Coronavirus Disease 2019

• On March 12, 2020, Brookings Health began temporarily restricting outside visitors to The Neighborhoods at Brookview nursing home in order to protect residents, many of whom are classified in the COVID-19 vulnerable population.
• On March 13, 2020, Brookings Health implemented a temporary policy to restrict visitors to Brookings Hospital to immediate family members only. Only one visitor is allowed per patient. Staff will screen visitors upon entrance, checking them for respiratory illness symptoms (fever, cough and shortness of breath) and asking about recent travel.
• On March 17, 2020, Brookings Health System suspended all in-person events, classes and support groups at their facilities. Limiting access from the public allows Brookings Health to maintain the infection control integrity of facilities and protect patients who need care and the healthcare workers who need to care for them.
• On March 30, 2020, Brookings Health temporarily closed Brookings Hospital to all visitors in order to protect both patients and team members from the spread of COVID-19. In addition, all persons entering the facility, including team members, are screened and logged for COVID-19 symptoms and exposure. 
• On April 24, 2020, Brookings Health System released its bed management plan for handling a medical surge capacity of patients in the event the community’s health needs exceeds Brookings Hospital’s normal medical infrastructure due to COVID-19. The plan will be used for the current wave of COVID-19 infections as well as any subsequent waves that may be experienced in the future.
• On May 4, 2020, Brookings Health System lifted the temporary restrictions placed on elective surgery and outpatient procedures, instituting a number of safety protocols. 
• On May 26, 2020, Brookings Health System began allowing one visitor or support person per patient per day at Brookings Hospital, Yorkshire Eye Clinic & Optical, and the primary care clinics in Arlington, Volga and White. This is inclusive all aspects of hospital care, including the inpatient care unit and outpatient procedures such as radiology and respiratory care appointments.
• On Oct. 26, 2020, Brookings Health System closed the inpatient care unit to visitors in order to protect both patients and team members from COVID-19 due the substantial virus spread within the community.
• On Dec. 17, 2020, Brookings Health System began vaccinating frontline healthcare workers for COVID-19. 
• On Dec. 21, 2020, Brookings Health System reopened the inpatient care unit to visitors, allowing one visitor per patient per day for all non-COVID patients.
• On January 19, 2021, Brookings Health announced it was partnering with both the Sanford Health Brookings Clinic and Avera Medical Group Brookings to begin vaccinating eligible in phase 1d of the Department of Health's vaccination plan. 

Brookings Health System is following guidelines from the CDC and South Dakota Department of Health regarding COVID-19 variants of concern which have been proven through scientific research to be more contagious or to cause more severe disease. 

Following recommendations from the CDC and South Dakota Department of Health, Brookings Health System will submit COVID-19 specimen samples for variant testing to the South Dakota Public Health Laboratory for confirmed COVID-19 patients who demonstrate any of the following conditions: 

• Have previously had COVID-19
• Are fully vaccinated
• Do not respond well to common therapeutics and treatments

PLEASE NOTE: Information about variants is rapidly emerging. Scientists are working to learn more about variants, including how widely variants have spread, how the disease caused by variants differs, and how variants affect existing therapies, vaccines and tests.

• Facilities have negative air flow (pressure) rooms in the emergency department, inpatient care unit and same-day surgery area to care for patients if needed while maintaining infection control integrity within the facility.
• Brookings Health screens all individuals entering facilities for symptoms of COVID-19 according to CDC guidelines.
• Brookings Health has encouraged people to call our facility first before entering if they are experiencing COVID-19 symptoms.
• Patients under investigation of, or confirmed to have, COVID-19 are cared for in isolation, separated from non-infectious patients.
• Staff performs extra cleaning and disinfection of high-touch surface areas.
• Brookings Health continues to follow CDC and South Dakota Department of Health guidelines and implements any guideline updates immediately.
• When a local case is suspected, Brookings Health works with the CDC, South Dakota Department of Health and other authorities as needed.

