Lori Walsh: Welcome to In The Moment. I'm Lori Walsh. Americans and South Dakotans have drastically changed the way we live all in an effort to slow the spread of coronavirus. Much changed over the weekend. We'll talk about the economic impact and actions by the federal reserve with Joe Santos in just a moment, but first Dr. Dan Heinemann. He's a chief medical officer for Sanford Health Network and he joins us on the phone. Dr. Heinemann, Thanks for coming back.
Dr. Dan Heinemann: Ah, good morning. Yes, thank you for having us.
Lori Walsh: Let's start with the update from over the weekend as Sanford continues preparations for coronavirus in South Dakota. What can you tell us that has changed over the weekend or updated?
Dr. Dan Heinemann: Well, we are continuing to update some recommendations and guidance to our staffs regarding the use of and saving personal protective equipment in terms of to make sure that we're good stewards of the resources that we have. So we're constantly sending new direction to our clinics throughout our entirety of our enterprise on our four states that we work with and within to make sure that they understand how to use that, how to clean rooms, how to screen patients, and we're changing our testing a little bit.
And then trying to help our staffs keep up with the changes that are coming from the Centers for Disease Control, which is where we get all of our information and we call it our one source of truth. So making sure that we get that information out to our clinics and hospitals and our incident commands have been open. Our enterprise incident command has been open and each market or each hospital market in our network, we also had our incident command up this weekend and we're in touch with our practices and our clinics and our small hospitals.
Lori Walsh: Because this affects everyone in your system. From the employee standpoint, housekeeping and food service as well as the emergency room doctors and clinic providers. It's a quite an endeavor.
Dr. Dan Heinemann: Correct. We need everybody to stay healthy and we need everybody to help us from the environmental services workers who help clean our rooms to our laundry personnel, to our lab personnel, to our doctors, our nurses, you name it. We need to make sure that we can keep everybody healthy and at work.
Lori Walsh: You mentioned changing testing. How so?
Dr. Dan Heinemann: Well, up until middle of last week, the only way you could get a test was to go through your state health department, but as part of this whole testing initiative across the country now there are some private labs like Quest and some others that are now coming online to be able to do the test. We actually hope in the short term to be able to do that test right within Sanford's labs, but there's a requirement that you get certified, that the federal government steps in to make sure that the tests are done, are accurate, and have followed the lab standards, if you will.
So on the weekend, going into the weekend and now coming out of the weekend, we can choose to send our tests in two directions. We can still send our tests to our state lab partners, as well as we now have an option to send our tests to Quest, which is a large lab partner that we've partnered with to send our tests to maybe get a little better and faster turnaround time.
Lori Walsh: So talk to us about the process now today, and I understand it's a very fluid situation, but for testing for people in South Dakota or in the Sanford system somewhere, who should get tested, how do they get tested? Let's start with who do you want to be tested now?
Dr. Dan Heinemann: Well, we would encourage, in fact require, everybody who has a concern about whether or not they should be tested to begin the process by contacting their primary care clinic provider. When they make that contact to their usual source of primary care or their usual source of care, there will be a series of screening questions that will be asked of the individual to identify what their risk is and whether or not they are in that risk category that should be tested because we still have to be careful about how many tests that we provide.
So if you answer the travel questions, you answer the symptom questions, and you answer the exposure questions in a way that would put you in a higher risk category, you will then be said, we should test you. And I should also add, if you're not ill, if you're seriously ill, we're not going to just send you to a testing location, but we're going to ask you to go to your doctor. And we want that prior knowledge that you'll be coming so that when you arrive at that clinic location you can be properly masked, taken back to an exam area, that our staff can be properly protected so that we can minimize the exposure to folks in the clinic as well as staff in the clinic.
So if you're deemed high risk and needing testing but not ill enough to be seen, we have opened in Sioux Falls a drive up testing where you will be sent and then the orders will be placed. You will be then sent to this area, sample will be collected, sent off. And then generally we get some results back in one to two days. If it's serious, if the patient is ill, then we may ask that individual to self isolate or stay at home. So it really does need to start with an assessment by the nurses and our clinicians, physicians, nurse practitioners, and PAs in our clinic locations.
In the sites outside of Sioux Falls, you may be directed to go to a site that has been set up either at a clinic or at a local hospital where that sample can be obtained and then sent off for evaluation and testing.
Lori Walsh: For those people who do not have a primary care doctor, either because they're uninsured or they only see a specialist because they have a chronic health condition, who should they call?
Dr. Dan Heinemann: They can call our one call number, which is 333-4455. Nurses and infection prevention specialists will help them identify. They can do those screening questions, they can get that testing done. They can also make arrangements for them to be seen if need be by either one of our acute care locations and or make an appointment at our closest primary care clinics. It really starts with those questions that determine whether or not an individual is at high risk.
Should also add that testing is of no... there is no charge for the testing and so people should not avoid getting properly evaluated because they have a concern about whether or not this will get covered or paid for. Many insurance plans are waiving copays, waving a variety of financial barriers. We want to make sure that we're getting our communities adequately screened and taken care of. And so please, please don't let whether or not you have insurance coverage and or a way to pay for it stand in the way of getting properly tested or properly evaluated and tested if necessary.
