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Alomere plans for a COVID-19 surge

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Leaders of Alomere Health in Alexandria, Minn., gather for a daily briefing, including (clockwise, from top right) Carl Vaagenes, CEO, Eddie Reif, director of community relations, Margaret Kalina, chief nursing officer and vice president of patient care, Celeste Gardner, director of human resources, and Mike Doyle, administrative director for Heartland Orthopedic Specialists. On the video screen are Nate Meyer, CFO, Dr. Deb Dittberner, chief medical officer and Brad Lenertz, administrative director, Alexandria Clinic. (Contributed)

As the number of confirmed cases of COVID-19 grows in Minnesota, Alomere Health is trying to stay ahead of the curve.

The newspaper asked Carl Vaagenes, CEO, and Dr. Deb Dittberner, chief medical officer, what the hospital is doing to prepare for the surge and a few other questions related to the coronavirus.

Q: Hospital leaders are having daily briefings on COVID-19, correct? Who attends the meetings and what kind of things are being discussed?

A: We have a couple standing internal meetings related to COVID planning and communication. Dr. Dittberner leads a “daily brief” and provides an update on the number of cases, hospitalizations, intensive care unit patients, fatalities and recoveries from the world, U.S., state and county.

There are also several daily reports from across Alomere on system response as it relates to all the planning and preparations from staffing and personal protection equipment (gloves, masks, etc.) supply updates, human resources and community partnerships. Over 100 individuals (physicians, managers, and staff) from across the organization regularly participate via Zoom video conferencing.


The “daily brief” is followed almost immediately by an “incident command” meeting led by the CEO where operations, logistics, planning, communications and public information, and finance/administration matters are discussed in more detail to drive decisions by a smaller group.

For all of these meetings, we utilize Zoom to encourage social distancing, so there seldom is more than a few individuals actually in the same meeting room.

Q: How many beds are in the intensive care unit? Are they all being used? What happens if more ICU beds are needed?

A: We have seven ICU beds. The limiting factor for our ability to care for ICU patients is based on the number of patients that need a ventilator and negative pressure rooms. In addition to the seven ventilators in the ICU, we have planned for the utilization of eight additional anesthesia machines from the surgery center as ventilators.

The availability of ICU rooms changes on a daily basis depending on what volumes are and severity of our patients. In the event where we had more patients that require ICU care than we have in the current ICU, we would be able to use our negative pressure medical/surgical rooms.

Q: If a patient is displaying serious COVID-19 symptoms, are they treated at the hospital or are they referred to CentraCare in St. Cloud?

A. Our plans are to refer inpatients who test positive for COVID to CentraCare based on their capacity. The collection of specimens for testing patients is sent to Mayo or MDH, and is currently approximately a 24-hour turnaround time. Patients would be treated at Alomere Health until we get the test results back from MDH or Mayo.

We are also planning for the event that St. Cloud is at surge capacity and we need to keep positive COVID patients.


Q: What's the best protocol for people who think they have symptoms? E-Visits? Phone?

A: Many cases have mild or moderate illness and do not require a clinic visit and most do not require hospitalization.

There is no specific treatment for COVID-19. Get rest and stay hydrated.

If your symptoms worsen to the point that you need to see a doctor, call ahead before going in.

A respiratory clinic is now open at the Alomere Health Plaza located at 1500 Irving St. in Alexandria. Respiratory Clinic hours are Monday through Friday, 9 a.m. to 6 p.m. and Saturday and Sunday, 9 a.m. to 3 p.m.

There are no walk-in appointments at the respiratory clinic and all patients should call prior to coming to any clinic or hospital location, except in the event of an emergency.

Phone visits, e-visits and virtual visits are also available through the Alexandria Clinic.

Q: How are the hospital's COVID-19 supplies (PPEs) holding up? Are there enough for now? Can people still donate masks, gloves, etc. to Alomere?


A: There is a global supply chain shortage, but we are working around the clock to obtain PPE through suppliers as well as through the state’s emergency preparedness organizations, which extend from the local level up through the governor’s office to the federal government.

We are using a surge capacity calculator to determine how many days of supply of PPE will be available following airborne precautions for treatment of patients. We are projecting our maximum surge volume of 20 COVID patients requiring hospitalization at full capacity.

We are following the latest guidance on the use of PPE provided by the Minnesota Department of Health and the federal Centers for Disease Control and Prevention. This expert guidance for optimizing PPE is different from what we would use during normal operations because it is designed and tested to be used in exactly this situation – a pandemic when there is a limited supply of PPE.
The products that are in shortest supply at this time are N95 masks, gowns and face shields. The supply of PPE across the U.S. is in very short supply and all hospitals have now been limited to allocations when reordering supplies based on past volumes.

The supply and demand has also dramatically increased the price for limited supplies, and the federal government is outbidding even state governments on contracts with manufacturers in order to increase the federal stockpile and ability to distribute limited supplies to “hotspots” across the U.S.

In order to make sure our local needs are met to the best of our ability, we are researching alternatives, which has included soliciting volunteers to help us make products such as facemasks out of materials that are considered equal or superior to surgical masks.

Al Edenloff is the editor of the twice-weekly Echo Press. He started his journalism career when he was in 10th grade, writing football and basketball stories for the Parkers Prairie Independent.
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