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South Dakota Doctor On How His Hospital Is Strained As Coronavirus Cases Surge


New coronavirus cases continue to shoot up around the country. Yesterday alone, 136,000 new infections were confirmed, and more than 4,500 people died. South Dakota is one of the places driving this surge. Daily confirmed cases there have roughly doubled in the last month. Some hospitals are reaching capacity because even if they have the patient beds, they may not have the staff to attend to those patients. We're joined now by Dr. Shankar Kurra. He's the VP of medical affairs at Monument Health Rapid City Hospital in Rapid City, S.D.


SHANKAR KURRA: Thank you, Ailsa. It's a pleasure to be here.

CHANG: Well, can you just tell us what it's like right now? What's the situation at your hospital?

KURRA: Yes. As you all know, South Dakota has seen a rise in cases over the last four to five weeks. And we are on that exponential curve. And what it has done is put a lot of strain on our capacity in the hospital. We planned for this in early March, when we were seeing those rising cases on the east side in New York City and the eastern part of the nation. And we were fortunate enough to have a new tower that we were building that had a whole fourth floor that was, you know, empty and had no infrastructure. And we built capacity. But what we're facing now is a shortage of staff to meet that demand.

CHANG: Right. If you do run out of staffers to treat COVID patients, where will you get additional staff members?

KURRA: We've had a phased plan in place since March. We've been refining it over and over again. We have several options to staff these areas. If we ever have a surge like, say, North Dakota, we can shut down our ambulatory services and then repurpose those staff and even our more non-critical areas such as ORs that are not trauma and not essential emergency procedures, those areas can be repurposed. Staff there can be repurposed to take care of our COVID surge.

CHANG: OK, well, North Dakota's governor said this week that health care workers who are positive for COVID-19 but are not showing symptoms will still be allowed to keep working in COVID units in order to deal with their staffing shortages. And I'm wondering, do you expect to see something like that happen in South Dakota soon?

KURRA: That's a possibility. And, you know, it's - mathematics of infection are very clear. You have a community-wide outbreak right now. We are one of the rampant spread states. And when you have that kind of a community-wide spread with positivity rates in the high 20s and 30s, the likelihood of any of your workers falling ill and therefore unable to either take care of folks or be required to is distinctly possible.

CHANG: Well, as you mentioned, the proportion of positive tests in your state is now hovering around 20%. As a comparison, you know - as you know, public health experts generally say the virus is under pretty good control if the positivity rate is lower than 5%. So what does that 20% positivity rate in South Dakota signal to you as a hospital professional for what's to come in the weeks ahead?

KURRA: Yeah, and we are entering into the flu season, and that's our biggest concern. And we've been exhorting all our communities to get the flu shot. But the real risk here is at the rate of roughly 23% or so statewide of positive rates, what I can conclude and we all can conclude epidemiologically, the spread is uncontrolled. There's no mitigation or suppression, and - which means coming into November, December and January, this is sad to say, but we will see an increase in cases and increase in hospitalizations. Our biggest worry from a hospital standpoint is to maintain capacity, be able to take care of critically ill folks that need ICU level of care and will quickly run out of that if these numbers continue. And that seems to be the direction based on this high positivity rate.

CHANG: That is Dr. Shankar Kurra. He's the VP of medical affairs at Monument Health Rapid City Hospital in Rapid City, S.D.

Thank you very much for joining us.

KURRA: Thank you, Ailsa. Transcript provided by NPR, Copyright NPR.

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