Toole County is experiencing an increase in positive coronavirus cases and on Monday reported two fatalities from the virus, prompting the Montana Nurses Association to put out an urgent call for any available nurses and other health-care professionals to assist staff at the Marias Medical Center in Shelby.

According to a post on the Nurses Association’s Facebook page, “MNA has been notified that Marias Medical Center is in dire need of RNs, LPNs, and CNAs.”

Robin Haux with the Montana Nurses Association said the call has received a good amount of traction so far and a handful of nurses are making their way to the area to assist.

As of Monday morning, Toole County, which has a total population of about 4,700, had six confirmed positive coronavirus cases.

At least one of the positive cases, according to the Marias Center's social media pages, is a health-care employee. This positive prompted the center to send multiple other staff members home to quarantine, according to Haux.

"We have received a pretty good response to the call we put as far as nurses go," Haux said. "We are hoping these temporary employees can help bridge the gap while the center's other employees are quarantined. The hospital is so small, so when you lose staff even temporarily it can be a big problem."

On March 26, Marias Medical Center officials posted on social media, stating that Marias Heritage Center — an assisted-living facility based in Shelby — learned “one of the residents of the facility, who was not currently in the building, has tested positive for COVID-19. Once we became aware of this situation, we immediately took action to further protect residents and employees.”

This post was followed shortly with another, stating “additional COVID-19 cases have been confirmed positive, and includes employees of the Marias Heritage Center facility. This situation also exposed others to COVID-19 and, as such, we expect that there could be other positives.”

None of the press releases thus far have provided information on Toole County’s two fatalities.

However, the Cut Bank Pioneer Press reported Sunday that an elderly woman had passed away at the Northern Rockies Medical Center in Cut Bank on Saturday after testing positive for coronavirus last week. The family of the woman offered a statement in the article thanking the center’s staff who “went above and beyond” and “fearlessly cared” for her. They also thanked the staff at the Marias Heritage Center, which according to the Marias Medical Center’s website, houses over 30 retired individuals.

At this time, it is unclear whether there is evidence of additional coronavirus spread in the assisted-living facility. But the Toole County Health Department sent out a somewhat somber press release Monday morning, urging residents to consider having conversations with their loved ones about how to proceed with end-of-life care in the event the medical emergency escalates.

“The scary thing with this virus is that it knows no limitations,” the press release states. “That is why it is important to know all family members’ wishes.”

Health department officials also called for local residents to stay in quarantine if they have been asked to do so and to “please take it seriously.” The notice then touched on the hyper-rural nature of Toole County and said the health department will be “working diligently with Pondera County, Glacier County and Liberty County Health Departments to work on all public health matters.”

Mellody Sharpton, spokesperson for Kalispell Regional Healthcare, said in an email the hospital has been having daily discussions with Shelby leaders to compare, coordinate and share COVID-19 related work and activities.

“Our experts, such as our Infectious Disease physician, have provided assistance and in our daily discussions there are a number of strategies that we are currently working through with Shelby leadership,” Sharpton wrote.

Sharpton said currently Kalispell Regional has not requested staff to go to the Shelby or Cut Bank areas to assist with medical care.

AS THE coronavirus continues to spread throughout the United States, officials are turning their attention to how rural and hyper-rural hospitals are handling the outbreak. Typically, these facilities already face staff and resource shortages — a difficult reality that is only exacerbated by major medical events such as the coronavirus pandemic.

According to the Rural Health Information Hub, Montana is home to 58 rural health clinics. Assuring these clinics and other rural facilities receive sufficient supplies has been a focus among Montana officials including Gov. Steve Bullock.

CBS News reported Monday that Bullock is one of several governors who recently urged President Donald Trump to ensure a sufficient amount of medical supplies and coronavirus testing kits are delivered to rural states like Montana. CBS cited a phone call recording in which Bullock said the federal government has canceled several supply orders that were in place for Montana.

Bullock also warned “we’re going to have some real problems” across smaller rural states if they cannot soon obtain the necessary testing equipment for battling the coronavirus outbreak.

Other state leaders, including Sen. Jon Tester, D-Mont., have called for the prioritization of rural hospitals and clinics.

“Our rural providers need your immediate assistance,” Tester wrote to the federal Department of Health and Human Services, along with 40 other Senate colleagues. “Congress has provided you with the funding and flexibility. Now it is up to the Administration to respond with rapid action to sustain rural providers. Any unnecessary delay will only worsen this situation. Therefore, we request you make the financial relief of rural hospitals a priority. Rural hospitals need access to financial resources immediately and in the most streamlined manner.”

Reporter Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com