• Brookings Health has updated health system policies and procedures with Coronavirus guidelines for staff to follow in the same manner as previous outbreak threats, such as SARS and Ebola.
• Brookings Health continues to educate care teams and staff about COVID-19, including how it spreads and how they can protect themselves if called upon to care for a patient.
• Brookings Health has the needed safety equipment, including masks and respirators, in place to protect health care staff as needed.
• All persons entering the facility, including team members, are screened and logged for COVID-19 symptoms and exposure.
• Brookings Health has established COVID-19 worksite protocols for team members in accordance with CDC guidelines. The protocols establish what team members should do if they are ill as well as gives quarantine guidance after travel.
• On Dec. 17, 2020, Brookings Health System began vaccinating frontline healthcare workers for COVID-19.
• Per Center for Medicare & Medicaid Services (CMS) requirements, all healthcare workers must be fully vaccinated for COVID-19. Brookings Health allows for exemptions based on recognized medical conditions or sincerely held religious beliefs, practices or observances. Employees who are not vaccinated for COVID-19 are required to mask and don appropriate personal protective equipment. 

Care providers are following General Testing Recommendations from the Department of Health to help determine if a patient should be tested. Symptoms healthcare providers look for when they test include fever greater than 100°F, cough, shortness of breath OR one of these symptoms that cannot be attributed to another condition: fever or chills; fatigue; muscle or body aches; headache; recent loss of taste or smell; sore throat; congestion; nausea or vomiting; diarrhea.

If you’ve had close contact with an individual who has a confirmed case of COVID-19, call your primary care provider. Contact is defined as being within 6 feet for more than 15 minutes with a person or having direct contact with infectious fluids from a person with confirmed COVID-19.

If you need to be tested for COVID, consider using a self-test, sometimes referred to as an at-home test. Self-tests give fast results and can be more convenient and cheaper than testing at the emergency room, a clinic or pharmacy. Self-tests may be used if you have COVID-19 symptoms or have been exposed or potentially exposed to an individual with COVID-19. For safety, you may also consider taking a self-test before gathering indoors with other people. Learn more about free self-tests available from the South Dakota Department of Health. 

If you show no symptoms and have not had known close contact with a confirmed case, continue the recommended safety precautions, including good respiratory etiquette, hand-hygiene, social distancing, wear a face covering in public, disinfecting high-touch surface areas and monitoring your health.

Brookings Health System does charge for diagnostic testing costs for COVID-19 just like any other lab test. Patient insurance is accepted and any out-of-pocket patient costs will go toward co-pay and deductibles. 

Results for COVID-19 tests administered at Brookings Health System's emergency room take approximately 20 minutes.

If your test was administered by the Sanford Brookings or Avera Medical Group Brookings clinics, please contact their respective facilities for results. 

Yes. Brookings Health System has put safety measures in place to protect all patients from COVID-19 and any other infectious disease. That includes respirators and masks, frequent hand washing/sanitizing, and social distancing.

If you have ongoing chronic health conditions, we urge you not to delay or deny your care. 

Brookings Health System followed Governor Noem's Executive Order regarding COVID-19 and temporarily only performed urgent and emergent surgical cases.

On May 4, 2020, Brookings Health System lifted the temporary restrictions placed on elective surgery and outpatient procedures and instituted a number of safety protocols. 

Patients who wish to schedule their elective surgery or outpatient procedure should first visit with their care provider.

Brookings Hospital has reopened the inpatient care unit to visitors. If a rise in COVID-19 cases occurs, Brookings Health may reinstate a restricted or no visitor policy for the inpatient care unit.

All individuals entering Brookings Health System facilities are encouraged to mask, especially in instances where social distancing cannot be achieved. Patients, visitors and support persons may bring their own mask or may opt to wear one supplied by the health system. Individuals will also be encouraged to maintain six-foot social distances and to perform proper hand hygiene. 

Visitors SHOULD NOT enter Brookings Health System facilities if they have had COVID-19 symptoms, have tested positive for COVID-19 in the past 10 days, have been exposed to COVID-19 in the last 14 days or are waiting on results from a COVID-19 test. 

Following the South Dakota Department of Health (DOH) guidelines, visitor restrictions will remain in place for The Neighborhoods at Brookview skilled nursing home. The DOH has stated reopening nursing homes, like The Neighborhoods, will be a phased approach using recommendations from the Centers for Medicare & Medicaid Services (CMS). Once nursing home visitor restrictions can be lifted, Brookings Health will work with the DOH and CMS to ensure reopening criteria for The Neighborhoods is met.

