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In these rural parts of the country, medical resources to battle COVID-19 are limited

COVID-19 infections and hospitalizations are soaring in areas that have previously been relatively unaffected -- including rural, less populated states in the West and Midwest. Dr. Bridget Brennan, chief medical officer of Benefis Health System in Great Falls, Montana, and Renae Welhouse, a nurse practitioner at Sanford Medical Center in Bismarck, North Dakota, share what they are seeing.

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  • Amna Nawaz:

    The current surge in U.S. COVID cases means both infections and hospitalizations are now soaring in places that previously were less affected by the pandemic. Many of them are rural, less populated areas in the Midwest, Plains states and out West.

    We now start with voices from a pair of states that are now on the front lines of battling the virus. One is the chief medical officer and an emergency room physician of a health care system in Great Falls, Montana, the other a nurse practitioner in Bismarck, North Dakota.

    Both states right now have some of the highest infection rates per capita in the country.

  • Bridget Brennan:

    And I'm an emergency physician, as well as a chief medical officer.

    The things that make things different a little bit here in Montana is the distance. It is such a huge state, that most of our residents live in very rural areas. There are several large hospitals throughout the state, but we don't have the luxury of having multiple large hospitals in every city.

    The limiting capacity or the limiting factor throughout the state is going to be ICU beds. Once somebody becomes ill enough to require ICU-level care, that number of beds throughout the state is finite. And so that is what we're trying to manage. They — unfortunately, that's not a short stay in the ICU. It is a longer stay. And so the volume gradually increases to the point where it really becomes an issue.

    It is certainly concerning to see numbers of 500, 600, 700 new cases a day in the state. I know that doesn't sound like a lot to many parts of the country, but when your resources are limited, like they are, it doesn't take more than just a few hundred patients a day to have a number of really, really ill people all at once.

    And so, yes, I'm hoping — I'm hoping people will come around to believe that this is real, because it certainly is. I have got staff working just endlessly trying to take care of patients. And when we hear people not taking this seriously, it's a little disheartening.

    We don't see the numbers slowing down, at least not yet. I'm hoping it will start to taper off here. My concern is going forward into respiratory season, flu, colds, RSV. It is that time of year. And when we combine it with something like this, it makes me a little nervous about going through the next three or four months.

  • Renae Welhouse:

    My name is Renae Welhouse. I'm a nurse practitioner here at Sanford Health in Bismarck, North Dakota.

    Currently, here in North Dakota, we're seeing a surge in COVID patients, which, of course, is impacting our health care system.

    I'm from here. I'm born and raised in North Dakota. And, usually, we are able to escape under the radar. So, seeing this is definitely new. It is surprising. But we wake up every day and face the new challenges and somehow overcome it to face another day.

    When we have a patient on the COVID unit, we require isolation. And they're isolated from their family at their greatest time of need. That becomes very difficult. And, as health care providers, we provide and try to bridge that communication and try to bridge and provide that emotional support, not only for our patients, but also for the patients' family members, because they aren't able to come and sit at the side of the bed and hold their hand.

    You know, the biggest thing is the unpredictability of COVID. We don't know a lot about it. We learn something every single day. We don't know how the patient is going to present, the unpredictability of symptoms, who is going to present with fever and chills, who is just going to have loss of taste, who is going to have decreased respiratory status.

    And then learning how to manage those symptoms, and then how are those symptoms going to progress? How fast are they going to, if they do progress, to needing a ventilator? And we have opened up another unit to try to accommodate. And we are taking those steps, not only for what we're dealing with right now, but for what we think the future will bring us.

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