Rural Minnesota hospitals struggle with COVID-19 surge

A woman in a face mask.
“There are no ICU beds to be had, and that's the scary part right now." Dr. Ulrika Wigert treats patients and helps run CentraCare’s hospital and clinic in Sauk Centre, Minn., less than an hour northwest of St. Cloud.
Mark Zdechlik | MPR News

The challenge of providing health care in many parts of Minnesota is simple but severe: Too many people remain unvaccinated, hospitals are short-staffed, and there is not enough space for those who are critically ill.

“There are no ICU beds to be had, and that's the scary part right now,” said Dr. Ulrika Wigert, who helps run CentraCare’s hospital and clinic in Sauk Centre, less than an hour northwest of St. Cloud. 

“We need help,” Wigert said, “and we need this surge to start coming down.”

Faced with a lack of options, health systems are improvising to treat COVID-19 patients and everyone else who needs hospitalization. 

“We are taking care of patients right now in our facility that I normally would not take care of. It is not ideal,” Wigert said. “So in normal situations, we would transfer these handful of patients, we'd be able to get them to that level of care that they need.”

Top of mind of this day in Sauk Centre is a non-COVID patient with serious heart problems. The person needs to be in an intensive care unit, which this small hospital does not have. 

“The problem is, we called everywhere,” Wigert said. “So, from Duluth to Grand Forks to Fargo to Mayo to the places in the cities to St. Cloud — there are no ICU beds available anywhere.”

So the Sauk Centre hospital has transformed a regular room to a place they can deliver near-intensive level care. A large stuffed chair sits awkwardly in the hallway. It was removed from the room to make way for makeshift ICU equipment and staff.

“We can do what we can, but it’s not the same care that they would receive in an ICU bed somewhere else,” Wigert said.

A large stuffed chair sits in a hallway.
A large stuffed chair sits in the hallway at CentraCare's hospital in Sauk Centre. It was removed from a heart patients room to make way for extra makeshift ICU equipment and staff.
Mark Zdechlik | MPR News

In another space, behind doors posting ominous “do not enter” warning signs, a small section of the hospital is reserved for COVID-19 patients. It’s been converted from the outpatient surgical area, Wigert explains, and on this day has six patients in four rooms. 

“I think one is hopefully being transferred to a higher-level care if we can find a bed as they're clinically worsening,” Wigert said.

In the unit on that day Pam Meyer, 50, who had not been vaccinated, was being treated for COVID-19. She went to the hospital because she was struggling to breathe.

“It was scary not knowing what’s going to happen and what’s going on,” Meyer said later after she had been released.

Despite her close call, Meyer, now at home on oxygen, said she has no regrets about her decision not to get vaccinated. She also does not believe that unvaccinated people are the reason many hospitals are overwhelmed. 

“All the so-called facts we are given, I do not feel are actual facts right now,” Meyer said.

Dr. George Morris has been overseeing CentraCare’s COVID response from the beginning. Unlike Meyer, most unvaccinated COVID patients are quick converts to immunization, he said. 

“Many people say, ‘Now that I know how awful COVID is, I’ll get vaccinated and I’ll tell my family and friends to get vaccinated,’” Morris said. “We would like to do it one step before that. Don’t wait for yourself to get sick. Don’t wait for your family to get sick before you say, ‘Wow! This is real.’ ”

A man stands in front of an ER entrance.
Dr. George Morris has been overseeing CentraCare’s COVID-19 response from the beginning. He said much of the health system's client base is unnecessarily vulnerable to COVID because of low vaccination rates in the area CentraCare serves.
Mark Zdechlik | MPR News

Morris said much of CentraCare's client base is unnecessarily vulnerable to COVID because they have not been vaccinated. He and his colleagues don’t know what’s next as the weather cools down and people move indoors.

“We cover a large area of central Minnesota and a little bit of western and southwestern Minnesota, and the vaccination rates are lower,” Morris said. “In some of our counties, they're less than 50 percent. And what that has led to is that more people are susceptible to getting COVID.”

According to the Minnesota Department of Health, just over half of those eligible for the COVID-19 vaccine in Stearns county, where Sauk Centre is located, have been vaccinated.   That frustrates caregivers.

“We have so many COVID patients in our facility, that if somebody else needs a bed for a cardiac procedure, or needs a bed for a surgical procedure, we don't have space,” Morris said.

“There's so much misinformation and disinformation out there that I feel sorry for people that just don't know what to believe anymore,” Wigert said. “It’s like people have been brainwashed.”

The Sauk Centre hospital is by no means unique in the pressure it is facing due to COVID-19.

“We are definitely seeing an escalation in volumes across all of the hospitals and health care systems in all parts of the state,” said Dr. Rahul Koranne, the CEO of the Minnesota Hospital Association. Staff shortages are aggravating the challenge of providing care, said Koranne.

A woman in PPE stands outside a door.
Nancy Primus, health unit coordinator at CentraCare in Sauk Centre, prepares to enter the room of a COVID patient.
Mark Zdechlik | MPR News

In addition to calling on people to get vaccinated, Koranne said Minnesotans can help ease the pressure by properly managing their chronic health conditions — such as asthma and heart disease — that, if unchecked, can land them in hospitals. 

Still, Koranne and others underscore that people who think they need hospital care should seek it even though the system is bogged down. 

Back in Sauk Centre, Wigert said if anyone wants to pitch in, maybe answering phones or restocking supplies, their local hospital will likely welcome volunteer help.

“We’ll take anything we can get at this point in time,” Wigert said, “to just give a little bit of an ease to what we’re going through.”