Visitation of patients who are positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 otherwise known as COVID-19) is HIGHLY DISCOURAGED by the Centers for Disease Control and Prevention (CDC).

Visitation is limited to TWO VISITORS PER PATIENT AT ONE TIME in the hospital during regular visiting hours, including surgical areas, the obstetrics department and the emergency department.

• Visitors MUST self-screen for COVID symptoms before entering the building.
  • Visitors with COVID symptoms, those who have tested positive for COVID-19 in the last 10 days, those who have been exposed to COVID-19 in the last 10 days or those who are waiting for the results of a COVID-19 test are RESTRICTED from visiting.
  • Visitors MUST continue to mask at all times while in the facility.
    • Before entry into the COVID positive room, visitors will be asked to don recommended PPE including gown, gloves, and standard mask.
    • Visitors should be encouraged to use restroom before visiting, avoid coming in and out of the patient’s room or using shared community spaces (cafeteria, visitor waiting areas).
    • Visitors must perform hand hygiene and doff gown and gloves in the room before exiting. Visitors' standard surgical mask may be doffed upon exiting the building.

It is STRONGLY RECOMMENDED that visitors are vaccinated. Visitors are considered close contacts to COVID-19.

• Unvaccinated visitors are advised to quarantine for 5 days after their visit followed by strict mask use for 5 days.
• Fully vaccinated visitors should wear a mask for 10 days after their visit.

Guests/visitors who are asymptomatic are encouraged, but not required, to mask when visiting the hospital. They are especially encouraged to wear masks when social distancing cannot be achieved. 

Patients are encouraged to mask when receiving care from staff and social distancing cannot be achieved. They are required to mask if they are waiting on results from a COVID-19 test, have tested positive for COVID-19 in the past 10 days, have been exposed to COVID-19 in the past 14 days or are experiencing any COVID-19 related symptoms. Patients who are hospitalized for COVID-19 will not need to mask once they are in negative pressure room.

In the interest of public safety, Brookings Health will indicate on our website the current range of patient-occupied hospital beds according to the Bed Management Plan for COVID-19 Medical Surge Capacity in the event our community has a surge of COVID-19 patients. 

Please Note: Brookings Hospital's range of COVID-19 patient-occupied hospital beds is not a direct correlation to the number of COVID-19 positive cases or patient hospitalizations within Brookings County. 

In accordance with the February 2020 HIPAA Privacy and Novel Coronavirus Bulletin issued by the Office for Civil Rights and the U.S. Department of Health and Human Services, Brookings Health cannot give affirmative reporting to the media or public at large about an identifiable patient or specific tests, test results or details of a patient's illness without the patient's written authorization.

Brookings Health System has four ventilators on-hand at Brookings Hospital. In addition, two more ventilators are on-hand with the Brookings Ambulance. 

The South Dakota Department of Health also has a pool of ventilator equipment available to hospitals as-needed during the COVID-19 threat. Brookings Health System has access to this pool and can request additional ventilators as needed anytime throughout the pandemic. 

Please Note: A ventilator is different than a respirator. Ventilators are devices designed to assist patients to breathe when they can not breathe on their own. Respirators are masks designed to protect the wearer from inhaling particulates from the air. Brookings Health maintains a ready supply of respirators to protect health care workers who must care for COVID-19 or other infectious patients. 

Brookings Hospital has two dedicated intensive care (ICU) rooms in the Inpatient Care Unit. However, in accordance with the COVID-19 Bed Management Plan for Medical Surge Capacity, Brookings Health can provide intensive care as needed anywhere throughout the hospital.

Intensive care is the continuous monitoring and treatment of critically ill or injured patients using special medical equipment and services. Intensive care requires a team of doctors, nurses, pharmacists, dietitians, therapists and others of the medical team working in close collaboration to continuously monitor the patient and adapt treatment as needed. As such, in the case of a medical surge, Brookings Health will provide intensive care to patients as needed regardless if they are housed in ICU rooms or not.

