Metro hospitals are running short on intensive care unit beds due to an increase in patients with COVID-19 and other medical issues, prompting health officials to call for more public adherence to social distancing to slow the spread of the infectious disease.
The Minnesota Department of Health on Friday reported a record 233 patients with COVID-19 in ICU beds, and hospital officials reported that 95% of ICU beds in the Twin Cities were filled by patients with COVID-19 or other unrelated medical conditions.
Patients with unrelated medical problems needed intensive care, along with patients recovering from surgeries — including elective procedures that resumed May 11 after they had been suspended due to the pandemic.
“We are tight,” said Dr. John Hick, an emergency physician directing Minnesota’s Statewide Healthcare Coordination Center. “Resuming elective surgeries plus an uptick in ICU cases has constricted things pretty quickly.”
At different times, Hennepin County Medical Center and North Memorial Health Hospital were diverting patients to other hospitals. Almost all heart-lung bypass machines were in use for severe COVID-19 patients and others at the University of Minnesota Medical Center and Abbott Northwestern Hospital in Minneapolis.
As planned, Children’s Minnesota took on some young adult patients to take pressure off the general hospitals.
People might think the pandemic is over because public restrictions are being scaled back, but “in the hospitals, it is not over and it is not getting back to normal,” said nurse Emily Sippola, adding that her United Hospital was opening a third COVID-specific unit ahead of schedule. “The pace is picking up.”
The pressure on hospitals comes at a crossroads in Minnesota’s response to the pandemic, which is caused by a novel coronavirus for which there is yet no vaccine. Infections and deaths are rising even as Gov. Tim Walz lifted his statewide stay-at-home order on Monday and faced pressure this week to pull back even more restrictions on businesses and churches.
Despite talks with Walz on Friday, leaders of the Catholic Archdiocese of St. Paul and Minneapolis issued no change in guidance for their churches to defy the governor’s order and hold indoor masses at one-third seating capacity starting Tuesday. President Donald Trump might have altered those talks when he threatened to supersede any state government that tried to keep churches closed any longer, although the White House didn’t cite any law giving him the right to do so.
A single-day record of 33 COVID-19 deaths was reported Friday in Minnesota — with 25 in long-term care and one in a behavioral health group home — raising the death toll to 842. Infections confirmed by diagnostic testing increased by 813 on Friday to 19,005 overall, and Dr. Deborah Birx, the White House’s coronavirus response coordinator, called out Minneapolis for having one of the nation’s highest rates of diagnostic tests being positive for COVID-19.
People can slow the spread of COVID-19 if they continue to wear masks, practice social distancing, wash hands and cover coughs, said Dr. Ruth Lynfield, state epidemiologist.
“There are those among us who will not do well with this virus and will develop severe disease, and I think we need to be very mindful of that,” she said. “It’s not high-tech. We know what to do to prevent transmission of this virus.”
While as many as 80% of people suffer mild to moderate symptoms from infection, the virus spreads so easily that it will still lead to a high number of people needing hospital care. Health officials are particularly concerned about people with underlying health problems — including asthma, diabetes, smoking, and diseases of the heart, lungs, kidneys or immune system.
Individuals with such conditions and long-term care facility residents have made up around 98% of all deaths. The state’s total number of long-term care deaths related to COVID-19 is now 688.
The University of Minnesota’s Center for Infectious Disease Research and Policy estimates that only 5% of Minnesotans have been infected so far and that this rate will increase substantially.
Hospitals working together
Part of the state response strategy is aggressive testing of symptomatic patients to identify the course of the virus and hot spots of infection before they spread further. Widespread testing is being scheduled in long-term care facilities that have confirmed cases, and testing has taken place in eight food processing plants with cases as well.
The state averaged nearly 7,000 diagnostic tests per day this week, and the state should get a boost from a new campaign of testing clinics at six National Guard Armory locations across Minnesota from Saturday through Monday, said Jan Malcolm, state health commissioner.
The state’s pandemic preparedness website as of Friday indicated that 1,045 of 1,257 available ICU beds were occupied by patients with COVID-19 or other unrelated medical conditions — and that another 1,093 beds could be readied within 72 hours.
Several hospitals are already activating those extra beds, though in some cases they are finding it difficult to find the critical care nurses to staff existing ICU beds — much less new ones, said Dr. Rahul Koranne, president of the Minnesota Hospital Association. Staffing difficulties, rather than a lack of physical bed space, caused some of the hospitals to divert patients.
Nurses in the Twin Cities reported being called in for overtime shifts for the Memorial Day weekend, which in typical years also launches a summerlong increase of car accidents and traumatic injuries. North Memorial, HCMC and Regions Hospital in St. Paul are trauma centers.
“This increased trauma volume typically persists throughout the summer season and into fall,” North Memorial said in a statement provided by spokeswoman Katy Sullivan. “To be able to provide the needed level of care for the community and honor our commitments to our healthcare partners throughout Minnesota and western Wisconsin, we need to preserve some capacity for emergency trauma care.”
An increase in surgeries might have contributed to the ICU burden, but Koranne said many didn’t fit the definition of elective. Some patients delayed the removal of tumors due to the pandemic but can no longer afford to do so.
“They are patients who have been waiting for critical time-sensitive procedures that their physician is worried might be getting worse,” Koranne said. “To call those type of procedures elective could not be further from the truth.”
Competing hospitals have long cooperated when others needed to divert patients, but that has increased with the help of the state COVID-19 coordinating center and is showing in how they are managing ICU bed shortages, hospital leaders said.
“We all have surge plans in place,” said Megan Remark, Regions president, “but more than ever before, everyone is working together and with the state to ensure that we can provide care for all patients.”