Minnesota’s ICU bed use hits highest level of pandemic

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

Minnesota COVID-19 hospital admissions rose to 1,570 on Friday, including 346 people in intensive care. The state reported that 994 of 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 lessen the burden by receiving COVID-19 vaccines and boosters and limiting the chance of virus exposure at gatherings and crowds, said Dr. Andrew Olson, a hospital doctor and chief of the COVID-19 response at 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 cannot go on as if nothing had happened.”

Minnesota leaders are watching closely for signs of a spike in COVID-19 as a result of the virus spread over Thanksgiving. The state-reported positivity rate of COVID-19 diagnostic tests rose to 10.4% for the first time in two weeks, staying above the 10% high risk threshold for significant virus spread. However, the rate is from the seven-day period ending Nov 26, so the impact of the holiday remains unclear.

The Minnesota Department of Health reported an additional 38 COVID-19 deaths and 6,122 coronavirus infections on Monday, bringing the total pandemic count to 9,654 deaths and 933,025 infections.

The shortage of staff in nursing homes has put hospitals under pressure, with nowhere to send patients who are ready to discharge but are too frail. The backup can be seen all the way to emergency rooms, where COVID-19 and other patients in need of advanced care wait days or hours for open inpatient beds.

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

The state responded on Monday by opening a fourth alternative care center in the Benedictine residential community Regina in Hastings. The 17-bed site will merge with those in Brainerd, St. Paul and Shakopee to provide temporary care for patients after hospital stays.

Governor Tim Walz also announced that 50 specially trained Minnesota National Guard members would arrive on Tuesday to assist in staffing nursing homes in New Hope, Onamia and Fergus Falls. In addition, a new training program has been started to place 1,000 certified nursing assistants in long-term care facilities by January 31st.

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

Staff pressures have also reduced bed capacity in Minnesota hospitals, although they reported losses due to vaccine mandates were minor. HealthPartners said it had 99% fulfilled its obligation for workers to get vaccinated or apply for exemptions. Out of 133 workers who were given 30 days of unpaid leave when they missed an October 29 deadline, 70 fulfilled their mandate by the end of November and 63 did not return to work.

Hospitals in the greater Minnesota area admitted the majority of COVID-19 patients earlier this fall, but the Twin Cities hospitals percentage has increased from 47% on Nov. 1 to 56%.

Mercy Hospital was the busiest hospital in terms of COVID-19 volume, serving the densely populated metropolitan area but also rural counties with low vaccination rates. The hospital recorded an average of 122 inpatient COVID-19 cases per day between its Coon Rapids and Fridley locations in the seven days beginning November 19. Two-thirds of the 31 intensive care patients also had COVID-19.

Hospitals postpone surgeries but also have to perform surgeries they postponed a month or two ago in hopes the pandemic wave would subside. Dr. Ryan Else, Mercy’s vice president of medical affairs, said there is an increase in patients being sent home with rehab instructions and outpatient support, including COVID-19 patients being sent home with supplemental oxygen.

Minnesota reported one of the first cases of Omicron variants in the country last week in a Hennepin County man who was traveling to New York for a convention in late November. Government surveillance found seven other potential Omicron cases, but genome sequencing found four did not affect the variant. Results for three more are pending.

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

“We don’t yet know what impact this will have on the pandemic,” said Dr. Andrew Badley, an infectious disease specialist who leads the Mayo Clinic’s COVID-19 research working group. “There have been some reports that disease penetration is lower with the Omicron variant, which means people get less from it. If that’s true, that’s a very good thing.”

On the flip side, Omicron could cause so many infections that it will lead to more hospitalizations even if the rate of serious illness is lower, he said. Monoclonal antibody therapies may not work as well for omicron infections, although Badley said they are likely to offer some benefit.

The Delta variant is the dominant strain in Minnesota, which, according to the Centers for Disease Control and Prevention, had the third highest rate of new infections in the United States in the past seven days.

Breakthrough infections in fully vaccinated Minnesotans continue to make up a growing proportion of the pandemic wave. Health officials believe immunity wears off six months after vaccination, putting early recipients at risk and needing booster doses.

People who were vaccinated accounted for 42% of infections in the five weeks between October 3 and November 6, compared with just 31% between May and September.

The majority of COVID-19 hospital admissions and deaths affect unvaccinated Minnesotans, even though they make up only a third of the state’s population. Among the 133 COVID-19 deaths reported in the week of October 31st, 85 were unvaccinated.

“We’re seeing a slight increase in the intake of vaccinated patients,” said Else. “What we are seeing, however, is that patients who have been vaccinated have much better results.”

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