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Serving Northern St. Louis County, Minnesota

Range hospitals reeling from COVID ‘marathon’

Staff shortages, long shifts tax medical providers

David Colburn
Posted 9/1/21

REGIONAL- The rising tide of new COVID-19 cases across the Iron Range and throughout Minnesota is putting increased strain on a health care system already stretched thin by the prolonged pandemic, …

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Range hospitals reeling from COVID ‘marathon’

Staff shortages, long shifts tax medical providers

Posted

REGIONAL- The rising tide of new COVID-19 cases across the Iron Range and throughout Minnesota is putting increased strain on a health care system already stretched thin by the prolonged pandemic, according to three regional providers.
“Hospitals are again close to capacity,” said Dr. Andrea Boehland, an emergency room physician at Essentia Health-St. Mary’s Medical Center in Duluth. “We have between 15 and 20 hospitalized patients with severe COVID. More concerning: This number has doubled over the past two weeks.”
Boehland was part of a panel of regional experts convened by Essentia on Tuesday via Zoom to put a local face on the looming challenges.
“When hospital capacity becomes tight like this, our ability to care for patients with any kind of health problem is put at risk. We’ve experienced here that younger, healthier people are more likely to get very sick. My team and I have cared for many people younger than me, including children who have had serious COVID cases. This is really unsettling to me.”
County public health director Amy Westbrook, also on the panel, confirmed that 17 percent of recent cases involve children 18 and younger, although none so far have required intensive care placement. She also provided more information about the county’s increasing number of cases.
“We had 273 new cases reported last week, which was a 52 percent increase over the previous week,” Westbrook said. “There has been a definite correlation in our county between rising case rates and lower vaccination rates. The areas with lower vaccination rates are seeing the highest incidence of new cases. Our case rates are higher in the northern and central southwest areas, and the Iron Range is primarily in that central southwest.”
Boehland said that while hospitalization and ICU numbers haven’t approached the levels of last year’s November/December peak, the non-COVID patient load has increased significantly.
“Our non-COVID patient load during this surge is higher than it was during previous surges,” she said. “Our non-COVID patients tend to be sicker these days.”
Seasonal increases in accidents, people who delayed health care procedures during previous surges, and increased effects of substance abuse, depression, and other stresses are contributing factors that have non-COVID cases competing with new COVID patients for limited beds and services.
“Sadly, today our situation is quite serious,” she said.
Emily Meyer, nurse manager of women’s health and birthing at Grand Itasca Hospital in Grand Rapids, said the challenges for staff there are no different from anywhere else right now.
“Even one sick call can drastically affect our staffing,” she said. “There have been times this summer when you find yourself working 16-hour shifts or 12-hour shifts for six days in a row or more. I love what I do and I can’t imagine working in any other profession, but when I went to nursing school 11 years ago this isn’t what I imagined the nursing field would look like.”
“A lot of health care and frontline people of all kinds are experiencing burnout,” Boehland said. “I think that they’re tired. A lot of people have retired, a lot of people have left health care, because it’s been a really long haul.”
Harmony Tyner, an infectious disease physician at St. Luke’s Hospital in Duluth, said, “We were running as though it were a sprint to begin with. And it really turned out to be a marathon. And as any sprinter will tell you, you can’t run a marathon at that pace. I think a lot of us feel an overlay of guilt about not being able to do everything for everybody, and we’re seeing people become injured by this who avoided medical care, including poor outcomes, and watching our patients die.”
The issue of getting vaccinated or not has also created stress and conflict that can be detrimental to one’s health, Tyner noted.
“This isn’t just about information,” she said. “It’s also about an emotional component that people feel invested in or feel very strongly about for a lot of different reasons. I’ve seen people be ripped apart by conversations about vaccination and about why they’ve chosen to do one thing or another. Whether you’ve chosen to be vaccinated or you’ve chosen not to be vaccinated, please, be kind to each other. We’re all in this together whether we’re vaccinated or not.”
Tyner also addressed something she said she’s been hearing in “an alarming amount” among some segments of people of the Christian faith that’s keeping some from being vaccinated.
“In terms of the Christian church, I’ve heard a lot of people who have been advised by their church not to be vaccinated because it’s a sign of the beast,” Tyner said. “And something I remind my Christian friends and followers who have thought that or have heard that is that the vaccine doesn’t mitigate your salvation. Jesus’s blood is more powerful than that. If that’s something your patients have heard or come across, remind them what they already know about their faith. Don’t try to talk them out of their faith, it’s not going to work. It’s not what we should be doing.”
Westbrook said that 59 percent of the county’s total population, and 69 percent of those 16 and older, have received at least one dose of COVID vaccine. Like the other panelists, she emphasized the importance of getting vaccinated in the midst of a surge driven by the more highly contagious Delta variant.
“This is for the health of our kids too young to be vaccinated, our neighbors who may be experiencing waning immunity, and to prevent other strains of COVID-19,” she said. “Just half of one percent of new cases and .03 percent of hospitalizations are among fully vaccinated individuals.”
School concerns
While Tuesday’s focus was on the Iron Range, state health officials raised concerns last week about a developing COVID outbreak in southern Minnesota. Schools in Albert Lea, which started early this year, had 36 cases of COVID-19 and 290 students and staff in quarantine by the end of the first week of classes, according to state infectious disease director Kris Ehresmann.
Cases have also been reported in summer camps and childcare centers, Ehresmann said, and while children have generally experienced less severe effects from COVID-19, trends emerging as the Delta variant has become dominant are concerning, she said.
“We were seeing about 0.7 percent of the cases in children being hospitalized (last fall),” she said. “And now we’re seeing that at 1.5 percent. That is still a low number, but it’s a doubling of what we saw last fall. And that is definitely concerning. And as (Commissioner Jan Malcolm) said, we’re seeing more and more cases of illness in each group.”
Officials implored local decisionmakers to adopt mask mandates for all individuals in schools, regardless of vaccination status, as recommended by the CDC, American Academy of Pediatrics, and Minnesota Departments of Health and Education.
“We’re concerned to hear reports that in some school districts and schools, the fact that we as a state are no longer mandating these prevention measures is being misunderstood to mean that the recommendations are not important or that we don’t feel they are essential to implement,” Malcolm said. “I want to be really clear on this point. Our recommendation of universal masking is a recommendation for schools to require it. In the face of the highly contagious Delta variant, there has never been a more important time than right now for everyone in schools where there is a high transmission of the virus to be masking and using the multiple layers of prevention available to prevent infection.”
Regional data
Consistent with Westbrook’s information about higher case rates in northern St. Louis County, new cases in the six North Country zip codes monitored by the Timberjay jumped by 18 last week, bringing the total for the past three weeks to 50.
Tower topped the new case count with nine, followed by Cook, 4, Ely, 3, Embarrass, 1, and Orr, 1. No new cases were reported for Soudan.

(9/2/21:  An earlier version of this story misattributed a quote regarding "some segments of the Christian faith" and COVID vaccinations.  The statement was made by Dr. Harmony Tyner.)

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