Altru is evaluating how it might safely schedule asymptomatic staff to work in its COVID-19 unit following an announcement Monday, Nov. 9, from Gov. Doug Burgum that the state would allow hospitals and other health care facilities to do so as they deal with staffing difficulties during the pandemic.
“If implemented, we would follow strict guidelines and protocols to ensure the rest of our workforce and patients remain safe,” Kenneth Harvey, communications specialist for Altru, said in a statement to the Herald. “These staff would remain strictly in our COVID units and separate from other staff and patients during breaks and upon entry. This is an accepted practice according to CDC guidelines to ensure capacity is available during staffing shortages.”
Harvey said steps such as these “are being considered as we face increased volumes of patients and a high number of staff requiring quarantine.”
“In order to safely care for all patients who need us, we must consider this option to do so,” he said.
No final decisions on the matter have been announced as of Wednesday, Nov. 11.
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Burgum announced in a Monday press conference that an amended health order will allow health care workers with asymptomatic cases of COVID-19 to continue working in COVID-19 units at hospitals and nursing homes.
The decision is in line with “crisis” guidelines from the Centers for Disease Control and Prevention, Forum News Service reported Monday. Only the patients with COVID-19 would receive care from health care workers with the virus, Burgum said, adding he believes that there would be little risk of additional spread. The workers would continue to wear protective equipment.
Burgum noted throughout the press conference that there has been tremendous stress on hospitals across the state as North Dakota continues to deal with high active case numbers of COVID-19.
“Our hospitals are under tremendous pressure now and the current rates of growth in COVID active cases,” Burgum said during the press conference. “Active cases come first, then hospitalizations later and, in some cases, unfortunately, that’s followed by an increase in the death rate.”
Burgum said the state is considering hiring emergency medical technicians and paramedics to run COVID-19 testing sites, which would allow nurses who are currently doing the testing to begin working in hospitals.
How all of that will ultimately affect hospitals, such as Altru, remains to be seen.
During the press conference, Burgum also noted that the state would be sending rapid COVID-19 tests to various hospitals, nursing homes, schools and colleges, including UND, North Dakota State, Minot State and Dakota College at Bottineau. The tests, formally called BinaxNOW, can produce results in as little as 15 minutes, which could help get results quicker for those who are showing symptoms of COVID-19. The state has about 150,000 BinaxNOW tests on hand and may have as many as 220,000 by year’s end and has requested more.
Dr. Joshua Wynne, dean of the UND medical school who has been heading the university system’s response to the virus, said the rapid tests will aid the state in a few ways. First, sample won’t have to be shipped to Bismarck or another lab, which may help with lab capacity. Second, the BinaxNOW tests are much less expensive. A BinaxNOW test costs around $5, while the typical PCR test is around $125, he said.
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However, one catch is that the BinaxNOW tests are not quite as accurate as the standard PCR tests, according to Wynne, noting the BinaxNOW tests do perform well on those who are symptomatic. That means a student who is presenting cold-like symptoms can be administered a rapid test and find out in 15 minutes if he or she is positive or negative for COVID-19, where as a PCR test might take days to get the result.
“If we can do the BinaxNOW test, we can get the answer in 15 minutes, which means we can immediately isolate that student and prevent them from potentially spreading it to other students,” he said. “So the speed of being able to do it means that we can reduce transmissibility.”
The rapid tests also make repeated testing of populations, such as students easier, because the tests are cheaper.
“Even if it isn't as accurate as PCR in asymptomatic people, if we're able to test them over and over, we're likely to pick up infections,” Wynne said. “It expands the ability to test beyond what the state capacity is .... This will enable us to test even more people, and especially testing people repetitively. I do think that this is going to be a real help.”
UND spokesman David Dodds said that, according to UND Chief Eric Plummer, who is helping to lead a team at the university on COVID response, the university is still awaiting the training and delivery of the kits for the BinaxNOW tests. He noted that there is a plan in place and, once the kits arrive and are distributed, the university will be able to roll the testing out.
