Tri-County Health Care continued its online communication with the public about COVID-19 preparations, precautions, concerns and questions through a virtual town hall meeting April 7.

President and CEO Joel Beiswenger and chief medical officer Dr. Ben Hess spent the hour explaining Tri-County preparations, medical advice, future plans and the importance of Minnesota’s mitigation efforts.

“You can rest assured that we here at Tri-County are prepared,” Beiswenger said.

Due to the pandemic, Beiswenger and Hess noted the care changes Tri-County has implemented, including suspending elective surgeries about two weeks ago, limiting rehab and routine check-up services and using the Wadena rehab center for OB, cancer care or other specialized types of care. The Verndale clinic is being used for specialists such as orthopedics and gynecology and this week the Henning and Bertha are “clean clinics” for patients that are not COVID-19 suspect.

Beiswenger said the Sebeka and Ottertail clinics are not currently functioning. The restricted visitor policy has been in place approximately one month, with exceptions being minors and dependent adults, according to Beiswenger. The care changes come as a way to preserve personal protective equipment and protect community members, patients and staff from unnecessary possible exposure to COVID-19.

Patients can also make use of telehealth visits and a new feature on the e-clinic which screens for COVID-19 symptoms for free, as Beiswenger and Hess said.

Beiswenger also reminded people of the tents outside the hospital main entrance which are for screening purposes for patients entering for appointments, anyone who has been approved to accompany them and staff members. People are asked about symptoms such as a cough and shortness of breath while also having their temperature taken and applying hand sanitizer before entering the hospital. Appointments for specialized care will take place at the rehab center and ready and emergency care patients are asked to enter through the north entrance of the hospital. Outside of these categories, people should use the main entrance, according to Beiswenger.

With these precautions in place, one of the questions to come up pertained to pregnant women and their risk for COVID-19 complications which Hess said is maybe, due to the lack of data surrounding COVID-19. He added that the issue seems to be more at the time of delivery rather than during the pregnancy. Prenatal education is also partially online already and further methods will be added along with stricter guidelines for pregnant women, according to Hess.

Although there are no positive cases of COVID-19 in Wadena or Todd counties, and two positive cases in Otter Tail County according to the Minnesota Department of Health on April 7, Tri-County has ICU beds, ventilators and negative pressure rooms available. Beiswenger said the average number of inpatient beds is seven to eight, which can flex up to 17-18, and with the pandemic the number of inpatient beds is flexible up to 54. The additional beds, equipment and supplies to meet this possible need have been ordered.

“Now the challenge is, and this is where the social distancing and mitigation efforts have become so important, is we couldn’t mobilize those 54 beds today,” Beiswenger said.

There are also six ventilators accessible, with two specified for ambulances to transport patients to St. Cloud, and one more is trying to be acquired, according to Beiswenger and Hess. The board had previously budgeted for three surgical anesthetize application and monitoring units, expanding the ventilator capacity, though they will take approximately one month to arrive. The hospital also has negative pressure rooms, which take the air with contaminants directly out of the building instead of cycling it back through. There are four inpatient and two ER negative pressure rooms available with the ability to increase, according to Beiswenger.

During the pandemic, hospitals also face the question of where will overflow patients go, as one community member asked during the meeting. Hess explained the current plan for CentraCare in St. Cloud to be the regional center since this plan has been shown as successful in other areas. CentraCare would focus and dedicate its resources, staff and equipment toward COVID-19 patients who require hospitalization. Patients would still be identified first at Tri-County and possibly stay in the hospital for a day or two before being transferred to CentraCare if deemed necessary, according to Hess.

“It seems to be working, it just really greatly depends on how flat that curve is and how slow that surge happens and so everybody plays a role here,” Hess said.

Hess also explained the importance of flattening the curve and how this affects hospitals’ abilities to prepare for a surge of patients, impacting each patient’s care level with equipment and staff available as people follow Gov. Tim Walz’s orders to stay at home. While 80% of COVID-19 patients have a mild case, people could be saving others and themselves by continuing to follow the orders, according to Hess.

One of the ways Hess showed this need is through healthdata.org, which shows the United States’ number of inpatient and ICU beds as well as the needed predictions for beds and ventilators, with a shortage of 16,323 ICU beds across the U.S. For those who do need hospitalizations for COVID-19, patients need significant amounts of hospital support that could sometimes be several weeks, as Hess said. In Minnesota, the number of inpatient and ICU beds available is greater than the number needed currently, according to the website. Hess compared this to Michigan, which has had less time for mitigation and preparation efforts, and is short 910 ICU beds while inpatient beds available exceed the number needed currently, according to the website.

“If you look at Minnesota, however, we’ve been a little more proactive than the average state and you can see that our curve is much flatter,” Hess said after showing Michigan’s curve.

Hess also reiterated the common symptoms of COVID-19 as a fever, cough and shortness of breath, becoming ill between day two and 14 day of exposure. He noted that people can spread the illness before showing symptoms and that people might not have these symptoms.

Tri-County has completed 57 tests for COVID-19 as of April 7. They are prioritizing people with upper respiratory infections and health care workers. The tests take approximately 24-72 hours to receive the test result, according to Hess.

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