ICU Bed Use in Minnesota Reaches Pandemic Highest Level – Community News
Covid-19

ICU Bed Use in Minnesota Reaches Pandemic Highest Level

No new cases of COVID-19 involving the omicron coronavirus variant were reported in Minnesota on Monday, but the dominant delta variant caused many problems for the state.

COVID-19 hospitalizations in Minnesota rose to 1,570 on Friday, including 346 people receiving intensive care. The state reported that 994 of the 1,012 available adult intensive care beds were occupied by COVID and non-COVID patients, a 98% occupancy rate that is the highest in the pandemic.

Minnesotans can reduce the burden by getting COVID-19 vaccines and boosters and by limiting the chances of viral exposure at gatherings and crowds, said Dr. Andrew Olson, a hospital physician and leader of the COVID-19 response for M Health Fairview. Of the 307 COVID-19 patients in the system’s hospitals, 72% are unvaccinated.

“I think life can go on,” he said, “but life can’t keep pretending nothing’s wrong.”

Minnesota leaders are watching closely for signs of a COVID-19 surge following the viral spread over Thanksgiving. The state-reported diagnostic test positivity rate for COVID-19 rose to 10.4% for the first time in two weeks, keeping it above the 10% risk threshold for substantial viral spread. However, the rate dates back to the seven-day period ending Nov. 26, so the impact of the holiday remains unclear.

The Minnesota Department of Health reported a further 38 COVID-19 deaths and 6,122 coronavirus infections on Monday, bringing pandemic totals to 9,654 deaths and 933,025 infections.

Staff shortages in nursing homes have added to the pressure on hospitals, leaving them nowhere to send patients ready to be discharged but too weak to go home. The backup can be seen as far as the emergency rooms where COVID-19 and other patients in need of extensive care are on board for days or hours awaiting open inpatient beds.

“We don’t have a choice right now,” Olson said, “but that’s a lot less safe than being in a clinical ward.”

The state responded Monday with the opening of a fourth alternative care site at Benedictine Living Community-Regina in Hastings. The 17-bed site, along with those in Brainerd, St. Paul and Shakopee, will provide temporary care to post-hospital patients.

Governor Tim Walz also announced that 50 specially trained members of the Minnesota National Guard would arrive as early as Tuesday to support nursing home staff in New Hope, Onamia and Fergus Falls. A new training program was also launched to place 1,000 certified nursing assistants in long-term care facilities by January 31.

“We continue to use all available resources to support our overworked and understaffed doctors, nurses and long-term care personnel who have been fighting on the front lines of this pandemic for nearly two years,” Walz said.

Staff pressure has also reduced bed capacity in Minnesota hospitals, although they reported losses from vaccine mandates were small. HealthPartners reported 99% compliance with its mandate for employees to be vaccinated or file waivers. Of the 133 workers who were given 30 days of unpaid leave after failing an October 29 deadline, 70 met the mandate at the end of November and 63 did not return to work.

Larger hospitals in Minnesota admitted the majority of COVID-19 patients earlier this fall, but the share of Twin Cities hospitals rose from 47% on Nov. 1 to 56%.

Mercy Hospital has been the busiest in terms of COVID-19 volumes, serving the densely populated urban area as well as rural counties with low vaccination rates. The hospital had an average of 122 clinical cases of COVID-19 per day in the seven-day period beginning Nov. 19 between the Coon Rapids and Fridley campuses. Two-thirds of the 31 ICU patients also had COVID-19.

Hospitals are postponing surgeries, but are also having to perform surgeries they postponed a month or two ago in hopes that the pandemic wave would abate. dr. Ryan Else, Mercy’s vice president of medical affairs, said there has been an increase in the number of patients being sent home with rehabilitation instructions and outpatient support, including COVID-19 patients being sent home on supplemental oxygen.

Minnesota last week reported one of the country’s first cases of ommicron variants in a Hennepin County man who traveled to New York for a convention in late November. State surveillance found seven other potential ommicron cases, but genomic sequencing found that four did not involve the variant. Results for three others are pending.

Omicron was identified as a variant of concern after it was identified in South Africa due to its rapid spread and potential ability to evade immunity to previous infection or vaccination.

“We don’t know yet what impact this will have on the pandemic,” said Dr. Andrew Badley, an infectious disease specialist who leads Mayo Clinic’s COVID-19 Research Task Force. “There are reports that disease penetration is lower with the ommicron variety, so people are getting less of it. If that’s true, that’s a very good thing.”

On the other hand, omicron can cause so many infections that it results in more hospitalizations, even if the number of serious illnesses is lower, he said. Monoclonal antibody therapies may not work as well against ommicron infections, although Badley said they will likely provide some benefit.

The delta variant is the dominant strain in Minnesota, which had the third-highest number of new infections in the US in the past seven days, according to the Centers for Disease Control and Prevention.

Breakthrough infections in fully vaccinated Minnesotans are still a growing share of the pandemic wave. Health officials believe that immunity begins to wane six months after vaccination, putting early recipients at risk and requiring booster doses.

Vaccinated people accounted for 42% of infections in the five weeks between October 3 and November 6, compared to just 31% in May through September.

Most hospitalizations and deaths from COVID-19 involve unvaccinated Minnesotans, even though they make up only one-third of the state’s population. The 133 COVID-19 deaths reported during the week of October 31 included 85 people who had not been vaccinated.

“We are starting to see a slight increase in the number of vaccinated patients being admitted,” Else said. “What we’re seeing with that, though, is those patients who have been vaccinated have much better outcomes.”