APEX May Board & Investor-Member Meeting Recap

At the May 7, 2020, APEX Board and Investor-Member meeting, Kevin Nokels, President & CEO of St. Luke’s, shared how the healthcare system has taken steps to prepare for the pandemic. The system consists of the hospital in Duluth, wholly owned Lake View Hospital in Two Harbors, and a management contract with North Shore Health in Grand Marais.

Nokels’ presentation started with the historical connection between St. Luke’s and previous epidemics and pandemics. St. Luke’s was founded in 1881 by the St. Paul’s Episcopal Church as the first hospital in Duluth during the height of the typhoid epidemic. By 1918, the world was combating both the Spanish flu and Polio pandemics. Through all healthcare crises, St. Luke’s mission to care for the patient above all else has stood strong—COVID-19 is no exception.

Preparation at St. Luke’s for the pending pandemic began in January after the World Health Organization initially identified the crisis. To reduce risk, the system implemented a travel ban for their employees and launched an incident command to prepare for COVID-19 patients. Coordinated efforts between St. Luke’s, Essentia Health, and hospitals across Minnesota have developed a tiered plan to expand capacity up to 200% or more using existing hospital beds and excess space. The system is ready and capable of caring for a surge of patients.

At the time of Nokels’ presentation, hospital admissions were down 25% across the country. Out-patient visits continue to go up just as technology advances. With the reduction of elective and non-essential surgeries and procedures, Minnesota hospitals saw up to a 70% decline. Much of the reduction was due to fear of acquiring COVID-19 in the hospital. Nokels reiterated several times that hospitals are safe and patients should not wait to come in for medical treatment.

Kevin Nokels

President & CEO of St. Luke's

Much like when St. Luke’s was founded during a pandemic, the community was extremely supportive and generous. Nokels expressed gratitude for the donations of face masks, face shields, gowns, or gloves from other hospitals, individuals, and businesses—companies like Frost River, National Bank of Commerce, and Cirrus Aircraft helped ensure St. Luke’s was prepared. By delaying the surge, St. Luke’s and the state have built up their supply of personal protective equipment (PPE).

Nokels discussed the projected surge and indicated the models had suggested early to mid- July. These projections have been altered due to Minnesota’s adherence to staying at home during the executive order, taking additional safety precautions, and to social distancing. These collective efforts flattened the curve and pushed the projected surge out to September.

Nokels shared perspective on the longevity, nuances, and spread of the virus—stating just how uncertain the state of healthcare is at this time. “We have to be prepared for the surge, the possibility of a resurgence, and the ramifications of people putting off doctor visits, surgeries, and other necessary care,” he stated. While there are many vaccines in development, a typical vaccine can take 16 years to develop and getting it done in two years would be a significant achievement.

Additionally, Nokels shared details about the various state and federal grant programs to aid surge capacity planning and fund capital equipment purchases for ventilators, monitors, and additional beds. These grants, while important, only scratch the surface of the need. Operating in an already compressed margin environment, it’s projected Minnesota hospitals will lose close to $3 billion from March to July.

The future of St. Luke’s will be driven by clinical quality and patients’ safety. The team at St. Luke’s will continue to be prepared for the uncertainty in today’s healthcare environment—they were founded during an epidemic and are well-prepared to help the community weather this one.