Hospitals across Minnesota and North Dakota are implementing special surge plans and working together to locate available medical beds in response to climbing COVID-19 cases and brimming capacity levels.

It’s been a busy fall for hospitals in both states, with many operating at full or nearly full capacity while also dealing with worker shortages resulting from staff exposures to the virus and the required quarantines that follow.

In North Dakota, where hospitals have reached their limits and there’s a major shortage of health care staffing, Gov. Doug Burgum made headlines Monday for his extraordinary announcement that health care workers with asymptomatic cases of COVID-19 would be allowed to continue working in hospitals’ COVID-19 units, according to a Forum News Service report.

The situation in Minnesota has not called for such extreme measures, but state health officials and hospital leaders have expressed alarm about the current spread of COVID-19 and have taken the unusual step of collaborating across multiple health systems to coordinate patient care.

Recent weeks have brought increasingly high, record-setting numbers of cases in Minnesota, with new cases per day now topping 4,000, as reported by the Minnesota Department of Health. Along with that, there have been more than 100 new hospitalizations nearly every day for the past two weeks (compared to about 20-30 new hospitalizations per day in June). And intensive care units are nearing capacity, especially in the Twin Cities metro area, where they’re at 98% (statewide, 92% of ICU beds are full).

In Becker County, as of Nov. 10, there were 208 active cases, the rest no longer require isolation, according to the Becker County Public Health website. Becker County has had more than 1,000 positive cases since the pandemic began with four deaths as of Tuesday

At Essentia Health-St. Mary’s in Detroit Lakes, “We’ve been very busy for about the past month,” said Dr. Richard Vetter, the chief medical officer for the Essentia West area, which includes Detroit Lakes and Fargo. “To date, we’ve not exceeded capacity, but I would say we’ve neared capacity a couple times… As of yesterday (Monday), we have available ICU and medical beds, but that could change any day.”

The Detroit Lakes hospital has not yet needed to enter into its “crisis level” surge plan, but in recent weeks it has at times operated a step down from there, in its mid-level “contingency” plan. Most days, the hospital has continued to operate at its basic, conventional level -- just with more patients than usual.

“The numbers in our hospitals have increased,” Vetter said. “Both COVID and non-COVID cases have been busier.”

The biggest challenge with that has been staffing, he added. Typically, Essentia hospitals are staffed for 75% capacity, but during these higher-capacity pandemic times, more workers are needed. At the same time, a certain percentage are unable to work because they’ve been exposed to, or infected by, the virus, leaving a smaller pool of employees to cover shifts.

To address the shortages, Essentia leadership has asked its care providers to voluntarily pick up extra hours if they can, with incentive pay. Essentia Health in Fargo has about 15 to 20 “traveling nurses” that are providing additional help there, and the regular staff has occasionally had extra hours required of them. Vetter said he wasn’t aware of any mandatory shifts at the Detroit Lakes hospital.

Hospitals that don’t have the staff or beds to accommodate a patient right away might have that patient sent elsewhere, most likely to a nearby hospital. The state’s health systems “are sharing what beds they have available and moving people to where there’s availability,” Vetter said. “There’s a good shared system in place … People have really stepped up and are here to serve patients.”

In the vast majority of cases, patients are still being seen at their regular, preferred hospital. Tara Ekren, Essentia Health’s media relations specialist, reminds patients that, “Even though we’re at or near capacity, that doesn’t mean we don’t want you to come in. The emergency room is still available and will never turn people away. Don’t delay your care, either. There are several examples of people who have delayed (routine or preventative) care and then ended up needing hospital care --- so if you aren’t feeling well or if you need care, make sure that you seek it out.”

Encouraging people to keep taking care of themselves is part of Essentia’s broader goal of encouraging whole communities to take care of themselves and each other, to help reduce the transmission of COVID-19. Vetter said the organization is working with other health systems and state health departments “to get our message out to our communities to do whatever they can to reduce the spread of COVID-19: mask up, stay away from large gatherings, wash your hands…"

“Because if we can have healthy staff,” he continued, “that’s going to make sure we can care for our patients when they need us. We all need to pitch in. We need our communities’ help.”

Waiting on a COVID-19 test? Here’s what to do

After you get tested

• Stay home and away from others, especially if you have symptoms. If you do not have symptoms and must leave the house, wear a mask and stay 6 feet from others.
• Make a plan for what you’ll do if you test positive, because you will need to stay home for at least 10 days.
• Make a list of people you have been in close contact with recently. Tell them you may have COVID-19 and they should stay away from others until they hear from you.
• If you were in close contact with someone who has COVID-19, you need to stay home for 14 days even if your test is negative because you could still become sick.

If your test is positive

• This means you currently have COVID-19.
• Stay home. A public health worker will call you with questions about who you’ve been in direct contact with and places you’ve visited, as well as information about what you should do and how long you should stay home.

If your test is negative

• This means you do not currently have COVID-19.
• Continue to take the usual precautions to protect yourself and others from the virus.

For more information, visit the Minnesota Department of Health’s COVID-19 website or call the Minnesota Helpline at 1-800-657-3504 on weekdays.

1/2: Alexis Steffel, a CMA at Essentia Health-St. Mary's in Detroit Lakes, prepared a COVID-19 test for a patient at the drive-up clinic late last year. (Marie Johnson / Tribune)

2/2: Essentia Health CMA Alexis Steffel administers a COVID-19 test to a patient at the drive-up testing site in Detroit Lakes on Tuesday. (Marie Johnson / Tribune)