‘We’re begging for your help’: County hospitals face limited staffing and resources

This article was published in the Lakes Area Review on Nov. 21, 2020

As COVID-19 ravages Kandiyohi County in its worst week of the pandemic so far, health care facilities are feeling the strain of limited staffing and resources. While by some estimates two-thirds patients admitted to Carris Health have COVID-19, 10% of the hospital’s staff have either contracted or have been exposed to the virus and are now in quarantine.

On Wednesday, officials from Carris Health and Kandiyohi County Public Health held a joint press conference and pleaded to the public for better cooperation in following the guidelines – especially as the holidays approach – as the hospital fights on the front lines of the pandemic.

“We continue to see a steep increase of COVID-19 positive cases in our county,” said Jennie Lippert, county Director of Health and Human Services.

When the Lakes Area Review went to press on Thursday, there were 3,047 total cases in the county with, as of Tuesday’s data released by Lippert, 578 active cases. Deaths continue to soar as well. As of Thursday there have been 12 county deaths from COVID-19 – three more than since the press conference on Wednesday – as Kandiyohi County reported the second-fastest growing number of cases in the state.

Comparing the initial spring outbreak to the surge now, Carris Health Co-CEO Mike Schramm said “it’s a tale of two very different situations.”

At the onset of the pandemic, Carris Health shut down a significant portion of services, such as elective surgeries, to preserve much-needed personal protective equipment. They also had ample staff on-hand to deal with the pandemic. Now, however, though the hospital currently has a secure amount of PPE, they are starting to see critical staffing shortages.

On Wednesday alone, over 40% of patients admitted in Carris Health were there because of COVID-19 – the highest number seen thus far, according to Ken Flowe, Emergency Room Physician and Co-Incident Commander.

Though there has been worry about intensive care unit beds being filled, as of Wednesday, several of Carris Health’s bed were still open, Flowe said. However “just thinking about the number of beds is not the whole story and not even half of the story,” he said.

The top concern for Carris Health is staffing. As of Wednesday, 10% of CentraCare – Carris Health’s parent company that operates hospitals across central Minnesota – have either contracted the virus, or were in quarantine after being exposed.

“Much of that staff illness could have been prevented if people followed the public health guidelines that have been set forward,” Flowe said, referring to the Centers for Disease Control and Prevention’s COVID-19 guidelines of wearing masks, maintaining six feet of social distance and avoiding indoor gatherings. “These simple acts can have profound impacts.”

Currently, the hospital is well stocked on PPE and has extra beds, Flowe said – but they need to be very careful. “The tricky thing is we have such a drastic rise in COVID patients and such a drastic decline in resources that we have to be very creative,” he said. “Again, help us. Follow the public health guidelines.”

Dr. Mike May, a hospitalist at Carris Health who coordinates patient care, estimates that two-thirds of the patients he now sees are COVID-19 positive. Dealing with the sudden influx of COVID-19 patients, and trying to provide them the best care with the hospital’s limited resources, has been “heartbreaking,” he said.

Due to limitations in resources and staffing, the worst-case scenarios that existed only in theory at the onset of the pandemic may soon become a reality, said Dr. Fred Hund, a veteran 31-year hospitalist and Carris Health chief-of-staff.

If trends continue, he said it is highly plausible that the hospital could get five patients who need a ventilator, but only have three ventilators on-hand. In addition, with the strain on hospital resources, Carris Health may have to turn away non-COVID-19 patients.

“There is a very real chance that you could be in a car wreck and we can’t take care of you and we don’t have a place we can send you,” he said. “That is not an abstract possibility anymore.”

The holidays this year come on the heels of what is bound to be the darkest chapter of COVID-19 experienced thus far in Minnesota, and both Carris Health and county officials are worried that family celebrations and travel will contribute to the surge.

“Stay home. Celebrate with the people that you live with,” said Dr. Cindy Smith, co- CEO of Carris Health.

“This germ doesn’t care whether you want to go to Thanksgiving, whether you want to sing in the choir, whether you want to go to a basketball game. All this germ cares about is jumping person to person, making more germs and, oh, by the way, some people die and suffer along the way. That’s what people need to understand is the big picture,” Hund said. “Everyone of those decisions should be ‘is it worth it?’”

If Halloween is any indication, the spike in COVID-19 after Thanksgiving could be severe. “We have several events and holidays in the next several months and we are concerned we may see a higher number of cases after these events,” Lippert said. “We started to see a rise in positive cases about a month ago and can assume this to be when the cooler weather arrived and settled in and more people moved their activities indoors,” she said, suggesting that the county’s COVID-19 spike may have been driven by Halloween.

Hund expressed deep frustration with the public’s denial and inability to take COVID-19 seriously. “It is a little troublesome to leave this hospital, and leave this suffering, and enter a store where half of the people aren’t wearing masks,” he said. “What you guys do right now is going to determine how much more awful it gets in two, four, six weeks.”

Dr. Lucio Minces, infectious disease specialist at Carris Health, echoed Hund’s frustrations.

“It is – I don’t think ‘frustrating’ is the right word – I think ‘sad’ is the right word, that the solution is very, very straightforward: you stay home, that’s all,” Minces said. “The point being: if you are young and healthy and say ‘I won’t get it’ ... you are part of the problem.”

Hund stressed the seriousness of the pandemic. “This is not just the flu... There is a lot of evidence that people will be left with a lifelong disability from this.”

“This is going to get worse, OK,” Hund said. “The next few weeks are going to be pretty much awful. OK? This is going to last a long time. This is not going to be better by Christmas, this is not going to be better if a vaccine is released tomorrow, this is not going to be better by Valentines or Easter.”

Though the consensus was unanimous that health care facilities needed better public cooperation to survive this pandemic, Smith said this isn’t just about health care, it is about people.

“We are just as exhausted about this damn virus that everybody else is, but we need your help,” she said. “This is not a health care issue, this is a human issue and we’re begging for your help. Please.”