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Iowa Is Among The States Experiencing A Surge In COVID-19 Cases

RACHEL MARTIN, HOST:

All right. So as we just heard, big vaccine news out today. But that doesn't change the health crisis that's unfolding every single day in hospitals across this country right now. We've been hearing from medical professionals in different areas experiencing a surge in cases, and today we're going to focus in on Iowa. Governor Kim Reynolds said last week that the state is experiencing significant community spread, but she assured Iowans resources are available.

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KIM REYNOLDS: Recent news coverage has warned Iowans that hospital beds in some areas are full, suggesting that people may not be able to receive care. My team and DPH is in regular contact with health systems and hospital leaders, and they assure the team and me that is not the case.

MARTIN: But that's not what we heard from a doctor treating COVID patients at the University of Iowa hospital.

NICHOLAS MOHR: Yeah, the hospitals in eastern Iowa are full. That's something that has us really concerned, as we see case counts continuing to rise.

MARTIN: That's Dr. Nick Mohr. He works in both the ER and the intensive care unit.

MOHR: Here at the university, we've had to start canceling some elective surgeries, which we don't want to do because we know that people need to have surgeries done. But that's happening throughout the state and throughout the Midwest.

MARTIN: We're going to bring in another voice in Iowa. Dr. Glenn Hurst is a rural primary care physician in a very small city - Minden, Iowa. He's also a medical director at several nursing homes in Pottawattamie County. And he's on the line. Dr. Hurst, thanks for being here this morning.

GLENN HURST: Hi, Rachel. Thanks for having me.

MARTIN: I want to focus in on nursing homes in particular. Can you explain what the situation is in the homes that you oversee?

HURST: Sure. So the situation, in terms of how do we move patients through, is the same concern that the hospitals have - you know, numbers of beds available. That's the bottleneck for treatment of COVID patients. So if your hospitals are bottlenecked and you open up that bottleneck with more beds or field hospitals or however you do that, but you don't open the bottleneck at the nursing home end, we're just going to fill up all those beds in the hospital, and everybody will be stuck. So we're part of the flow problem in the state of Iowa.

MARTIN: Do you have - are there any outbreaks, significant outbreaks, in nursing homes right now?

HURST: Oh, sure. Our community - our county right now, three of the seven nursing homes are in outbreak status, and in Iowa, that means that they have three or more cases in patients, not staff.

MARTIN: So what needs to happen? I mean, we've been living this - with this for so many months. I mean, are you just catch as catch can? Are you just trying to mitigate it at every turn? Or is there something more holistic that should be happening that's not?

HURST: So we have to be thinking about the patients who don't have COVID and protecting them. And that's what I have been doing with nursing homes in our county. This is a frail population. Forty-eight percent of all deaths in Iowa from COVID are people from nursing homes - 434 patients. We've got to prevent the condition from coming into the facility and infecting those people.

But at the same time, we've got to be able to provide rehabilitation care for those patients who did have COVID and were hospitalized and ventilated and need some rehab time. Back in March, we looked at trying to open a nursing home that had been closed in the community as a COVID space. It would save us staffing issues. It would provide beds and appropriate care. But we didn't get the support from the government to do that.

MARTIN: So this is just - not just, but this is largely a financial issue, or at least the money could help?

HURST: A big part of it. Money could solve a lot of this problem in terms of space to take care of patients. You know, here in western Iowa, we're also dealing with a staffing problem. There just aren't enough nurses and CNAs who are able and willing to do this work. We've got to train people up quickly.

MARTIN: You know, I wonder if you could speak a little bit to the emotional component of these care facilities - right? - how you are managing the expectations of residents who, especially around the holidays, will expect or hope to be able to connect with family.

HURST: Sure. Residents, family, staff - everybody is on an emotional roller coaster through this crisis. We take care of these people on a daily basis. We know their likes, their senses of humor, their kindness towards one another and the relationships with one another, and we value that in the same way that we value the relationships with our families, in the same way we value relationships with one another. And the isolation absolutely has a negative effect on that family relationship.

But I had a facility that had an outbreak, and six patients died. And I assure you that the pain that those patients suffered losing their friends that they see on a daily basis and trying to recover through that whole outbreak process was far greater a trauma than the separations that we're seeing with family that we do mitigate with window visits and with assisting them using the computer and online technology to have some face-to-face time.

MARTIN: I guess...

HURST: The holidays will be difficult.

MARTIN: I guess I should step back. Are there no in-person family visits allowed right now?

HURST: Well, in the state of Iowa, they have been really pushing the nursing homes to allow more face-to-face visits. Even as our numbers climb, there's still pressure in terms of regulations from Department of Inspection and Appeals and Public Health to begin getting face-to-face visits with family. And it's just not safe. It's a battle that we, as nursing homes and caregivers, have to fight to protect our patients.

MARTIN: How are you, as a leader in this moment, trying to help your staff, the people who report to you? How do you keep them focused, grounded and stable in heavy heart...

HURST: Sure. So our group, Seniors: Fighting for our Lives, grew out of the Indivisible movement in Iowa and brought together medical providers that were involved in that movement to look at the whole process, look at the patient and the providers - how do we support one another?

MARTIN: Right.

HURST: The thing we're hoping for is that we have a Biden-Harris administration that puts people on their COVID task force to address all aspects of patient need, emotional and medical.

MARTIN: Dr. Glenn Hurst - a family medical practitioner in Iowa and the co-founder of Iowa Seniors: Fighting for our Lives. He joined us on Skype. Thank you so much for your time.

HURST: My pleasure. Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.