Minnesota doctors enlist quilters, COVID-19 workarounds

In Alexandria, Minn., a physician has started organizing people who sew and quilt to make masks for patients who might be hospitalized with COVID-19.

In Minneapolis, a doctor is trying to rally the community to avoid getting too close to one another to prevent the spread of disease.

And in Mankato, a physician had to explain to a patient this week that he couldn't be tested for COVID-19, even though the patient's spouse has been hospitalized with a possible case.

This is not how doctors or patients want medicine to work.

But family physicians say they're working around shortages in coronavirus testing while trying to rally patients to the cause of keeping the health care system from becoming overwhelmed.

"I went into medicine because when bad things happen, I wanted to help," said Dr. Renee Crichlow, president of the Minnesota Academy of Family Physicians. "Bad things are happening right now, and I have a purpose."

The Minnesota Department of Health announced Tuesday that it was restricting criteria for COVID-19 testing after a surge in activity taxed limited supplies of the test and related chemicals.

Currently, tests through the state's public health lab are being reserved for hospitalized patients, health care workers and residents of long-term care facilities.

Dr. Keith Stelter, the family physician in Mankato, said his patient's desire for a test is completely understandable considering his spouse's illness.

But it's also true that the diagnostic isn't crucial for the patient and others.

"We know that for the majority of people that they can weather this, kind of on their own, using Tylenol, rest and hydration," said Stelter, who is a physician at Mayo Clinic Health System. "If they start to get worsening shortness of breath ... then that's a time to get addressed or seen."

Patients who have trouble breathing are "usually going to be brought into a hospital setting," he said. "We think if we're judicious with the testing now, we will have some sort of test for them as we get increased production."

On Thursday night, Mayo Clinic announced it had purchased new testing equipment that will greatly expand its capacity, increasing the supply of tests from 200 to 300 per day to about 4,000 tests per day. It helps that private labs like Mayo are adding capacity, but the nation still is far short of what's needed, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Among other things, the lack of a diagnostic test to confirm that patients have coronavirus makes it a challenge to make sure patients isolate themselves for 14 days, Osterholm said.

"People want to be tested so they can make a decision: Am I actually going to take 14 days out of my life and tell others that I may have exposed them, if I'm not really positive?" he said.

Patients with COVID-19 symptoms who aren't eligible for testing are told to isolate themselves, said Dr. Deb Dittberner, a family physician in Alexandria. Her clinic calls every day to see how patients are feeling in case symptoms worsen.

On Thursday, Dittberner heard that a hospital in Indiana had organized quilters and sewers to start making patient masks to help the medical center deal with supply shortages in a patient surge. Dittberner then discovered the Centers for Disease Control and Prevention had endorsed handmade masks "as a last resort."

Friday morning, she reached out to friends and her church to organize the community to make cloth masks. Her pastor started calling other churches to recruit quilters and sewers.

"My husband, bless his heart, has gone and bought all the eighth-inch elastic that he can at Walmart and Joann Fabrics — he's never walked into Joann Fabrics before by himself," said Dittberner, who's also chief medical officer with Alomere Health. "He's dropping it off at my church right now as we speak."

Doctors recognize the health department's push for "social distancing" asks a lot of people, Stelter said, by asking them to behave as if they're potentially infectious, no matter how they feel.

Life in the clinic is changing, too. More patients are seeking advice through e-visits, said Stelter, who is president of the Minnesota Medical Association.

When a patient with an upper respiratory infection arrives in an exam room, both the doctor and the patient are wearing masks and eye protection.

The extra protection is just one indicator of how caregivers are in the cross hairs with the outbreak.

A shortage of equipment like high-tech masks in hospitals helps explain, Stelter said, why M Health Fairview has decided to dedicate Bethesda Hospital in St. Paul to COVID-19 patients. He suspects there could be other designated facilities in the state, as well, that could help concentrate resources.

It's understandable that people are afraid as the outbreak grows, but Crichlow, of the family physicians group, said she's a fan of determination in the midst of fear.

"It's so much easier to be afraid when you have a purpose," said Crichlow, who practices in Minneapolis. "One of the big things I want people to know is that staying home is a really important purpose right now."

"Physicians have the purpose of being out there working for patients," she continued, "and they have a very important purpose staying inside and sheltering so that the system doesn't get overwhelmed."