Lori Walsh: I can imagine some people in rural South Dakota are saying, you know, what if I have symptoms, do I bother driving to a testing site to get tested or should I just care for myself at home? Because that's what you're going to tell me to do anyway. Is it important to reach out and be evaluated for testing if you have symptoms or if you're in one of those travel risk categories or exposure risk categories?
Dr. Dan Heinemann: The other thing that testing can help us with is, remember we're still in influenza season and a vast number of patients who think they have this respiratory virus or the COVID-19, what we're finding is they have influenza. They can use their best judgment. Ff they believe that they are just dealing with a common variety, upper respiratory infection. Nothing is getting worse for them. Staying at home, treating themselves at home with symptomatic care is appropriate. If however they begin to worsen, then they should be seeking out at least some phone consultation evaluation to make sure that there is not a reason for them to be seen and seen early to make sure that we understand what's going on. And then also if they did have this Cove at 19 we would like to know so that we can then reduce and mitigate the exposures that they may have had to other individuals either at home or in their communities as they've been out and about.
Lori Walsh: As people are getting symptoms, whether it's an influenza symptoms or a scratchy throat from talking about this too much, for example, there's a certain amount of fear that's going on because of the thoughts of people being ventilated. What if that happens to someone I love? When do people know that they need to seek emergency care and make that phone call once they have... What do you know about the people who are sick? When is it an emergency? Because the flu can feel awfully... you can feel pretty desperate and out of it when you have the flu and you're running a very high temperature, when do you make an emergency call and seek emergency care?
Dr. Dan Heinemann: Typically, influenza makes you feel miserable. You'll have a bad cough, you may get short of breath. But from what we understand about this particular virus is that it does tend to make people more short of breath. So if you've had a fever and you've had some aches and you've had a bad cough, but you don't get significantly short of breath or you don't have any other complicating medical conditions like heart disease, lung disease, etcetera, then you can stay home. But I say if you start to get more short of breath, you definitely need to be making contact with a healthcare provider so that they can assess your situation and recommend what might be the most appropriate care.
And it also depends on your age. If you're older, you need to probably make those phone calls sooner. If you're older and have complicating things like diabetes, heart disease, lung disease, even sooner. And that's not to say that if you're young and don't have those illnesses, you shouldn't be at least making a call to find out if you need to be more concerned.
Lori Walsh: Tell us how Sanford is working with state government or federal government officials to prepare for that potential influx of patients. We've heard a lot about the number of intensive care beds and the accessibility of personal protective equipment for staff and ventilators or respirators. And what can you tell us about what that process looks like? Are you getting the response from the federal and state government that you need?
Dr. Dan Heinemann: Yes, for quite some time Sanford has had an emerging threats group that's been meeting now for probably about six weeks. The last week and a half we've opened up our incident command center. So there's an incident command center for the entirety of Sanford and then each region has its own incident command. We've been working with... We've been working very well with the governors of our states, with the emergency preparedness people in our states, our state's departments of health.
Dr.Believe it or not, now our state's Departments of Education. In other words, as states began to start talking about canceling schools, what's best. And so our leadership at a corporate level, it has almost daily interaction with those governmental agencies, both local, state, and federal. As we get ready, as we look for materials, as we plan for the worst case scenario, but I hope that we never get there because we do such a good job in the early aspects of the best way to prevent this illness from taking over our immediate area is social isolation, staying home, minimizing exposure. And then if and when you need help, seeking it by calling first and then we'll help people to get the necessary care that they need and that we can provide in a safe way, so we don't overwhelm our healthcare system.
Lori Walsh: And to recap, people are washing their hands. You can call that Sanford one call number if you don't have a primary care doctor. If you don't have insurance, and that's 333-4455. The South Dakota department of health website is covid.sd.gov. You can reach out for all kinds of information for how to take care of things in your home. It has links to the CDC sites as well.
And Dr. Anthony Fauci said on the new shows this weekend, Dr. Heinemann, that if it looks like you're overreacting, you're doing it right. When we talk about people who are still thinking, this is not relevant to me, I'm healthy, I'm young, I don't have condition or it's not that big of a deal. If it looks like you're overreacting, you're doing it right. Do you agree with that assessment from Dr. Fauci?
Dr. Dan Heinemann: Absolutely. We need to remember that we shouldn't act selfishly. Yes, I may feel well, I don't see why I have to stay home, but this is all of us coming together to do the best for those who cannot necessarily survive or would not necessarily come out of this in the best. And we know like our longterm care elderly residents in our long term care facility, the elderly residents in our communities. So we all need to take this seriously and not be selfish in our activities and our actions.
Lori Walsh: Dan Heinemann, I appreciate your time. We'll send you some radio broadcast or tips for taking care of your voice in the days ahead. Thanks, Dr. Heinemann.
Dr. Dan Heinemann: Thank you very much and always happy to have you reach out to us.