Rural hospitals preparing for delayed spike in COVID-19 cases

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While the urban populations in the United States brace for the predicted spike in COVID-19 cases by mid-April, rural medical facilities predict the surge to happen much later for them.

Rural hospitals predict to see an increase in cases, for them, about two weeks after major cities. Leaders with rural hospitals in the Piedmont Triad cite smaller populations, and clusters of people.

“We are much more spread out just to begin with,” said Dr. Jason Edsall, the chief medical officer for Northern Regional Hospital. “The epidemiology of this will act very differently in [large cities] than it will here.”

The two-week delay is giving rural hospitals a chance to stock up on supplies they will need, such as respirators, masks and ventilators. However, community hospitals are having to take second or third priorities over larger hospitals.

“We do not have the rapid tests. … Those are being sent to the larger facilities,” Edsall said. “Our resources and less deep, so while we have plenty for now, we have to be very cautious when they come in and use them wisely.”

As they wait for supplies to come in, some rural hospitals in the Piedmont Triad have received help from the community and each other.

“When a church brings in masks to be used … if one of [the rural hospitals] gets in supplies and the other’s need it, we’ll send it to them. … Normally we would be competitors, but now those lines are blurred and gon,.” Edsall said.

The financial aspect of the COVID-19 response has begun to take a financial toll on community hospitals. As they suspend non-essential care, they are seeing fewer patients, therefore losing revenue potential.

Northern Regional Hospital operates on a $100 million a year budget. With the loss in non-essential care, the hospital has lost around 8% to 10% of revenue in February, and March, the predictions that will continue into April.

Randolph Health, who has been in a financial hole for the past several years has taken a tremendous hit on revenue. The COVID-19 response caused Cone Health to back up out of potentially taking over health care operations for those in Randolph County.

Randolph Health CEO Angela Ortho explained they, “filed chapter 11, and so we don’t have the resources, we’re not able to go and purchase a lot of ventilators.”

The hospital will still be able to provide care for patients, but with limited resources. For those in the county who need medical help for COVID-19, the hospital will treat them while ICU rooms open up at a Cone Health facility nearby.

“We are working to provide the best level of care possible for these patients. We believe we would stabilize them, care for them in our emergency department, until a bed’s available,” Ortho said.

At Northern Regional Hospital, they have created more ICU rooms with capable equipment and staffing to accommodate the anticipated increase.

When asked if there was a threat of Randolph Health closing during the COVID-19 pandemic, CEO Ortho said, “this is an unprecedented situation we’re all facing. Our organization is unfortunate that we are battling multiple things at one time. With that said, we anticipate being here for our patients through the COVID situation. I don’t anticipate that we won’t be here.”

Both hospitals stress, they will continue to serve the community and treat at-risk patients for COVID-19, or another other ailments they may endure.

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