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A North Dakota Health Center Confronts Covid Surge

As state records surge in cases, health staff at Spectra Health in Grand Forks are working overtime to treat patients and administer tests.

Health care workers at Spectra Health conduct a Covid-19 test in Grand Forks, North Dakota. (Photo courtesy of Spectra Health)
Health care workers at Spectra Health conduct a Covid-19 test in Grand Forks, North Dakota. (Photo courtesy of Spectra Health)

In North Dakota – where cases of Covid-19 have reached record levels – one community health center has found itself nestled in a state hotspot.

“We’ve all seen the maps and the region as a whole is not doing well. So, we’re certainly in the middle of that,” said Mara Jiran, CEO of Spectra Health in Grand Forks, North Dakota.

The state, which maintained low numbers throughout this summer’s “second wave,” now has the nation’s highest case rate per capita, according to the Centers for Disease Control and Prevention.  Grand Forks is one of several counties edging into the state’s “critical risk” category, in part due to its high positivity rate. Over the last 2 weeks, 20% of people tested for the virus were positive. The national average currently hovers around 8.5%, according to John Hopkins University.

While there are several testing sites throughout the state, Spectra Health has been doing walk-up testing for patients without a car or other mode of transportation. Within the the first week of November, more than one-third of tests came back positive, according to data collected by the health center.

“The most frustrating part is the general amount of community spread we’re experiencing right now,” said Jiran. “It’s causing a ripple within the economy.”

As people, and employees, fall victim to the virus, many businesses have shut down. For Jiran’s staff, the closures have made getting to work difficult. “A lot of times it comes down to childcare,” explained Jiran. Most daycares and schools choose to close if a worker tests positive, which for parents–including staff at Spectra Health–has meant staying home to take care of children.

The high case numbers have also increased the likelihood of exposure, further contributing to staffing shortages. “Their child is a close contact or their roommate is a close contact,” said Jiran. “At that point, if they’re not essential, we are trying to stop the spread, so we are asking people to stay home.”

This week, North Dakota’s governor announced hospitals were at 100% capacity due to a limited number of staffed beds. To alleviate the pressure, the state is allowing  health care workers with asymptomatic cases of the virus to continue working in COVID isolation units. While Jiran said Spectra Health is “not immune to staffing challenges,” they are maintaining their current protocol to send home employees that have tested positive for the virus.

As hospitals face a surge in emergent care needs – from complications due to COVID to strokes induced by deferred chronic care – community health centers are picking up the pieces of another crisis spurred by the pandemic.

Social service visits have increased 300% at Spectra Health since March. “We’re seeing a massive influx in that need, coming here,” said Jiran. While many of their patients were living on the margins before the pandemic, the paycheck reductions and job losses have made it even harder to secure the basics. Some can’t afford their housing. Others are food insecure.

For those experiencing homelessness, Jiran said the isolation has been particularly challenging. “Their normal outlets are no longer available: libraries, their faith community, that sort of thing.” Sometimes it’s “as simple as just needing somebody to check in with,” said Jiran.

Due to the high case numbers, the health center is moving as many visits as possible back to telehealth, including social services. To ensure those without a computer or cellphone can stay connected, they’ve cordoned off a section of their building for virtual visits. “Somebody can walk in, dial up and engage with social work, behavioral health, or their primary care provider,” said Jiran, without risking exposure. “We want to make sure those services are available to the entire community.”

As hospitalizations soar, the health center is working to keep primary care services available to their patients. For those with chronic conditions, like diabetes or hypertension, regular check-ups can help prevent unnecessary emergency department visits later on.  “That is a role that primary care can play in a pandemic” said Jiran. The health center has remained open throughout the pandemic.

“Theoretically, if there’s enough primary care, we can help bend that curve,” she said.

Direct Relief’s Response

In November alone, Direct Relief has provided more than 1 million units of personal protective equipment to U.S. health facilities battling a spike in Covid-19 cases.

Direct Relief has provided Spectra Health with nearly $81,000 worth of requested medical aid since the start of the pandemic in January. The latest shipment for the health center departed Nov. 11, and included containing personal protective equipment, including gloves, gowns, and N95 masks, thermometers, pulse oximeters and other requested items.

Direct Relief is preparing 62 shipments of medical aid for hospitals and safety-net clinics in states across the U.S. Midwest, including North Dakota, South Dakota, Montana, Wisconsin, Iowa, Wyoming and Nebraska. Each shipment contains 1,920 N-95 masks, 2,000 surgical masks, 10 contact-less thermometers, 10 pulse oximeters, 100 face shields, and 180 isolation gowns. These shipments are in addition to shipments last week to health facilities in Montana, South Dakota, and Idaho.

Since November 2, Direct Relief has dispatched 682 shipments of PPE and critical care supplies totaling more than $6.7 million to health centers, free clinics, and hospitals across the United States.

As cases of Covid-19 continue to rise, Direct Relief stands prepared to deploy requested medical aid and supplies to frontline health facilities in the United States and abroad.

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