Mayo Clinic expert: 'Social distancing is more effective than many of us thought it would be'
As the coronavirus pandemic reaches its apex in some parts of the world, Minnesota’s peak is still forecast to be a couple of weeks away. While this may mean extended periods of social distancing and slow economic activity, it gives healthcare providers time to prepare for the incoming wave of cases.
Mayo Clinic, Minnesota’s largest hospital system and private employer, is chief among those preparing for the height of the pandemic locally.
Dr. Pritish Tosh is one of Mayo’s top doctors in the field of infectious disease. Today, we were able to talk with him over the phone about the Clinic’s efforts to prepare for a potential surge in cases, as well as the dramatic effect social distancing has had on slowing the spread of the virus. Below are some of the highlights of our conversation.
MCB: This has been an incredibly fast-moving situation. How have Mayo’s preparedness goals changed during this situation?
PT: People are looking at a lot of the modeling, to give a forecast of what’s to come. Yes, we’ve been paying attention to what the models tell us, but that has not been dictating our preparedness. Rather than aiming for a target, what we’ve been doing is really understanding the staff, space and supplies needed to take care of patients and developing contingency plans, so we can take care of as many patients that come our way safely and effectively.
MCB: We’re in week two of Gov. Walz’s stay-at-home order, and there are rumblings of an extension past the original April 10 end date. In these first weeks, what impact has social distancing had on COVID-19 in Rochester and across Mayo Clinic’s network?
PT: It’s actually been remarkable to see… it appears as if social distancing is more effective than many of us thought it would be. Thankfully, Minnesotans started social distancing before we hit our peak, so we’re not trying to learn how to fly a plane mid-flight. By enacting this somewhat stringent social distancing ahead of the peak, we’ve been able, it looks like, flatten the curve effectively. Combining that with statewide preparedness efforts… in Minnesota, we have the ability to do this, do this right, and do this well. As case counts hopefully start to decrease nationally, even if our local surge comes in the coming week or two, these efforts Minnesotans are doing to socially distance, keep to themselves, and be cautious about hand hygiene, this is actually working.
We’ve been very fortunate here… we’re on the tail end of the nation’s outbreak, in terms of the timing of our surge; but also, people have been heeding the warnings, really paying attention, not having mass gatherings, and not amplifying the existing outbreak.
MCB: Have these measures affected when the peak will hit? Does Mayo have a projection as to when the peak will hit in our area?
PT: It’s really difficult to know, really difficult to predict with great accuracy. In fact, you don’t really know you’re hit the peak until you’re past it and you see case counts start to decrease. Yes, the projections are suggesting in the next couple of weeks, we may be seeing our peak locally, but that doesn’t change how we’re approaching our preparedness. We’re really focusing on staff, space and supplies needed to meet the growing patient care surge. Even if it ends up looking like we didn’t need half of our surge capacity, it still helps us prepare for the future. We’re pushing our boundaries and asking, ‘what are all the things we can do, to maximize the things we have, so we can take care of as many patients as possible?’
MCB: What’s gone into consideration when thinking about Mayo’s total surge capacity? How large can this response get?
PT: Let’s look at a few examples. When we think about staff, are there nurses that we can move to areas that need more staffing, especially if we have more COVID patients? Same thing with physicians, people like that… repurposing our sometimes highly specialized staff to do other tasks that they’re able and licensed to do. With some good training, and using the workforce that we have, we can meet those needs.
That’s just about staff, too. When looking at space, how can we best utilize the space that we have? It might be that the spaces isn’t normal ICU space… potentially, an anesthesia space that isn’t being used. If we run out of ICU beds, can we expand to these less traditional areas and still deliver the same level of care? When looking at supplies, for example, personal protective equipment: what can we do to maximize our PPE? What can we do to re-process, re-use, or minimize use, potentially even manufacture these things ourselves? There’s so many things we’re looking into, specifically in those three areas, to meet any surge that comes our way.
MCB: Let’s talk about PPE for a little bit. There’s been a well-documented shortage of face masks at hospitals around the country. Does Mayo have an adequate supply of face masks and PPE in general right now, and does it have the capacity to handle a surge in patients?
PT: There’s a lot of things we’re doing… first off, we’re making sure there isn’t PPE being used when it doesn’t need to be used. Normally, for example, when one of our dietetics folks would go into a patient’s room with a tray of food, they’d put on their PPE. What if, instead, you give the food to the nurse, who’s already in their PPE? That way, you don’t burn through those things needlessly. Some of it is modifying our existing plans, but some of it is looking at novel strategies. Can we manufacture something like a face shield? How do we safely re-use and re-process a respirator? These are the things we’re looking at, recognizing there’s huge supply chain strain on the manufacturing and distribution of personal protective equipment.
Isaac Jahns is a Rochester native and a 2019 graduate of the Missouri School of Journalism. He reports on politics, business and music for Med City Beat.
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