Although the ongoing coronavirus pandemic has altered the jobs of hundreds of health care workers in Northeastern Minnesota, they say their level of care is unwavering.

They had to take on new responsibilities, establish new clinics and implement daily policy changes — all while educating the public on the importance of hand washing, mask wearing and physical distancing.

The News Tribune spoke with several health care workers to learn how their roles have changed and how they adapted.

Daily policy changes

Kari Russell's role at Essentia Health is focused on keeping staff and patients across the health care system safe from any and all diseases.

"We want to make sure that nobody leaves one of our facilities with an infection that they didn't come in with," Russell, an infection prevention manager at Essentia, said.

When COVID-19 hit, she and her team pivoted to focus solely on the pandemic.

They study state and federal guidelines and virus research, which seemingly change daily, to implement process and policy changes at Essentia, she said. For example, one of her team's recommended guidelines was for hand hygiene.

"Sometimes those basics have a big impact," she said.

They also oversee the use of personal protective equipment, which was initially challenging to secure, Russell said. To get more use out of N95 respirator masks, which were in short supply at the pandemic's start, they implemented UV light disinfection practices — something not typically done in non-pandemic times, she said.

To battle the ever-changing pandemic and ensure the safety of staff and patients, Russell helped Essentia set up an incident command center that ensures policy changes and recommendations are made across the entire health care system.

Staff have been receptive to their policy changes and quickly adapt, Russell said.

"It's been a crazy time, just with everything that's been going on," she said. "I really do think that we as a health care system ... everybody has just pulled together so great."

Dr. Amanda Noska, a infectious disease expert at Essentia Health in Duluth uses a computer to check the latest research about the coronavirus that causes COVID-19. Noska receives up to 200 links to new medical research abstracts on the coronavirus daily.  (Clint Austin / caustin@duluthnews.com)
Dr. Amanda Noska, a infectious disease expert at Essentia Health in Duluth uses a computer to check the latest research about the coronavirus that causes COVID-19. Noska receives up to 200 links to new medical research abstracts on the coronavirus daily. (Clint Austin / caustin@duluthnews.com)

Messages and meetings

When Dr. Amanda Noska of Essentia first heard of the novel coronavirus, she envisioned a handful of outbreaks only occurring in larger cities that had airports. Many pieces of literature and podcasts that she consumed predicted the U.S. would get a hold on the virus before it became too widespread.

"I certainly didn't expect it to ravage the country, which it is actively doing," she said.

As one of Essentia's infectious-disease experts, her main responsibilities included working with outpatients and inpatients who had diseases such as bloodstream infections, pneumonia, cellulitis and more.

She still meets with patients to discuss their diseases and treatment. But, now, her primary disease of concern is the coronavirus.

"To some degree, (my job) changed quite a lot. And in another sense, it's the same," Noska said. She fields many more questions from colleagues, (all about COVID-19), and attends numerous meetings.

When she's not running between meetings or answering colleague questions, Noska is still meeting with patients. She prefers to meet them in person, although many have been transferred to virtual visits.

Initial patient questions are detailed ones that can mostly be done during video visit. Diagnosing often requires a physical examination, which typically needs to be done in-person to ensure proper examination, she said.

And Noska screens every patient for COVID-19. "It would be reckless as an infectious disease physician not to ask about that," she said.

When working with patients, she said she's noticed they are eager to learn about COVID-19. Their questions range from what to do if their family members have the virus, to when they can go back to work after recovering from the virus, to what COVID-19 symptoms look like.

"Knowledge is power," she said. "Folks feel less anxious and more equipped to handle their body and their health care and to make informed decisions."

Even with more responsibilities and demands, she hasn't taken on more stress. Noska's interest in and passion for infectious diseases, as well as constant support from other staff, fuels her work.

"In these (sort) of unprecedented situations one steps up and you find you find the energy to do it," she said.

Taking on a new role

Dr. Matt Hansmeier worked as an emergency care physician for six years before the coronavirus pulled him into a new role.

He was tapped to help start St. Luke's new respiratory clinic — a clearinghouse for patients who have symptoms similar to those of the coronavirus. People receive coronavirus testing there, and are also screened for other illnesses like strep, ear infections and bronchitis.

"As we can all imagine, everyone's kind of (focused) on COVID, But I've seen a lot of people who've had, say, fevers and chills (that) turns out to be Lyme disease or .... it turns out to be shingles or pneumonia," he said. "We need to look comprehensively – those other (illnesses) didn't go away."

Dr. Matt Hansmeier. (Courtesy of St. Luke's)
Dr. Matt Hansmeier. (Courtesy of St. Luke's)

Because of this, Hansmeier said, he still wants to see patients in person — even when the use of virtual appointments are on the rise.

Demands of the respiratory hospital have greatly changed since the start of the pandemic. The hospital saw one or two patients on opening day. Now, they see anywhere from 100-150 patients daily.

It's a change that's also underlined the importance of teamwork in his field. Several staff from St. Luke's Q Care Express Clinics moved to the respiratory clinic, as the express clinics temporarily closed due to low patient volumes.

"Who would have thought that they (would become) one of the most critical people to have right now?" he said.

Prior to the clinic's opening, Hansmeier's daily routine was more simple as his primary role was working hands-on with patients. Now, although he still works with patients, he's also responsible for administration tasks and workflow changes.

They've had to redesign workflow to account for a larger number of tests and more people to call with results. As a result, they were also able to bring back some staff members who were laid off, he said.

"I've never thought so much about administration (and) workflows," he said.

Although much about his job has changed, patient needs and the standard of care hasn't changed.

"I think, more than anything, though, what they do need is more guidance on how to take care of like their home and return to work," he said.