COVID numbers are ramping up across the state faster and earlier this summer compared to the September surge last year, and while hospitals are now better equipped with knowledge of the virus and how to treat it than they were in 2020, Altru is still facing concerns of a smaller and more worn down staff, said Janice Hamscher, Altru's chief nursing officer.

"As an industry, we are seeing a smaller health care workforce this year, this is likely in part to the strains from the pandemic," she told the Herald this week via emailed statement. "We know that our team is weary, and is one reason we so urgently ask our community to get vaccinated, to protect themselves and our health care resources."

Countywide, the number of active COVID-19 cases rose from about a dozen in early July to 181 people as of Tuesday, Aug. 31. Meanwhile, the proportion of tests for the virus that come back positive rose from less than 1% to 5.7%. About 21 people per day over the past week have tested positive for COVID-19.

“We knew there was going to be an increase in cases,” Michael Dulitz, Grand Forks Public Health’s lead COVID-19 data analyst, told the Herald. “We were hoping that it was going to be more of a bump or a blip than something that looks like it has teeth.”

He pointed to a statewide rise in “breakthrough” coronavirus cases in which someone catches the virus despite being fully vaccinated. The North Dakota Department of Health recently began publishing statewide data about those cases. It indicates that unvaccinated people constitute considerably more COVID cases than their vaccinated counterparts, but the absolute figures for both still spiked in August.

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Overall, state employees report, one in 175 vaccinated North Dakota residents have nonetheless tested positive, compared to one in 15 unvaccinated residents. Miniscule fractions of vaccinated residents have been hospitalized or killed by the virus.

In a press conference Wednesday morning, Sept. 1, North Dakota Gov. Doug Burgum said this year's earlier summer surge is creating staffing problems for hospitals. He noted that the traveling nurse workforce, which local hospitals leaned on last year, are still occupied in the southeast due to the large case surges there.

Hamscher told the Herald that Altru is currently hiring for about 100 inpatient registered nurses, among other roles. Despite rumors, Hamscher said the health care organization has not seen a significant portion of its workforce leave due to the hospital's vaccine requirement, and Altru is continuing to work with individuals who choose to submit exemptions to receiving the vaccine.

As of Tuesday, Aug. 31, Altru reported it had 12 COVID patients admitted to the hospital, three of whom were in critical care and two of whom were on ventilators. Of those 12 patients, only one was vaccinated, Hamscher said. This is in line with the trend Altru has seen in recent months: 91% of its total COVID inpatients have been unvaccinated since February, when vaccines became widely available to the general public.

Also on Tuesday, Hamscher told the Herald that Altru had one staffed hospital bed available, and one staffed ICU bed. She noted that those numbers can change hourly -- but Altru has noted a slow increase in daily COVID patients over the past month. In July, she said, Altru admitted two COVID patients all month.

Hospitalizations are also considered a lagging indicator, and those numbers are expected to increase rapidly in the coming weeks due to the emergence of the highly contagious Delta variant in North Dakota. The hospital is closely monitoring those trends, Hamscher told the Herald.

In the press conference, where she appeared with other health care leaders as well as the governor, Wednesday morning, Hamscher noted that the 14-day rolling positivity rate in Grand Forks has reached heights not seen since April, with no signs that it will come down any time soon.

"If we do see a surge of COVID patients, we will enact our surge planning, which may lead to pausing of elective surgeries or clinical appointments, if we need those resources to support the hospital," she said.

Some major hospitals across the state have already begun scaling back surgeries, health care leaders said in the press conference. As beds fill up and staff is stretched thin, Altru has sent some patients to hospitals as far away Minneapolis recently for care, and in turn has accepted patients from other full hospitals when possible.

"We're collaborating, as a health care entity, across the state in order to provide care for the citizens of North Dakota, but we really don't have unlimited resources," she said in the press conference. "I'm making a plea for individuals to really take personal responsibility to protect yourself form COVID by getting the vaccine. Our staff to beds is really limited, and we know that that is going to cause challenges for us."

Hamscher emphasized that it's important for members of the community to continue to seek care for all health care needs, as delaying care can be very dangerous.

To find a COVID-19 vaccine appointment near you, visit www.vaccinefinder.org.