– Layoffs, reduced hours and hiring freezes are hitting local hospitals as business dries up before an expected rush of COVID-19 patients.

St. Luke's has asked employees to reduce hours and laid off seven people, as the ban on elective surgeries and nonessential appointments has left some workers idled and slashed revenue, said Chief Medical Officer Dr. Nicholas Van Deelen.

"Once the surge arrives, it will be all hands on deck," Van Deelen said at a news conference Thursday. "Until then we're in this no man's land where we have to be very good stewards of the resources we have."

Essentia Health, Duluth's largest employer, is taking a look at who can be put on administrative leave before an abundance of work is expected.

"If we don't have money to pay people to be here when we really have the surge, that's going to be creating problems," said Dr. Jon Pryor, president of Essentia's northeastern Minnesota and northwestern Wisconsin operations. "All of our attention needs to be on preparing for the surge."

He said Essentia has not yet laid off workers and is "trying not to reduce hours," but hundreds of job postings were taken down over the weekend. The openings that remain are nearly all physicians.

Pryor said the health system has "slowed down, postponed or rescinded some offers," while some openings continue to be filled.

Essentia has more than 6,500 employees, and St. Luke's has about 2,000. Together they comprise about 15% of the city's total workforce.

Both hospitals are redirecting and retraining staff to prepare for a cascade of cases.

"What they're really focused on is when that surge hits — how are we going to care for 400 patients?" said Pete Boyechko, a St. Luke's nurse and Minnesota Nurses Association bargaining leader. "It's the calm before the perceived storm."

Boyechko said some nurses have volunteered to trim their hours, with the anticipation they'll see their workloads grow soon. But if the rush of coronavirus cases doesn't show up in the next few weeks as anticipated, more layoffs are on the table, he said.

"We're all working together to figure this out," he said. "Communication is the toughest part."

There are now five confirmed cases of COVID-19 in St. Louis County, according to the Minnesota Department of Health. The first was confirmed Saturday, and none have required hospitalizations so far, according to the county.

Across the border in Douglas County, Wisconsin, there were four confirmed cases as of Thursday; each was recovering at home.

A St. Luke's employee is one of the confirmed cases; the health system said the infection was travel-related.

"Contact tracing has already taken place, and all close contacts have been notified," spokeswoman Melissa Burlaga said. "St. Luke's Occupational Health has been working with the employee and completed an investigation into the employee's contacts and followed up."

Health officials are urging residents to act as if the virus is being transmitted in their community, to follow the governor's order to stay home, to remain at least six feet from others and to wash hands well and often.

"The most important thing right now is what you do," Van Deelen said.