"The storm is here"

Four Corners dangerously close to staffing limits

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Seward County's COVID-19 situation is anticipated to worsen. And the end is not near. Memorial Health Care Systems CEO Roger Reamer gave a blunt assessment at the Nov. 12 Four Corners Health Department briefing.

“We have planned for this a long time,” he said. “The storm is here. We're in the middle of the storm.”

Reamer also spoke briefly, switching his title from MHCS CEO to Board of Health Director. He said the district is close to being overwhelmed. He advocated for Four Corners Health Department Executive Director Laura McDougall, as well as the district as a whole, when it came to contact tracing efforts. They've done a great job, he said, but they are swamped and won't get on top of the issue any time soon.

“We can't keep up,” he said. “We aren't built for this. We aren't staffed for this.”

Reamer said the key health measure for severity, dating back to the pandemic's infancy, was based on hospital capacity. Capacity has now been overwhelmed.

Reamer reported 443 COVID-positive patients in Nebraska hospitals during the Oct. 29 health briefing. In two weeks that number has grown to 885. Reamer said Bryan Health, to which MHCS has an agreement to send patients, was at 102 coronavirus-positive patients on Nov. 10. That number increased to 127 in two days.

Reamer said MHCS has started managing COVID-positive patients and utilizing swing beds for patients who tested positive for COVID-19 who still require rehabilitation needs. Patients with coronavirus require different management of care, Reamer said. He said MHCS staff has working with Bryan Health officials from the start of the pandemic on management of those coronavirus patients. He also said those plans are now becoming a reality.

“You may be retained here, go to Bryan, or you may go there and come back,” Reamer said. “All depends on circumstances.”

Reamer said a lot of the situation can be traced back to a lack of face coverings.

MHCS has started tracking all hospitalizations, going into patients' medical records while they are at Bryan Health and watching day-to-day progress. That's been needed, Reamer said, to anticipate whether those patients will be transferred to MHCS for short-term care or as a swing bed – a hospital that can provide post-hospital skilled nursing facility care.

Every Monday, Wednesday and Friday MHCS receives an update from Four Corners. They utilize a spreadsheet of known percentages of COVID-positive patients in their 70s, 80s and 90s who require healthcare. They track how many have arrived into emergency rooms.

Reamer said anticipation is necessary. The hospital tracks daily cases and age groups because, typically, a COVID-positive patient experiences their most severe symptoms around a week after contracting the virus. Reamer said the increase in cases this past week means increased hospitalizations over the upcoming weeks.

“We won't slow down for a while,” he said.

Reamer also said testing has increased. The hospital was averaging 30-40 tests per week until the week of Oct. 25. In the week starting Nov. 1 the hospital conducted 142 tests. Those have strained the numbers of tests the hospital has. Reamer said they have a good supply of tests, but if testing numbers continue to rise they will be challenged.

MHCS has also entered into a new agreement for testing through April. The hospital has also implemented a new winterized facility for drive-up testing in its west parking lot. Testing there was already booked full for Nov. 11 and Nov. 13.

Reamer also said that plans have been made to install kiosks in December in the hospital to take temperatures and asks questions of those who walk in. Those kiosks would replace healthcare workers who are more urgently needed providing care to patients.

Lastly, Reamer once again urged community members to cooperate with local health officials. Engage in contact tracing, go into quarantine when necessary and wear face coverings when in public, he said.