FARGO — Preparations are being made for Sanford Broadway Medical Center to serve as an isolation campus during the expected surge of coronavirus patients that also could see state mobilization of the Fargodome as a field hospital.

Hundreds of cots and stockpiles of medical supplies have been delivered to the Fargodome for possible use in the event a surge of patients is more than local hospitals can handle — an eventuality that remains uncertain.

The preparations are being made as the number of coronavirus infections continues to rise — surpassing 100 in the Fargo-Moorhead area. As of Thursday, Cass County had 83 confirmed cases and Clay County had 23.

Sanford Broadway Medical Center in downtown Fargo already had been designated as the location where Sanford would care for adult patients infected by the coronavirus and has been scaling up its capacity.

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The Broadway Medical Center will have the ability to accept more than 400 patients if needed, including 225 in intensive care beds, Bryan Nermoe, Sanford’s Fargo president, said Thursday, April 9.

“We compare this a lot to a flood plan,” he said. “We plan for the worst and hope for the best.”

Sanford initially designated 18 beds at its Broadway campus for COVID-19 patients and has expanded that to 50 beds, with the capability of increasing capacity in stair-step fashion as the volume of patients grows.

Sanford’s projections indicate the surge in patients infected by the coronavirus could start in two weeks and could last for up to 60 days, with a peak lasting two to three weeks.

Dedicated bed capacity will expand as certain “trigger” points are reached, including the speed at which beds are filling as the epidemic intensifies, Nermoe said.

“We would put those beds on line as those trigger points get crossed,” he said. At the same time, Sanford’s other two campuses, the Sanford Medical Center and South University Medical Center, will continue handling other patients.

Isolating coronavirus patients within certain areas of Broadway Medical Center, including negative-pressure rooms to contain the virus, is intended to protect other patients.

Having three campuses gives Sanford flexibility and the ability to adapt, Nermoe said. Six pediatric beds have been allocated for COVID-19 patients, with the ability to add more if needed.

In recent days, Sanford has averaged 10 COVID-19 patients, Nermoe said. As of Thursday afternoon, Sanford has tested 2,491 patients in Fargo for the coronavirus and 98 have tested positive, he said.

As of Thursday, North Dakota had 269 positive coronavirus cases; 101 recovered, 14 were currently hospitalized, a total of 34 have been hospitalized since the outbreak began last month and six deaths have been reported, according to state figures.

Sanford's preparations also have involved training staff to assume new roles to help with the coronavirus surge.

Eight hundred clinical employees have received “upskill” training — for example, a nurse in a medical-surgical unit could shift to an intensive care unit, working under an intensive care nurse’s supervision, said Dr. James Volk, vice president of Sanford Clinic for the Fargo region.

Also, 1,500 non-clinical employees have been trained for assistance roles, such as running supplies and blood draws or checking blood pressure, he said.

Plans are intended to accommodate many sick patients seeking treatment all at once — a surge that can develop very quickly.

The projections underlying Sanford’s planning are being revised as conditions change, but Sanford remains confident that it has the staffing, beds and supplies to handle its projected patient demand, Nermoe said.

If that level is surpassed, he added, it would have to rely on the state to help provide needed supplies. Sanford is coordinating its response with state and local public health officials.

“We’ve been sourcing supplies from all over the world,” Nermoe said. “We have an outstanding supply chain team.”

Fargodome as a field hospital

Meanwhile, the Fargodome has been identified as the location for a field hospital in the event medical centers in the metro area are overwhelmed by people infected by the coronavirus.

State officials and others have been working to identify buildings that can serve as makeshift hospitals if the surge in COVID-19 patients — expected to arrive in late April — overruns hospitals.

The Fargodome has emerged as the top choice because of its size. Because of social distancing directives that have cancelled large gatherings, the dome can’t be used to host events.

The North Dakota National Guard has stocked the Fargodome with medical kits at the direction of the North Dakota Department of Health, Mike Nowatzki, a spokesman for Gov. Doug Burgum, said Thursday.

"Two hundred beds have been prepositioned in Fargo and 200 more in Bismarck for the establishment of minimal care facilities if needed," he said. "These aren’t site-specific or hospital-specific, they’re held in each community until redeployed."

Fargo Mayor Tim Mahoney said the city would of course make the Fargodome available if state officials request its use for a field hospital.

“It would be just like the flood fight of ‘09,” Mahoney said, referring to the Fargodome being used to fill millions of sandbags. “So if they need it, we’d be happy to do it.”

Nermoe said if the Fargodome becomes a field hospital, Sanford stands ready to offer assistance, just as it does in any emergency. Similarly, it would help if asked to accept patients from beyond its normal service area.

“We may see patients from beyond our normal draw,” he said. “We’re preparing for that.”

North Dakota officials have not yet released their projections for the coronavirus surge’s timing, magnitude or duration. State officials have declined multiple requests by The Forum for their predictions for the surge, including the number of hospital beds, intensive care beds and ventilators that will be required to deal with the pandemic.

"We’re in the process of finalizing our modeling and surge plan and hope to be able to communicate that early next week," Nowatzki said.

The state has identified the Fieldhouse at the University of Mary as the location for a field hospital, the Bismarck Tribune has reported. Two hundred cots have been brought to the Fieldhouse, along with boxes of masks, gloves, syringes and other medical supplies, as it is being converted for medical use, the newspaper reported.

Mahoney said he believes the state is also looking at sites in other cities, including Grand Forks and Minot.