COVID-19 hospitalizations increased to 847 on Monday in Minnesota, which is seeing a rising toll from a delta variant wave of the coronavirus that is falling in other hard-hit states.
While the latest count of COVID-19 patients is below the record 1,864 in late November, it is the highest total in Minnesota since Jan. 1 — when limited vaccine was just starting to be distributed to health care workers and long-term care facility residents.
Health system leaders urged unvaccinated Minnesotans to seek their shots — both against COVID-19 and upcoming seasonal influenza — to take the pressure off hospitals that are being whipsawed by the pandemic and patients with other urgent medical needs. Nearly 95% of Minnesota's intensive care beds were occupied Monday by patients with COVID-19 or unrelated medical issues.
"We're so busy with everything else. Our total numbers of hospital beds occupied are running at a higher level for a much longer time than we had to deal with at the peak of the pandemic," said Dr. Mark Sannes, an infectious disease specialist leading the COVID-19 response for Bloomington-based HealthPartners.
Unvaccinated people made up three-fourths of the 379 patients with COVID-19 admitted over the past 30 days to HealthPartners hospitals, including Regions in St. Paul and Methodist in St. Louis Park. Despite being younger, HealthPartners' unvaccinated patients also suffered more severe illness, making up 79% of the COVID-19 patients needing intensive care and 85% of those on ventilators.
Allina Health and Sanford Health have shown similar trends — with the latter reporting only one fully vaccinated patient out of 32 on ventilators Tuesday in its hospitals in Minnesota and the Dakotas.
Gov. Tim Walz and state Health Commissioner Jan Malcolm received influenza vaccinations in St. Paul on Tuesday afternoon and encouraged others to get their shots against COVID-19 and influenza — which can be administered at the same time. More than 75% of eligible people 12 and older have received at least first doses of COVID-19 vaccine in Minnesota, according to the Centers for Disease Control and Prevention.
"It's especially important this year," Walz said after getting his shot, "when hospital space is at a premium."
Walz on Tuesday asked legislative leaders to consider measures to address the worsening pandemic, including bonus pay for caregivers who are burning out and leaving patient care, and also temporarily relaxing regulations so hospitals can respond with more beds as needed.
The pressure is trickling down to Minnesota's smallest hospitals, which take care of fewer COVID-19 cases but are struggling to transfer patients who need higher-level treatment.
Dr. Chris Kaczmarczyk said it took two hours and multiple calls a week ago before he found a hospital that could provide surgery and a recovery bed for a patient with a disabling vascular condition.
"He needed an emergent surgery to save a limb, essentially," said Kaczmarczyk, medical director for the emergency department at Cuyuna Regional Medical Center, a critical access hospital in Crosby, Minn. "He did not have a bad outcome because of the delay, luckily, but he certainly could if it took longer or had he decompensated" and lost blood flow.
Hospitals managed the first spring 2020 COVID-19 wave under an emergency order by Walz that suspended nonurgent medical procedures that would otherwise take up beds.
Hospitals took that step on their own in the severe fall wave — reducing their total non-COVID patients to 5,127 on Nov. 29 when there was a record 1,864 COVID-19 patients.
By comparison, there were 6,652 non-COVID patients on Monday, but hospitals have hesitated to disrupt their usual schedules. Sannes said there was a group of patients that deteriorated because of the delays in care last year.
"Everyone is cautious to delay what we consider to be necessary care. Our experience over the last year and a half is that group of people needed that care, and when some of them got it later, we wished they had gotten it sooner," he said.
The rise and fall of COVID-19 cases last fall and winter also correlated with self-reported depression and anxiety levels in adults, according to a CDC study released Tuesday. Minnesota had one of the largest increases among states in adult depression severity from August to December last year, the study showed, but then had one of the largest declines in anxiety levels from January to June this year.
The pandemic has caused 725,451 coronavirus infections and 8,203 COVID-19 deaths in the state, including 12 deaths and 7,133 infections detected over the weekend and reported by the Minnesota Department of Health on Tuesday.
Minnesota had the 10th highest rate of new coronavirus infections over the past seven days compared with other states, according to the latest CDC data, with Iowa and Wisconsin having comparable rates. North Dakota has the third-worst rate, while states such as Arkansas and Missouri that had severe, early delta waves are seeing their infection numbers decline.
A silver lining is that rates have increased more gradually in Minnesota, even though the wave might last longer, said Curtis Storlie, a developer of Mayo Clinic's COVID-19 forecasting model.
"The growth should end relatively soon, though it likely won't come down as quickly as it has in other states either," he said. "That is, we won't go as high as many states have during this delta wave, but it will last longer. Overall, this is a very good thing for our hospital system."
Minnesota is following federal guidance and advising third booster doses to people who received Pfizer COVID-19 vaccine and are seniors or 50 or older with underlying health problems. Boosters also can be offered to younger adults with health problems or occupational exposure risks to the virus.
Booster recommendations for the Moderna and Johnson & Johnson vaccine are still under consideration.
Sannes said boosters are being offered already to health care workers, whose COVID-19 risks were outlined in University of Minnesota research that was published in preprint form earlier this week.
The study looked for COVID-19 antibodies in blood samples from 450 health care workers and found that their presence doubled to nearly 18% in a three-month period ending in mid-February. Odds of infection were higher in ICU workers and were more common in nurses and paramedics compared with doctors.
Jeremy Olson • 612-673-7744