LRH Experiencing Surge of COVID Inpatients

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Dickinson County experienced their peak of COVID-19 cases in mid-June, but Lakes Regional Healthcare is just now experiencing their peak of COVID-19 inpatients. Between March 1 and August 31, LRH had a cumulative number of 18 COVID-positive patients hospitalized. During September 1 and the October 8, an additional 16 COVID-positive patients have been hospitalized at LRH.


Of the coronavirus inpatients at LRH, all but three of them have been from Dickinson County, all but one have been age 60 and older, and all but one of them have at least two comorbidities such as COPD, CHF, diabetes, or high blood pressure.


The reason for the increase in hospitalizations despite the relatively low and stable number of COVID-positive Dickinson County residents is not known, although speculations abound. LRH President and CEO Jason Harrington said, “We do know that we have kept more patients in the hospital because the admission criteria for nursing homes to accept their residents back are very stringent. Also, many of our referral centers such as Avera McKennan are near capacity and are not accepting many patients. Furthermore, we had sent some patients there, and those patients have since become stable enough to return here for us to treat.”


In recent years the average number of patients spending the night at the hospital averaged around 10-12 patients. Over the past few weeks that number has increased to an average of 15-20 patients per night. “We’ve had to make some difficult decisions to ensure we have adequate staffing to care for our inpatients,” said Harrington. “This week we postponed some elective inpatient surgeries and are now in the practice of evaluating our capacity each day and making determinations accordingly. It’s not something we like to do, but something that is necessary.”


LRH has had much success treating COVID-positive patients. Dickinson County Board of Health Chair and Lakes Regional Family Medicine physician Zach Borus, MD, MPH said medical staff are following best practice treatment protocols from Avera and various hospitals and medical societies. Some of the ways LRH cares for COVID-positive patients include:


  • Various levels of supplemental oxygen

LRH has five heated high-flow oxygen machines and four ventilators/Cpap/Bipap machines that improve oxygen flow. There are also four negative pressure rooms in the hospital that are used for COVID-positive patients because they increase the air exchanges in the room to make the air in the room cleaner. The hospital also has in-house Respiratory Therapists to assist nursing staff and monitor the patients’ oxygen levels.


  • eServices for Additional Care

LRH patients receive extra care remotely from Avera professionals via eServices such as eICU, ePharmacy, eRespiratoryTherapy, eER, and eHospitalists.


  • Specialty Medications

Symptoms of COVID-19 have been shown to improve when patients take medications such as Remdesivir, an anti-viral medication. In addition, steroids such as Dexamethasone help to decrease inflammation in the lungs. LRH administers these and other specialty medications known to help COVID patients. Although currently supply levels of these medications seem stable, this remains an ongoing concern.


  • Convalescent Plasma

LRH patients who have coronavirus have also received convalescent plasma, which contains COVID-19 antibodies from people who have previously recovered from COVID-19.


  • Positioning

Many patients have benefited from prone positioning, which is a term that refers to the patient laying on their stomach. Dr. Borus said, “This is especially beneficial for larger patients because it relieves the pressure on the lungs, allowing the lungs to expand and allow more oxygen flow.”


According to Dr. Borus, COVID-19 transmission could be prevented by wearing masks and socially distancing. He said, “We also encourage people to stay on top of their health screenings and provider check-ups because getting other health conditions may not only compromise your health and immune system and make you more vulnerable to COVID-19, but also make it more difficult to recover from COVID-19 if you do get it.”


Those who have symptoms of coronavirus, including cough, shortness of breath, loss of taste or smell, or fever are encouraged to call LRH’s Respiratory Clinic at 712-336-6696. Those who have been exposed to someone with coronavirus can visit, complete the questionnaire, and then attend LRH’s Test Iowa drive-through site, located in the parking lot north of the hospital off 23rd Street in Spirit Lake. The Test Iowa site is open Monday from 8:00 am until 4:00 pm, Tuesday through Thursday from 7:00 am to 9:00 am and 3:00 pm to 5:00 pm, and on Friday from 7:00 am until 9:00 am.


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