With the announcement by Greenbelt Home Care and the Iowa Department of Public Health Thursday that the first case of COVID-19 has been confirmed in Hardin County, there are likely many questions on local residents’ minds. The Times Citizen spoke with Hansen Family Hospital Chief Nursing Officer Lori Krenos and Chief Executive Officer Doug Morse earlier this week to get some of those questions answered. If you have questions that are not answered here, send them to the Times Citizen staff using this form. We’ll track down the answers and add them here.
What information is available about Hardin County’s first COVID-19 case?
The Iowa Department of Public Health does not release specific identifying information (name, city of residence, etc.) about the people who have tested positive for COVID-19. At this time, we know only that a person in Hardin County has tested positive for the disease and they are self-isolating at home. Greenbelt Home Care/Hardin County Public Health will conduct an investigation to determine where that person has been in the last 14 days. People who may have come into contact with that person may be contacted and advised to self-isolate. Find a full list and map of Iowa’s confirmed COVID-19 cases on the state's coronavirus website here. The list is updated daily, around 11 a.m., and does not yet include Hardin County's case, which was announced after the daily update on Thursday.
Why isn't more information about COVID-19 patients being made public?
The Iowa Department of Public Health isn't releasing details of locations, times, etc. "because there is no public health action recommended that is different from what we are advising all Iowans to take," IDPH has stated. "Since we know there is community spread, all Iowans should be practicing social distancing, staying home when ill, and monitoring their symptoms, regardless of community exposures."
Can I or should I be tested for COVID-19?
Hansen Family Hospital has COVID-19 tests, but they are in limited supply and can only be administered if the patient meets criteria outlined by the Iowa Department of Public Health. Even if your primary care physician refers you for evaluation at the hospital’s testing tent location, that doesn’t guarantee you’ll be tested. If a test is administered and the patient doesn’t meet IDPH criteria, the test won’t be processed by the state lab.
What should I do if I think I may have COVID-19?
Call the hospital’s COVID-19 phone number at 641-648-7113, or contact your primary care provider. You’ll be asked a series of questions. Depending on your answers to those questions, you may be asked to report to the hospital’s testing tent. Even if you’re referred to the tent, that doesn’t guarantee you’ll be tested. Once you arrive at the tent, you’ll be evaluated again and asked another set of questions. Medical professionals will determine whether you should be tested for COVID-19. If you are tested, a nasal swab will be taken and you’ll be asked to go home and stay home. Your test results will be reported back to you in about 48 hours. During that time you should not have contact with anyone outside your home. You should follow medical professionals' directions for treating any symptoms you may have.
I’m not feeling ill and I haven’t been in contact with anyone who’s confirmed to have COVID-19. Can I leave my home?
Yes, you can still leave you home, but you’re asked to continue practicing social distancing. Even if you’re not feeling ill, you could be carrying the coronavirus, which you could spread to someone else. “The intent of canceling programs and school is to try to keep people at home,” said Krenos. “Yes, grocery stores are staying open because that’s an essential thing people need. Get what you need and go back home. When you’re in the store, keep your distance from people, give them room at the checkout. Use common sense.”
How does Hansen Family Hospital plan to treat patients who are confirmed to have COVID-19?
The majority of people who become ill from COVID-19 will be able to recover at home. Krenos said they’ll be directed to treat their symptoms. “If you’ve got a temperature, take things to keep the temp down,” she said. “Drink fluids, get rest.” COVID-19 patients who need to be treated inside the hospital will be treated in much the same way anyone with an airborne respiratory disease is treated. “When the patient comes in we’ll mask them so they can’t spread anything to anybody else in the area,” Krenos said. The patient will be put in a negative pressure room, which allows outside air in, but prevents air inside the room from escaping. “We’ll be wearing PPE (personal protection equipment) - masks, goggles, gowns,” she said. “It’s going to be somewhat standard, but different because it’s a brand new disease. But it’s still basic nursing medical principles.”
If a Hardin County COVID-19 patient requires hospitalization, where will they be hospitalized? Does Hansen Family Hospital have the capacity?
Hansen Family Hospital has 21 inpatient beds, but COVID-19 patients who need hospitalization may not necessarily be hospitalized in Iowa Falls. “If appropriate, folks will be hospitalized here,” Morse said. “But they could also be transferred to another hospital if it’s clinically appropriate.” Morse and Krenos said just like any illness or injury, a patient in Iowa Falls could be transferred to a larger hospital. Representatives of hospitals in the MercyOne North Iowa network - including HFH - meet daily to share the number of beds that are available at each facility. Morse said it’s possible that at some point, HFH could receive non-COVID-19 patients from other hospitals who need to be hospitalized so that beds at those other hospitals can be freed up for COVID-19 patients. That’s just one of the plans that could be put in place as the pandemic grows in Iowa. And transfers wouldn’t necessarily be limited to within the Mercy network. “There’s going to be statewide coordination,” Krenos said. “We’re looking at the entire state as opposed to just our network or our region.”
Does Hansen Family Hospital have ventilators to treat critically ill COVID-19 patients?
Hansen Family Hospital does not have ventilators. “The smaller hospitals are limited in what they can and should keep and treat,” said Krenos. “The hospital in Iowa Falls - like many rural critical access hospitals - does not have ventilators. If a patient were ill enough to require care in an intensive care unit or use of a ventilator, that person would be transferred to another hospital. If somebody is extremely ill, no matter what the disease process is, if they’re very very ill we're not going to keep them here.”
Does the hospital have enough personal protection equipment (PPE) for medical providers to treat COVID-19 patients in Iowa Falls?
“At this point we’re OK with PPE,” Krenos said on Tuesday, “but we haven’t had an influx of patients coming in . . . We are judiciously using the PPE we have now.” The hospital had put out a request for homemade masks last weekend, but it announced on Monday that it had received enough to complete its Phase 1 plans. It is not currently accepting any more masks, but it may put out a call for more masks later. Hospital officials said they’ve been in close contact with Hardin County Emergency Management Coordinator Thomas Craighton, who has the ability to order additional PPE.
What should I do if I’m feeling anxious? How can I help someone else who’s feeling anxious about COVID-19?
The best thing to do is validate yours or the other person’s feelings and reassure yourself or them. “Tell them, ‘I understand why you’re anxious.’ Validate that their feelings are real when you respond,” Krenos said. “Make sure you’re noting that most people do get better by staying home. But we need people to continue to self isolate if you’re sick.”
In addition, the Iowa Department of Public Health has issued advice about how to cope with anxiety caused by novel coronavirus. It includes directives like "Facts Not Fear," "Stay Calm" and "Unplug." Find that information here.