COVID-19 in a rural health system in New York – case series and an approach to management

Eyal Kedar; Regina Scott; Daniel M Soule; Carly Lovelett; Kyle Tower; Kylie Broughal; Daniel Jaremczuk; Sara Mohaddes; Imre Rainey-Spence; Timothy Atkinson

doi:10.22605/RRH6464

Original Research

COVID-19 in a rural health system in New York – case series and an approach to management

AUTHORS

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Eyal Kedar¹ MD, Medical Director *

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Regina Scott² PharmD, Antimicrobial Stewardship Pharmacist

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Daniel M Soule³ DO, Medical Director of Infectious Diseases and Antimicrobial Stewardship

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Carly Lovelett⁴ MS, Director

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Kyle Tower⁵ BS, Intern

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Kylie Broughal⁶ PA-C, Physician Assistant

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Daniel Jaremczuk⁷ BS, Clinical Research Coordinator II

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Sara Mohaddes⁸ PA-C, Physician Assistant

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Imre Rainey-Spence⁹ MD, Co-director

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Timothy Atkinson¹⁰ MD, Co-director

AFFILIATIONS

¹ Division of Rheumatology, Department of Clinical and Rural Health Research, St Lawrence Health, Canton Potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676, USA

² Department of Pharmacy, St Lawrence Health, Canton Potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676, USA

^{3, 6} Division of Infectious Diseases, St Lawrence Health, Canton Potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676, USA

^{4, 5, 7} Department of Clinical and Rural Health Research, St Lawrence Health, Canton Potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676, USA

^{8, 9, 10} Division of Hospital Medicine, St Lawrence Health, Canton Potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676, USA

ACCEPTED: 16 May 2021

early abstract:

Background: Many rural hospitals and health systems in the US lack sufficient resources to treat COVID-19. The St. Lawrence Health System (SLHS) developed a system for managing inpatient COVID-19 hospital admissions in St. Lawrence County, an underserved rural county that is the largest county in New York State.
Methods: The SLHS used a hub and spoke system to route COVID-19 patients to its flagship hospital. It further assembled a small clinical team to manage admitted COVID-19 patients and to stay abreast of a quickly changing body of literature and standard of care. A review of clinical data was completed for patients who were treated by the SHLS’s inpatient COVID-19 treatment team between 20 March and 22 May, 2020.
Results: Twenty COVID-19 patients were identified. Sixteen patients (80%) met NIH criteria for severe or critical disease. One patient died. No patients were transferred to other hospitals.
Conclusions: During the first two months of the pandemic, we were able to manage hospitalized COVID-19 patients in our rural community. Development of similar treatment models in other rural areas should be considered.