Covid - 19 - In the Great Plains and Upper Midwest, where cases of COVID-19 are increasing, the ranks of healthcare professionals are scarce.

COVID-19 cases are on the rise in rural areas of mountain states and the Midwest, and when it affects health workers, it's not easy to find reinforcements.

In Montana, the pandemic-induced staff shortage has closed a clinic in the state capital. A northwestern regional hospital prompted workers exposed to COVID-19 to continue working, and a health department emptied 600 miles to the east.

"Just one more person out, and we wouldn't be able to keep the surgeries going," said Dr. Shelly Harkins, chief medical officer of St. Peter's Health in Helena, a city of roughly 32,000 where cases continue to spread. "When the virus is just all around you, it's almost impossible not to be deemed a contact at some point. One case can take out a whole team of people in a blink of an eye."

The president of the North Dakota Hospital Association President Tim Blasl said, "In North Dakota, where the number of cases per inhabitant is growing faster than any other state, hospitals may again limit elective surgery and potentially seek government support to hire more nurses if the situation worsens." 

"How long can we run at this rate with the workforce that we have?" Blasl said. "You can have all the licensed beds you want, but if you don't have anybody to staff those beds, it doesn't do you any good."

The Northern Rockies, the Great Plains, and the Upper Midwest see the highest rise in COVID-19 cases. Some residents have ignored recommendations to contain the virus, such as wearing masks and avoiding large gatherings. According to an analysis by The New York Times, Montana, Idaho, Utah, Wyoming, North Dakota, South Dakota, Nebraska, Iowa, and Wisconsin recently ranked in the top 10 US states in terms of confirmed cases per 100,000 residents over seven days, according to an analysis from the New York Times.

These coronavirus infections - and the resulting quarantines - exacerbate healthcare workers' shortage that existed in these states long before the pandemic. Unlike the metropolitan centers of the country, these epidemics are scattered over hundreds of kilometers. And even in the largest cities of these states, there is a shortage of medical professionals. Registered specialists and nurses are sometimes more challenging to locate than ventilators, N95 masks, or hospital beds. Without enough health care workers, patients may not be able to get the medical care they need.

Hospitals have asked staff to pay for extra services and learn new skills. They brought temporary workers from other parts of the country and transferred some patients to less frequented hospitals. But, at St. Peter's Health, if one of the hospital kidney doctors becomes ill or is quarantined, Harkins doesn't expect to find a backup.

"We make it a point not to have over-staffing because we have to keep health care costs low for a community — we just don't have a lot of slack in our rope," Harkins said. "What we are not taking into account is a massive exodus of personnel for 14 days."

Some hospitals are already full or almost there. This is not only due to the growing number of COVID-19 patients. Elective surgeries have resumed, and medical emergencies don't stop with a pandemic.

Some Montana hospitals made arrangements with local affiliates at the start of the pandemic to share staff if a shortage arose. But with the disease spreading rapidly and widely, the hope is that their needs won't peak all at once.

Montana state officials maintain a list of mostly state volunteers ready to travel to cities with a shortage of contact seekers, nurses, and more. But at a press conference on October 15, the Democratic governor. Steve Bullock said the state had run out of that database, and his nationwide demand for medical personnel from the National Guard had resulted in no new hires.

This month, the Kalispell Regional Medical Center in northwest Montana even stopped quarantining staff exposed to COVID who remain asymptomatic, a change authorized by the Centers for Disease Control and Prevention guidelines for healthcare facilities facing shortages team.

Financial pressures in the first pandemic prompted the hospital to furlough staff, but it had to get most of them back to work because it needs these organs more than ever. The regional center is based in Flathead County, which has the state's second-highest number of active COVID-19 cases in the country.

Mellody Sharpton, a spokesperson for the hospital, said hospital employees exposed to someone infected with the virus would be tested and monitored for symptoms within three to five days. The hospital is also attracting new employees, with 25 traveling health workers on-site and 25 temporary workers on the way.

But Sharpton said the best way to maintain the hospital's workforce is to stop the disease's growth in the community.