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No local cases yet, but FCMC prepares for COVID-19

No local cases yet, but FCMC prepares for COVID-19
Floyd County Medical Center administrator Rod Nordeng said Wednesday that preparation for COVID-19 happens daily — sometimes more often than that — with conference calls with managers and providers, who make hour-by-hour determinations of FCMC’s readiness. (Press photo James Grob.)
By James Grob, jgrob@charlescitypress.com

The administration and staff at the Floyd County Medical Center are all working under the assumption that sooner or later there will be a lab-confirmed case of COVID-19 in Floyd County.

“If we have a positive test, we’ll just be confirming what we know — there must already be some positives out there in Floyd County,” said FCMC Administrator Rod Nordeng. “At that point, we end up taking direction from the state, as far as what are the next steps with that positive.”

Lisa Hintgen, FCMC emergency preparedness, added, “We just need to assume that, and follow the right procedures, and we need to make sure that we are prepared.”

Nordeng said there are conference calls with managers and providers who make hour-by-hour determinations of FCMC’s readiness.

“Even though what we’re doing every day may not be in the media — it may not be obvious to the public — this is major for us,” he said. “We recognize our role in the community and the county as a critical access hospital. We have a really good group of physicians, nurses, lab techs and others who can provide the care that will be needed in the coming weeks.”

Nordeng said that he expects the COVID-19 situation will be going on for a significant period of time.

Iowa health officials announced nine new positive COVID-19 cases Wednesday evening, bringing the total to 38 positive cases in the state. The positive tests closest to Charles City are in Blackhawk County, reported on Tuesday, and a new case reported Wednesday in Winneshiek County.

“One of the things that is happening with COVID-19 is decisions we make one day are changing by the next day,” Nordeng said. “Our biggest challenge in the public is, just because people want a test, they can’t get a test. There are certain protocols.”

COVID-19 testing, or the lack thereof, has been a much-discussed problem nationwide.

Nordeng said that FCMC currently has 11 test kits on hand, and although there have been numerous requests for tests, none have been conducted so far. He said that the hospital has been visited on a daily basis by people with some symptoms who are frustrated because they can’t get a test.

“We can’t just test because we want to test,” he said. “That has to go through the state, and we need to get approval on whether or not they can be tested. Hopefully that changes, because I think that’s where the concerns from the public come in.”

Hintgen said  the Iowa Department of Public Health limits testing to hospitalized patients with fever and respiratory failure with no alternate diagnosis, hospitalized adults over 60 with fever and respiratory symptoms and chronic medical conditions, and anyone who has had household contact with a lab-confirmed case of COVID-19 in the 14 days prior to becoming ill with fever or respiratory symptoms.

It will also allow testing on anyone with a history of international travel to a country with a Level 3 CDC travel health warning and anyone who has taken an international cruise in the 14 days prior to becoming ill with fever or respiratory symptoms with no alternative diagnosis, Hintgen said.

“That’s a challenge for our providers,” Nordeng said. “It’s a challenge for our lab who are having to say ‘you don’t meet the criteria that we’re held to.’ We also would certainly like to get more tests if we can get them.”

Travis Haberkorn, FCMC medical lab technician, said the challenge goes beyond the shortage of COVID-19 testing kits.

“One of the other issues we just found out is there is actually a shortage of the transport media as well, nationally,” Haberkorn said. “So not only are the tests themselves running out, they’re short on the transport media that we use.”

Transport media are special substances formulated to preserve a specimen and minimize bacterial overgrowth from the time of collection to the time it is received at the laboratory to be processed. In Iowa, COVID-10 tests are processed at the State Hygienic Lab at the University of Iowa and at a number of private laboratories.

Testing kits aren’t the only supplies in high demand, according to Nordeng.

“There are the face masks, the gowns, the IV solutions,” he said. “From a national perspective, there’s been so much pressure on health care in recent decades to be lean and very efficient, but there hasn’t been a national program to stockpile.

“We can stockpile fuel oil, but there’s been very little done to stockpile medical resources to help out hospitals on the front line,” he said.

A limit to the number of beds a particular medical center can have also presents a significant challenge to hospitals across the nation, according to Nordeng.

“There are limitations on the beds that we have available,” he said.

The governor’s health emergency proclamation allows health care facilities to add beds to treat COVID-19 patients, “but it’s not like you can flip a switch and all of the sudden you have 20 new beds waiting outside,” Nerdeng said.

Effective Friday, FCMC will start deferring elective operating room and outpatient non-emergent surgeries and procedures to help ensure that the hospital has the capacity and resources to care for patients who need it the most.

“We’re not the first medical center to take that action,” Nordeng said. “Nationally, some have already taken that step and others are scheduled to take that step on Monday.”

Physicians, physician assistants and nurse practitioners will continue to work with surgeon Dr. Angela VanGilder to determine if a surgery or procedure is considered urgent and should not be deferred.

“They’ll make that determination on a case-by-case basis,” he said.

Hintgen said if a patient who tests positive for COVID-19 locally is in need of hospitalization, whether or not the hospitalization can happen at FCMC depends on the severity of the illness — how sick the patient is and whether or not the patient needs ventilator support, among other things.

More than likely, patients who are more severe would be transferred to Mason City.

Kim Isakson, FCMC infection prevention, said misinformation about COVID-19 presents another challenge.

“We really want to encourage people to go to the Iowa Department of Public Health and to the U.S. Center for Disease Control to get their information, rather than get it from online sources that might not be credible. That’s really important,” she said.

In Iowa, call 1-800-362-2736 or 2-1-1 with questions regarding COVID-19.

“I think a lot of it boils down to being responsible by taking care of yourself, by washing your hands, covering your cough, all the things they talk about continuously,” Isakson said. “Stay home when you’re sick. We are a society of go-go-go, and we really need to take this seriously, where if you’re not feeling well, you’re not out.”

Nordeng said that he understands that everyone processes all the information — and misinformation — differently.

“Our sources are different and our reactions can be different,” he said. “For us, it’s important that the community knows that we’re doing everything we can within our means to be well-prepared to provide the care that we need to. We’ll work through this, we’ll deal with it. We’ll provide the care that we need to.”

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