WILLMAR — The initial surge of COVID-19 patients in west central Minnesota seems to have slowed, but no one should think the coronavirus pandemic is over in this area.

The removal of a triage tent outside Carris Health — Rice Memorial Hospital is a sign that area providers have learned more about how the virus is transmitted and how to keep people safe.

“We’ve seen enough of a decrease in community spread that we can manage the whole process of bringing people in in a safe way without using the tent,” said Dr. Kenneth Flowe, Rice emergency department medical director. “We do expect another surge in the fall; we don’t know exactly when, but probably around September or so.”

Less than a year ago, the coronavirus which causes COVID-19 was unknown. “The learning curve has been really fast” in the past five months, Flowe said.

“The key things people should know — it’s here in the community, even now, and at some point in the next few months it’s going to be even more common,” he said.

At this point, the coronavirus has infected nearly 2.6 million Americans and killed nearly 128,000. Case numbers are surging in some parts of the country, but Minnesota’s numbers are increasing more slowly with several hundred new cases identified each day.

Preventing spikes

Flowe said people in the area can help avoid a future spike in cases by following some simple rules — wash your hands thoroughly and often, stay 6 feet away from others and wear face masks.

While the hospital had many complicated preparations to make, “some of the most important are not complicated at all,” he said.

Elderly people are at high risk, he said, and they can be protected “if everyone wears a mask and helps contain the spread.”

“The key thing about getting infected is exposure time,” he said. “I would admonish everybody to be careful and be vigilant now while we don’t have a lot of COVID in the community and be ready for when we do.”

A 10-minute conversation “has a pretty good chance of causing an infection” through the spread of droplets expelled when breathing or talking. People without symptoms can spread the virus,

“Cloth masks are called source control — they're controlling the virus that’s shed from someone who may be asymptomatic,” Flowe said.

“Even a couple layers of cotton fabric is going to decrease the amount of virus that gets out,” he added.

People who work in a shared space are safer wearing a mask, and even safer if everyone else wears a mask, he said. In a space like a conference room, everyone should be wearing a mask, too.

Reopening, for now

When Rice saw its first cases in the spring, the emergency department was split to keep potential COVID-19 and general medical cases separate.

At the time, it took days to get test results, and patients with suspected COVID-19 were hospitalized in negative airflow rooms to wait for results, Flowe said.

Most of the suspected cases had negative test results, but the wait in isolation with no visitors was difficult for them. Test results are now available right away now, easing some pressure on ICU beds.

With new suspected cases at a lower level, at least for now, the medical community is opening up again, Flowe said.

The hospital’s backlog of elective surgeries has been reduced, and Carris Health is preparing to reopen the Surgery Center.

While it was closed, its employees were “borrowed” by other departments, too. Many were performing tasks they hadn’t gone to school for, he said, and performing their new tasks “cheerfully and well.”

Now, those employees will be returning to their jobs, and the hospital will have fewer workers available for other tasks, like those in the triage tent.

The COVID-19 unit at the hospital added and subtracted space as needed, Flowe said, and that can be done again if needed.

Depending on what happens in the future, the tent may even need to go back up, “but even as elaborate as that tent is, it’s amazing how quickly it can go up and down.”

As with other disaster preparedness, the tent is erected a couple times a year, just to make sure it’s ready to go when it’s needed.

‘Plenty of tragedy’

The arrival of COVID-19 in the community brought with it a few good things, too.

“There’s plenty of tragedy, no question, but if you only look at the tragedy, you’re missing a significant part of the story,” Flowe said.

Some practices developed during the pandemic could be here to stay.

A major development is the popularity of video visits. They’ve become more common, and providers and patients seem to like them.

“Video visits have been a real hit with patients,” he said. “They can do it from their own home.” Finding a ride or a babysitter can be difficult for many patients.

Flowe said he found that the required personal protective equipment he wore could be a barrier to working with patients, because only his eyes were visible.

If he could, he would go to an office where he could remove his PPE and have a “face to face” video chat with patients where they could see other’s expressions and communicate better.

“My intuition was that being in person would be better, but that’s only if I can be seen,” he said.

Another positive is the increasing ways the Willmar medical community has found to work together. There’s been an increase in communication and coordination statewide, too.

Rice Hospital and Affiliated Community Medical Centers were separate entities before joining Carris Health in 2019. Family Practice Medical Center in Willmar is also now part of Carris Health.

The pandemic preparation seemed to help complete the transition to one entity.

Employees who were laid off and redeployed to other jobs are an example, Flowe said. “The group of employees has really banded together and taken care of each other,” he said. “People have been very receptive to this is our reality, how do I fit in and contribute.”

Statewide preparedness also heightened cooperation, with hospitals prepared to take transfers from others depending on need.

During protests and riots after the death of George Floyd in late May, for example, ambulances sometimes had trouble reaching hospitals in the Twin Cities, and patients were diverted to St. Cloud in some cases.