Ask The Answer Person: Your questions about coronavirus and Winneshiek Medical Center

Posted: Sun, Mar 29, 2020 2:38 PM

(Our readers have been asking questions about the local response to COVID-19. We can't handle every question, but we have forwarded several questions to Winneshiek Medical Center about the local effort to respond to the virus):

--"What is being done today in Winneshiek County to identify (test), isolate and track the virus here?

Winneshiek Medical Center has set up processes to separate "well" and "sick" patients through screenings at both the main entrance and the emergency entrance to the medical center. WMC has deferred elective visits and procedures for the time being to focus efforts and resources on COVID-19 preparedness, testing and care. Limited testing is available. WMC is following the Iowa Department of Public Health's testing strategy. If tests become widely available, the guidelines would be broadened.

Those who are tested have their information sent to the Iowa Department of Public Health (IDPH). Instructions are provided for isolation for all "sick" patients.

"What kind of tests are available here?"
Winneshiek Medical Center collects specimens, then sends them to the state lab. Results are available within 24-48 hours. In some cases, the specimens are sent to reference laboratories. Those results are available within a 7 to 10 day period.

"What do we know about the projected timeline for an increase in the number of tests, masks, protective clothing for home health and medical workers?"

Winneshiek Medical Center continues to receive products as vendors are able to send them. Several area businesses have been generous in donating N-95 masks they are not using to WMC. Homemade cloth masks are not being accepted at this time until the infection standards for these masks can be determined (at this time, the World Health Organization DOES NOT recommended the use of cloth masks at any point). Additionally, WMC And Winneshiek County Emergency Management are working together to access personal protective equipment (PPE) such as masks, gloves and gowns. Most supplies are back ordered. Delivery times are unknown."

"Can you please provide a report on how the Decorah Clinic and Winneshiek Medical Center are faring during this tough time?"

A response team of physicians, nurses, therapists and administrative staff meets daily to adjust processes to keep patients and staff safe as the situation evolves. Winneshiek Medical Center is working with Iowa Department of Public Health and community partners to collaborate and share ideas/resources."

"Can Winneshiek Medical Center handle a serious outbreak?"

The medical center is prepared to handle the current needs of the community. It also is poised to adjust to meet the evolving needs as they arise. Emergency preparedness is a requirement of all hospitals and clinics. The medical center has policies in place on how to respond to emergency situations. Winneshiek Medical Center has many Memorandums of Understanding (MOUs) for supplies and services as part of their emergency preparedness efforts, in case of a serious situation. If a large "outbreak" were to occur, Winneshiek Medical Center's resources would be strained, just as the resources of the entire health system could be. It is important to stay home if at all possible and social distance to decrease the chance of an "outbreak."

"What are the anticipated needs and serious concerns?"

The medical center's anticipated needs are for medically-approved N-95 masks and for increased telemedicine capacities. Hospital officials say their biggest concern is that some people are not heeding the advice to STAY HOME. They are also concerned about staff illness and the health of staff family members; about the number of "sick" patients rising beyond ther health system's capabilities; and about the availability of medically-approved personal protective equipment. Once again, homemade masks are NOT approved at this time and not recommended by the World Health Organization (https://www.who.int/docs/default-source/documents/advice-on-the-use-of-masks-2019-ncov.pdf) WMC is accepting industrial N-95 masks. Many businesses that have a supply of these on hand have donated the masks to WMC, where they are the emergency back-up supply.

"Will Winneshiek Medical Center offer "drive through" testing for COVID-19? Wouldn't this be the safest for everyone?"

When there will be adequate testing supplies, WMC may consider "drive-through" testing. However, self-collection may be the safest option, which is also not available yet. Self-collection would still require a physician's order, and the patient must have symptoms that meet testing criteria.

Winneshiek Medical Center has taken steps to separate well patients from patients arriving with symptoms. WMC is only testing patients who fall under certain criteria. There is a national shortage of test media (what keeps the swab "live" on the way to the testing lab), which is why such restrictions are in effect. Test results are not going to change the treatment plan, or improve your prognosis if you are positive."

"What steps are being taken by our local hospital and Winneshiek County Public Health to prepare to care for those who become seriously ill with COVID-19 and require hospitalization and more intensive treatment?

"WMC is collaborating with Winneshiek County Public Health and Winneshiek County Emergency Management. The medical center also is adjusting its inpatient floor to create a safe space if patients need hospitalization. This includes facility adjustments to accommodate potential COVID-19 needs. The medical center is working closely with Mayo Clinic and Gundersen Health System if critical patients need a higher level of care. At this time, extremely ill patients would still be referred to Mayo Clinic and Gundersen Health System until their beds are exhausted."

"How well equipped is our local system to provide such care in terms of facilities, equipment, and trained healthcare workers?"

"Winneshiek Medical Center is equipped to handle the current situation, and has the capacity to increase utilization without a significant strain. The decision to defer elective procedures decreases use of personal protective equipment, makes additional staff available for other care needs and provides space to accommodate the evolving care needs of the community. Similar to most critical access hospitals, Winneshiek Medical Center would have limited capacity to provide ICU level care, and this would be done only if its referral centers reach crisis level capacity."

"Another question involving the Mayo Clinic's development of a test which they administer in a drive-through facility. Since Winneshiek Medical is affiliated with Mayo, are there any plans to bring that test to Decorah? If not, why not?"

"At this time Mayo Clinic is only testing for Mayo Rochester patients. If this changes, WMC will make such tests available in Decorah. However, to the best knowledge, the drive-through facilities that are in the news and on social media are collection sites only. Actual testing must be done in a controlled lab setting."

"Finally, who was it that decided to have all tests run through the state lab?"

"When COVID-19 first emerged, the Center for Disease Control was the only place in the country which was able to process results of the tests. As testing capabilities expanded, state public health departments were able to provide results. Now testing has expanded to some reference labs. The turn-around for these tests is 7-10 days. The state lab can return results in 1-2 days. Testing capabilities might give a truer sense of community spread, but the medical center staff assumes there already is community spread here in NE Iowa, which why it keeps stressing the need for community members to stay home."