• Brookings Health is the lead partner in the Brookings County Pandemic Preparedness Plan. We work with Brookings County Emergency Management, Brookings chapter of the American Red Cross, the City of Brookings, South Dakota State University and other surrounding counties and communities with a response plan in place for the outbreak of any pandemic.
• Brookings Health System has 49 hospital beds to care for people, including those with infectious diseases. For COVID-19, we have medical surge capacity of 80 beds. If a local outbreak occurs and if Brookings Health System’s facilities become overwhelmed, the county’s pandemic response plan goes into action.
• The pandemic response plan’s goals include:
  • Contain and control disease outbreak
  • Limit the number of illnesses and deaths
  • Preserve continuity of critical government functions
  • Minimize social disruption
  • Minimize economic losses
• The public can read the full pandemic plan at BeReadyBrookings.com.

Your body needs the energy to fight the illness. Do not take on big activities while staying at home; they can wait. COVID can get worse at the end of its course; it’s not unusual for days 8 to 10 be the hardest.

Try to drink 6 to 8 glasses of liquids (water, sports drink, juice) per day, especially with a fever. Urine should look closer to lemonade than apple juice. If it is darker, drink more liquids. Avoid caffeinated beverages or alcohol.

Use acetaminophen/Tylenol or ibuprofen to reduce fever and pain. Keeping the fever down helps prevent dehydration and helps so the body doesn’t have to fight as hard. Use cough suppressants, nasal decongestants and chest expectorants as needed.

Cycle through the prone positions to help with your breathing and keep your lungs open. Change positions every 30 minutes to 2 hours in this order: 1) lying on your belly; 2) lying on your right side; 3) sitting up; 4) lying on your left side; 5) back to lying on your belly and repeat.

See how to prone and learn more.

Taking 2 to 3 deep breaths every hour help gets oxygen deep in the lungs, assisting in clearing out mucous and other fluids.

If you have an at-home pulse oximeter, monitor your oxygen levels to be sure they are over 90%.

Seek medical immediately if you experience any of the following:

• Difficulty breathing or increased shortness of breath
• Persistent chest pain
• Unable to keep fluids down
• Unable to reduce fever with OTC medications
• Increased weakness or falling
• Inability to stay awake or new confusion
• Bluish lips or face

• COVID-19 is a respiratory illness that can spread from person to person.
• Patients with COVID-19 experience mild to severe respiratory illness with symptoms of fever, cough and shortness of breath.
• Complications may include pneumonia in both lungs.
• Older adults and those with chronic medical conditions like heart disease, diabetes, lung disease or other immune compromising conditions are at higher risk of developing more serious complications from COVID-19.
• Children are more likely to present with mild symptoms. There is currently no evidence that children are more susceptible to COVID-19.
• The best prevention is to avoid being exposed to the virus.

Viruses constantly change through mutation, meaning new variants of a virus will occur over time. While sometimes new variants disappear quickly, other times new variants will persist and stick around. 

Multiple variants of the COVID-19 virus are circulating globally. The CDC currently classifies variants by three categories: 

• Variant of Interest: has caused discrete clusters of infections in the U.S. or other countries, or seems to be driving a surge in cases. It also has gene changes that suggest it might be more contagious or that may help it to escape immunity created by natural infection or vaccination. Therapeutics and tests may not work as well against it. 
• Variant of Concern: has been proven through scientific research to be more contagious or to cause more severe disease. It may also reduce the effectiveness of therapeutics and vaccines. People who have previously had COVID-19 may become reinfected by the new strain.
• Variant of High Consequence: causes more severe disease and greater numbers of hospitalizations. It has also been shown to defeat medical countermeasures, such as vaccines, antiviral drugs, and monoclonal antibodies. 

Scientists and public health officials are currently focusing on variants of concern and variants of high consequence to learn how to control their spread. They want to know if the variants spread more easily; cause milder or more severe disease; respond to current medicine and treatments; respond to vaccines; and are detectable by current tests.

Learn more about variants and the progress being made on them from the CDC.

• Contact your primary care provider if you have any COVID-19 symptoms and fall into one of the following groups:
  • Over 65 years of age
  • Under 5 years of age
  • Pregnant
  • Have a chronic medical condition like heart disease, diabetes, lung disease or other immune compromising conditions
• If you do not fall into those groups, contact your primary care provider if your illness is worsening, including:
  • A fever of 100.4°F or greater
  • Difficulty breathing
• If you develop emergency warning signs for COVID-19, seek medical attention immediately. Emergency warning signs in adults include:
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
• Call your healthcare provider before seeking care and explain your symptoms.
• Immediately put on a facemask before entering any healthcare facility. This will help protect others, including health care workers, from becoming infected or exposed.

