North Dakota coronavirus news, March 11: Care facilities restrict visitors

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St. Vincent's in Bismarck is one of a number of long-term care facilities in North Dakota imposing visitor restrictions because of the new coronavirus. Above, signage in the entry to St. Vincent's alerts visitors to the new restriction.

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The latest North Dakota coronavirus news: care facility restrictions, insurance company guidance and tribal travel limits.

Long-term care facility restrictions

A number of long-term care facilities in the Bismarck area and throughout the state have restricted visitors in the past few days to protect residents from contracting the new coronavirus.

The restrictions come amid new guidance from several government agencies and long-term care associations in the wake of an outbreak at a nursing facility in Kirkland, Wash., that has killed at least 19 residents. Ten long-term care homes in the Seattle area have either a resident or employee who has tested positive for COVID-19, the disease caused by the virus.

Although most cases of the virus are mild in the general population, the elderly and people with underlying health problems are at a higher risk for developing life-threatening complications.

"We don't want what happened in Kirkland to happen here," said Shelly Peterson, president of the North Dakota Long Term Care Association.

North Dakota has 220 nursing homes, basic care facilities and assisted living facilities, and many are limiting who can enter, she said. Restrictions may differ from site to site.

"One of the steps they're taking is to limit visits with families and all nonessential people who come into the facilities, to limit any exposure there except in end-of-life situations," Peterson said. "The No. 1 reason is to keep residents safe."

She knows the restrictions will be hard on families with loved ones at the facilities. She said many homes are trying to make personal phone calls to keep families informed.

Peterson encourages families who have not yet heard from a facility caring for a loved one to call the home and have a discussion with staff about steps underway to ensure residents' safety.

Commissioner offers guidance to insurers

North Dakota Insurance Commissioner Jon Godfread sent a bulletin to insurance companies Wednesday asking that they take a number of steps related to the new virus "so that cost sharing does not serve as a barrier to accessing this important health testing."

In the memo, he asks health carriers to waive co-pays, deductibles and coinsurance for testing done at private labs. While the North Dakota Department of Health has offered testing free of charge to qualified people at its state lab in Bismarck, some health care providers might send samples to another lab, Godfread said.

Godfread also asked insurers to waive any cost-sharing associated with doctors' visits when testing for COVID-19. He also wants insurance companies to do away with requirements that a patient receive prior authorization for testing or treatment for the virus.

If an insurer does not have any in-network health care providers with adequate training and experience to meet virus-related needs, it should make an exception to provide access to an out-of-network provider at in-network rates, Godfread asked.

He added that if a vaccine for the virus becomes available, insurers should cover the cost of the immunization.

Insurers are encouraged to make information about coverage for the virus available on their websites.

The guidance issued Wednesday will expire May 1 unless the state insurance department extends it.

Blue Cross Blue Shield of North Dakota, the state's largest health insurance carrier, announced on Wednesday a number of steps it will take to make health care access less costly and more efficient for people seeking testing and treatment for the virus, including waiving cost-sharing for testing. Further hospital stays for COVID-19 will be covered based on a member's insurance plan, the company said.

Blue Cross Blue Shield also is letting pharmacies refill prescriptions earlier than typically allowed, so people can stock up. It will allow pharmacies to waive "refill too soon" limits on prescriptions, the insurer said.

Tribes limit travel

Some North Dakota tribes, including the Standing Rock Sioux and the Turtle Mountain Band of Chippewa, have issued limits on travel this week in an effort to prevent the spread of the new virus.

In a memo Standing Rock Chairman Mike Faith sent to tribal employees and the tribal council, he said the tribe is banning all tribally and government-funded travel to any area with known or possible cases of the virus. The restriction applies to travel by car, train, bus or airplane, and it includes travel through hubs such as Minneapolis and Denver.

Tribal leaders will consider "essential governmental travel" on a case-by-case basis.

"This ban is necessary in an effort to reduce the risk presented by any non-essential Tribal government activities on our Community and our people, in particular our elders," Faith said.

The ban will remain in effect until the tribe determines that the threat posed by the virus has lessened, he said.

Similarly, Turtle Mountain has restricted travel that uses tribal funds, Chairman Jamie Azure said in a press release. Restricted areas include regions with outbreaks identified by the U.S. Centers for Disease Control and Prevention and the World Health Organization.

Essential travel must be approved by the chairman, and travelers must consult with the Indian Health Service for screening upon returning.

Many tribal members use tribal medical assistance to fund travel for treatment of a variety of medical conditions, Azure said. The tribe will issue waivers to members who need to travel for care at out-of-state facilities, such as the Mayo Clinic in Rochester, Minn.

"As a Tribe, we have survived many threats to our way of life and have always persevered only to come together stronger as a people," Azure said. "This threat is no different."

The tribe plans to consider updates to its travel policies once a week.

North Dakota virus numbers

North Dakota on Wednesday confirmed its first presumptive case of COVID-19, the disease caused by the new coronavirus, in a Ward County man in his 60s.

The health department has tested 27 people for the virus. Twelve results came back negative, and 14 are pending.

Coronavirus FAQ

What is the coronavirus?

The coronavirus outbreak started in Wuhan, China, in late 2019 and has spread worldwide. The new virus causes a disease known as COVID-19. The virus is part of a larger family of coronaviruses, which can lead to illnesses ranging from a mild common cold to more severe respiratory diseases such as SARS and MERS.

Who is at risk and what are the symptoms?

Public health experts say the new coronavirus is more contagious than the seasonal flu. The majority of people who become sick experience mild symptoms, but some become more seriously ill. People who contract the virus can develop pneumonia, and some have died. People who are elderly or have underlying medical issues are at greater risk of becoming more severely sick. Symptoms of the virus include a cough, fever and shortness of breath.

What should I do if I develop symptoms?

The North Dakota Department of Health advises that people call their health care provider to tell them about recent travel or exposure, and to follow their guidance. Try to avoid contact with other people in the meantime.

What can I do to prevent the virus from spreading?

The health department advises that people wash their hands with soap and water or an alcohol-based hand sanitizer for at least 20 seconds. People who are sick should stay home from work or school, both to protect themselves and others with whom they would come in contact. Avoid touching your face, cover a cough or sneeze with a tissue or an elbow, clean and disinfect frequently touched objects and surfaces, and avoid contact with people who are sick.

Where can I find more information?

North Dakota Department of Health: www.health.nd.gov/coronavirus

U.S. Centers for Disease Control and Prevention: www.cdc.gov/coronavirus/2019-ncov

Reach Amy R. Sisk at 701-250-8252 or amy.sisk@bismarcktribune.com.

AMY R. SISK

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