With Bethesda Hospital nearing capacity with coronavirus patients, M Health Fairview will dedicate units this week within St. Joseph’s Hospital in St. Paul and Southdale Hospital in Edina for a potential surge of severe cases.
Bethesda, a rehabilitation hospital outside downtown St. Paul, was converted to care exclusively for critically-ill patients infected with the coronavirus. The 90-bed facility — referred to as Bethesda COVID by health workers — wheeled in its first patient on March 26. Dozens have followed.
“We are just right around 60 patients there, so we are not quite at 75 percent capacity,” said Jeoff Will, chief operating officer of M Health Fairview’s acute care hospitals.
Bethesda, outfitted with intensive care and “negative air pressure” rooms equipped with wall units and air filters that push de-contaminated air outdoors, is quickly filling, and the goal is to make 100 beds available at St. Joseph’s once Bethesda hits 75 percent capacity.
COHORTING STRATEGY
M Health Fairview officials said the “cohorting” strategy — or grouping patients infected with the virus into one area — has offered several benefits, including centralized resources.
That means minimizing the possible spread of the virus, creating a designated site for clinical trials of experimental treatments, and ensuring that healthcare workers dealing with the most contagious patients get the latest training and equipment, including antibody testing.
“At Bethesda, we have found that to be extremely effective to mitigate and control the spread,” Will said. “Not one of our healthcare workers in that facility has tested positive.”
In a statement, M Health Fairview officials said that as Bethesda fills up, they’ll look nearby to St. Joseph’s Hospital for critical coronavirus care. Once the 100 designated beds there are nearly full, they’ll turn to Southdale. Both units will be ready this week.
The hospitals will continue to operate emergency rooms, mental health inpatient rooms and other essential non-COVID procedures.
“Other healthcare services will continue to be available at those locations,” said M Health Fairview spokesman David Henke.
SURGE MAY BE WEEKS AWAY
It’s unclear when or even if all those beds will be needed, but known infected patients statewide appear to be doubling roughly every eight days based on limited testing of the very sick, seniors in congregate care facilities and front-line healthcare workers.
Minnesota has recorded more than 2,500 known cases, with more than 1,100 currently sick and 237 hospitalized so far this week. The state has recorded 160 known COVID-19-related deaths.
Health officials say many more are likely infected but have not been tested. In many cases, symptoms are mild or not evident at all. The hope is through social distancing and other precautions, infections will spread gradually enough that they won’t overwhelm bed supply.
“While we recognize a COVID-19 surge may still be weeks away, we want to be fully prepared to respond to a rapid acceleration of cases,” reads a statement from the health network. “As a result, we are preparing to implement our COVID-19 cohorting plan this week.”
The statement goes on to say: “The successful transformation of Bethesda Hospital to a COVID-19 only facility has shown the effectiveness of cohorting in establishing and maintaining the highest possible practices for staff and patient safety.”
Officials said St. Joseph’s and Southdale were selected because they already have acute care capacity, including ICU beds and negative air pressure rooms.
ANTIBODY TESTING
Among its advantages, cohorting allows for focused resources. Through a partnership with the University of Minnesota, M Health Fairview has rolled out targeted antibody testing — or blood tests — to determine if workers have had the virus.
The U of M has developed its own COVID-19 antibody testing technology. They began testing front line health workers at Bethesda Hospital about a week ago, while keeping those results confidential to the workers.
A second phase of antibody testing aims to assist multiple research studies. Antibody testing will be available to workers across the M Health Fairview system who wish to share their results for the good of science.
A third phase of antibody testing, still under development, will focus on investigative research aimed at informing on-the-ground clinical decision making and workforce safety.