• Stay at home except to get medical care. People who are mildly ill with COVID-19 are able to isolate at home during their illness. About 80% of patients can be treated at home for COVID-19. The rate of patient who experience serious complications is only slightly higher than that of seasonal influenza.
• Avoid public areas. Do not go to work, school, daycare, church, shopping or anything else in the public.
• Separate yourself from other people and animals in your home. Try to stay in a specific room and use a separate bathroom if available. Wear a facemask around other people or pets.
• Cover your mouth and nose with a tissue when you cough or sneeze and immediately throw used tissues in a lined trash can. Immediately wash your hands.
• Wash your hands often with soap and water for at least 20 seconds (sing Happy Birthday twice), especially after blowing your nose, coughing, sneezing, going to the bathroom, and before eating or preparing food. Use hand sanitizer with at least 60% alcohol if soap and water are not available.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Avoid sharing personal household items, such as dishes, glasses, towels or bedding. Wash household items thoroughly after use.
• Clean and disinfect all high-touch surface areas.
• Monitor your symptoms.

If you seek treatment, call your health care provider’s office before visiting them. If visiting Brookings Health System’s emergency department, call (605) 696-9000. If visiting Avera Medical Group Brookings, call either 1-877-AT-AVERA or (605) 697-9500. If visiting Sanford Health, call (605) 333-4444. Explain your symptoms to your health care provider.

• If you are being actively monitored, your healthcare provider will call the state health department. Persons placed under active monitoring or facilitated self-monitoring should follow instruction provided by the South Dakota Department of Health.
• If you develop emergency warning signs for COVID-19, seek medical attention immediately. Emergency warning signs in adults include:
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face
• For discontinuing isolation, stay at home until you’re instructed to leave if you have confirmed COVID-19. The decision to discontinue isolation will be made on a case-by-case basis in consultation with healthcare providers and authorities.

• Remain calm. We must not let fear influence our decisions.
• If you're eligible, get a vaccine.
• Remember: this is an evolving situation. Get information about COVID-19 from a credible source and do not spread misinformation. Brookings Health recommends the CDC or South Dakota Department of Health for the latest information.
• Practice good respiratory etiquette and hygiene: cover your coughs and sneezes with a tissue. If a tissue is not available, cough or sneeze in your upper sleeve. Avoid touching your eyes, nose and mouth with unwashed hands. Wash your hands often with soap and water for at least 20 seconds (sing Happy Birthday twice). If soap and water are not available, use an alcohol-based sanitizer that contains at least 60% alcohol.
• Practice social distancing when out in the community. Try to stay 6 feet away from other people. Do not hug, kiss, shake hands or make other unnecessary contact.
• Clean and disinfect high-touch surface areas, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, etc. every day. COVID-19 is easily cleaned by household cleaners or soap and water. Make sure you read and follow household cleaner instructions to ensure germs are killed.
• Wear a face mask in public following CDC guidelines. Based on evidence-based research, the CDC recommends wearing cloth face masks in public. The cloth masks do not protect the wearer, but instead prevents an unintentional spread of the virus from the wearer to others. Recent studies show many individuals with COVID-19 do not show symptoms. Those who eventually develop symptoms can transmit the virus to others before symptoms appear. As such, wearing cloth face masks in public can help slow community transmission of COVID-19. 
• Monitor your health. Be alert for COVID-19 symptoms and take your temperature if symptoms develop.
• Stay at home if you’re sick and self-isolate to prevent the spread of illness.

Recovery from COVID-19 is based on when symptoms started and when a person seeks care and gets tested. 

A person is considered recovered when: 1) seven days have passed since the onset of their symptoms; 2) they've been fever free for at least three days and other symptoms, such as cough, have improved.

Monoclonal antibody infusions are a way to intravenously provide laboratory-produced antibodies against the COVID-19 virus. These antibodies function like the antibodies made by the immune system but bind to a specific protein in the COVID-19 virus. They are a useful tool for people who have a positive test for COVID-19 and at are high risk from the infection (such as people with diabetes or chronic kidney disease) or for a select group of high risk, immunocompromised people that are known to have been exposed to the virus. Only one infusion is needed and it must be ordered by a medical provider.