 10,000 regular hospital beds and nearly 2,000 ICU beds, according to state data. There are nearly 3,500 ventilators statewide and more than 80 days worth of protective gear in hospitals and warehouses.
Turner says the state still needs to do more to secure adequate levels of personal protective equipment, or PPE, for health care workers and first responders. She says many on the frontlines are using N95 masks, which filter small particles and droplets, multiple times before they are replaced.
“It’s not consistent,” Turner said of the type of protective equipment provided to hospital workers and how often is replaced. “We don’t have enough PPE because everyone needs to wear it.”
Many of the state’s hospital beds are occupied, and a growing number are used by coronavirus patients.
Of the 1,119 ICU beds in use Friday, 176 were occupied with COVID-19 patients. There were also 7,151 regular hospital beds occupied, and 562 were patients with coronavirus infections.
Dr. Rahul Koranne, president and CEO of the Minnesota Hospital Association, says hospital leaders can adjust quickly to the demands of patients and the availability of supplies and staff.
“The management of a hospital is a very sophisticated and delicate balance,” Koranne said, noting that hospitals around the state are quick to collaborate if help is needed.
The biggest threat to Minnesota’s ability to care for the seriously ill, Koranne added, is if too many medical staff are sick or in quarantine.
Anyone with a known exposure to an infected person — within six feet for more than 15 minutes over a 24-hour period — needs to quarantine for 14 days. Now imagine if several nurses in one department are unable to work for that amount of time.
“That’s like taking out your top warriors. These are experienced COVID fighters,” Turner said. She noted that nationwide 20,000 medical workers are diagnosed with COVID-19 each week.
PUBLIC’S COOPERATION NEEDED
Koranne urged health officials, from the state leaders to local departments of public health, to flood media channels with pleas urging Minnesotans to follow coronavirus mitigation rules. Their campaigns should mirror the voracity of politicians seeking votes Nov. 3, he said.
“What we need now is much better messaging from public health, in very simple terms, so that (everyone) understands there is a direct link between community spread and more patients getting exposed, including nurses and physicians, and more patients needing ICU care,” Koranne said. “It is all connected, which is why we stress the basics: please physically distance and please mask up.”
Health officials are watching what’s happening in other states closely. Wisconsin opened a field hospital at its State Fair Park on Oct. 14 for less-severe COVID-19 patients. It was treating eight patients as of Friday. Hospitals in Utah are referring patients elsewhere, and officials fear they may have to begin rationing care within weeks if the COVID-19 outbreak in that state doesn’t lessen. More than 50 traveling nurses were called into one El Paso, Texas, medical center to deal with the outbreak there in mid-October.
In Minnesota, fewer than 20 percent of current ICU patients were people battling COVID-19, Koranne noted. The majority are patients recovering from traumas such as heart attacks, strokes, accidents and other serious ailments.
If that seems high, it is because hospitals are still catching up with patient procedures that were put on hold early in the pandemic at the request of Gov. Tim Walz. That type of limitation on so-called “elective” medical care is not something hospital leaders want to do again.
“We now know the pain and suffering it caused our patients,” Koranne said. “An across-the-board pause is not something we would support.”
Health officials have acknowledged that burnout is a real concern for medical providers entering their eighth or ninth month of working through a pandemic.
“I’m out here on the front lines where we are all just trying to stay healthy,” Turner said. “We are all working such long hours, we can’t keep that up for ever.”
Koranne says doctors, nurses and other medical workers are the heroes of the pandemic and the public should treat them as such by helping them stay healthy.
“It’s been a long year, and a long winter is ahead,” Koranne said. “I would argue the real story of how Minnesota is dealing with this pandemic is our frontline health care heroes. They have been working very hard since March.”
Powered by WPeMatico