The number of new coronavirus cases in Minnesota is expected to continue to grow, and regional health care providers say they are doing all they can to prepare for the worst.

Essential Health, Cuyuna Regional Medical Center and Lakewood Health System have a limited number of hospital beds but officials say they are doing what they can to meet the challenge.

“What we’ve done for the last two weeks is just prepare and have conversations on what that looks like for us ... for supplies and equipment, and how we make sure we have what we need for our community,” said Jessica Herron, director of in-patient surgical care at Essentia Health.

Starting Wednesday, April 1, patients visiting any Essentia Health clinic are asked to attend their appointments alone. Limited exceptions include one additional person to accompany children, obstetric patients and adult patients that require assistance.

Anyone accompanying a patient to an Essentia Health clinic appointment is required to be healthy and at least 18 years old. These steps are geared toward slowing the spread of COVID-19 and protecting patients, staff and the communities Essentia Health serves, the organization stated. COVID-19 is the potentially fatal respiratory disease caused by the novel coronavirus.

“Our medical and surgical units are separate, but most facilities operate them together … so we could put sicker patients in one of those units, utilizing additional equipment, relocating equipment and doing additional education for our nursing staff,” Herron said.

Cuyuna Regional Medical Center

Cuyuna Regional Medical Center officials have considered changing private rooms to double occupancy, repurposing rooms used for other functions into patient rooms and even using any open space (storage, conference rooms, etc.) as potential overflow space if needed.

“Challenges that we face as a smaller hospital are that our supplies and staffing are generally less and therefore, with a dramatic increase in need, we may have difficulty meeting those needs,” said Dr. Rob Westin, CRMC’s chief medical officer.

The number of those housed in an intensive care unit setting jumped statewide from 16 to 24 — almost 50% — as of Monday, March 30. The growing demand for ICU beds is considered the primary driver of mortality from COVID-19, according to state health officials.

“We can manage one to two patients getting sick at a time. Dozens or more getting exposed and ill at the same time will cause stress to our systems,” Westin said.

The nearest counties to Crow Wing County with confirmed cases of the coronavirus are Cass County to the north with one, and Benton and Stearns counties to the south with one and five, respectively, as of Monday.

Hospital beds

Essentia Health is licensed for 162 hospital beds, according to Herron, and as of Friday had about 40 of them occupied, but it also has 10 ICU beds with three of them occupied that Friday.

“We take a look at what our capacity is to handle the sickest of the patients, and what we can do to increase that capacity ... like how do we repurpose certain units within the hospital to be able to accommodate those patients,” Herron said.

According to Minnesota Department of Health officials, the state has about 240 ICU beds in total, which are almost always at capacity for non-coronavirus uses.

“We are seeing an incredible organization-wide effort to prepare for an influx of patients that, based on the experiences of others across the world and in the U.S., may be higher than anything we have ever seen,” Westin said.

Cuyuna Regional Medical Center has six ICU beds with half of them already occupied as of Monday, March 30, according to officials, and 21 non-ICU hospital beds with four of them taken.

“Being rural and having a smaller, more spread-out population has a significant advantage in preventing early spread of this illness, but we fully anticipate it still will show up in our region,” Westin said.

The number of people hospitalized statewide with COVID-19 also leapt Monday by almost 50% from 39 to 56, according to Minnesota Department of Health officials.

“We may have fewer people and a more spread out population base, but if the percentage of people that become ill exceed our capacity, we will face similar resource needs that we are seeing in the large urban areas,” Westin said.

Lakewood Health System

Dr. Christine Albrecht is a family physician with Lakewood Health System who, along with Rod Opheim, emergency preparedness coordinator, has been planning for the surge of COVID-19 patients in the Brainerd lakes area as part of Lakewood’s hospital incident command system.

“Normally, we’re a 25-bed critical access hospital … but the Minnesota Department of Health has recommended we’re able to care for 200% our typical surge capacity, so we do have a plan in place where we can have at least, we think, about 50 to 60 beds right now,” Albrecht said. “We have converted our area where we normally would be doing our elective surgery procedures. That area for holding patients already has hospital beds, so we've been able to just basically reuse the sites that we already have at Lakewood.”

The confirmed number of positive cases statewide grew Monday by its highest margin yet, from 503 to 576, although the state officials consider the number to be a substantial undercount.

“We’re doing our best to educate our physicians and our nurses and all of our staff here to help take care of these patients the best that we can. Our initial plan would be to transfer our really sick patients to a surgery care center that is used to taking care of ventilated patients,” she said.

As of Monday, a 10th person has died due to COVID-19 in Minnesota. Those at highest risk for severe illness include older people or those with certain underlying health conditions.

Under the state’s model forecasts at current transmission rates and health care capacity variables, ICU beds in the state could fill up within 11 weeks — three weeks before a projected peak for infections was expected to materialize statewide.

“We’ve not spent time trying to second guess the different models. What we’ve been spending our time on is to be as prepared as possible for whatever numbers that come … and handle all that we possibly can,” said Tim Rice, president and CEO of Lakewood Health System.

Tough choices

Minnesota Gov. Tim Walz did not say last week what may happen if the demand for hospital beds statewide exceeds the supply. He alluded to Italy, however, where hospitals with inadequate supplies have had to choose which patients receive care — a life-and-death choice.

“This is uncharted territory, but we have seen amazing unity of purpose and direction, creative and innovative ideas to expand and extend our care and resources provided to patients,” Westin said of CRMC.

Westin said CRMC has limited elective procedures and routine visits to the hospital and clinics; limited visitors and vendors; pre-screened those entering the building; and used more phone call and virtual clinic visits (e-visits) to meet the patients' needs, like other hospitals have done.

Westin said rapidly changing guidelines and limited quantities of supplies — such as personal protection equipment like face masks — have made providing health care challenging but added Cuyuna Regional Medical Center has adequate supplies for the moment.

“While our staff shares the same anxieties that we all feel regarding the unknown reach and impact of this pandemic, there is a shared commitment to work together to face this challenge while still providing high-quality, patient-directed care and keeping our staff safe,” Westin said.

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FRANK LEE, county and features reporter, may be reached at 218-855-5863 or at frank.lee@brainerddispatch.com . Follow him on Twitter at www.twitter.com/DispatchFL .