REGIONAL- While the fourth wave of the COVID-19 pandemic has started to wane in some areas of the country, case numbers in Minnesota and St. Louis County showed no signs of abating this past week, …
REGIONAL- While the fourth wave of the COVID-19 pandemic has started to wane in some areas of the country, case numbers in Minnesota and St. Louis County showed no signs of abating this past week, and that’s creating extreme pressure on healthcare systems throughout the state.
New records for COVID benchmark measures for 2021 continue to be set, topped only by the numbers seen during the massive coronavirus spike in November and December of last year.
Tuesday’s test positivity rate of 8.3 percent was the highest since last December, and the weekend total of 7,942 cases left Minnesota just shy of 750,000 cumulative cases since the pandemic began.
Only 45 of the state’s 1,158 intensive care hospital beds were available as of Tuesday, with COVID patients filling one out of every five occupied beds. The surge of COVID patients is making it difficult for hospitals to provide ICU care to non-COVID patients. Duluth area hospital representatives said in a Tuesday teleconference that they’re on the verge of being overwhelmed.
“Across Essentia Health we had 129 patients hospitalized with COVID-19, and of those nearly half, 59 of them, are hospitalized here at St. Mary’s Hospital,” said Dr. Anne Stephen, chief medical officer of Essentia Health’s East Market. “This is the highest census of COVID patients we’ve had at St. Mary’s since last winter. Here in St. Louis County, we’re regularly adding more than 100, sometimes close to 200 new cases every day, and we haven’t witnessed numbers that high since last December.”
Stephen collaborates with a regional group that coordinates critical care, monitors ICU bed availability, and helps hospitals find open beds. The current surge is a serious challenge, she said.
“There just aren’t beds available, and when patients have to be transported well beyond our region for care, that’s scary, especially when time is critical,” she said.
St. Louis County Public Health Division Director Amy Westbrook said Tuesday that the county has yet to round the corner on the latest Delta-variant-driven surge.
“We’re still seeing our cases and our hospitalizations going in the wrong direction, and that’s not good,” Westbrook said. “We’re probably where we were last year at the start of November when we were heading into our peak.”
The numbers on the county’s COVID dashboard reinforce Westbrook’s statement. The county’s seven-day case average on Nov. 3, 2020, was 104.3. Last week on Oct. 8, the same case rate number stood at 108.6.
“It’s just not about case rates but looking at who is getting sick. One thing to call attention to is that we have seen more hospitalizations among adolescents in our central region,” Westbrook said. “It’s just more of a reason to really have communities pay attention to mitigation strategies and doing those things, that can help prevent illness.”
Stephen said the surge among younger patients has created the need for additional coordination among hospitals to provide for them.
“As a pediatrician, it’s been troubling to see this latest spike’s impact on young people,” Stephen said. “We often hear that it’s now a pandemic of the unvaccinated and that unfortunately includes children. In addition to a daily call statewide about hospital bed availability for adults, we now have unfortunately had to set up a statewide bed availability call for children.”
Jonathan Shultz is a physician in the emergency department at St. Luke’s Hospital in Duluth, and he said handling the influx of additional COVID patients is stretching the department to its limits.
“We are currently seeing unprecedented volumes within the emergency department, seeing very high volumes and persistently high volume day and night,” Shultz said. “This is causing a number of problems in terms of being able to get ambulances, in terms of having enough ambulances for all the calls that are coming in, and then the system backing up in terms of trying to get patients into the hospital. This extra volume of patients in a system that runs full at baseline is really causing unprecedented strain.”
Shutlz said that they often will maintain and manage patients in the emergency room until an ICU bed becomes available. He also said that they’ve been using an innovative approach for patients in outlying hospitals who need emergency care procedures, transferring patients to St. Luke’s where they have the capability to do the procedure, and then transferring them back to the outlying hospital if there’s not a bed available at St. Luke’s.
This current COVID wave is having its greatest impact in the northern and central/southwest regions of the county, most starkly illustrated by the latest bi-weekly case rates posted on the county’s COVID-19 dashboard that reflect conditions at the end of September.
The northern St. Louis County rate, of 88.55, is more than double that of the Duluth area. Conditions are even worse in the central/southwest portion of the county, where the rate is 100.62. Given the ongoing case levels, the new rate for the northern region, to be posted this Thursday, could eclipse the pandemic record high of 92.3 at the height of last year’s surge. And the situation could be even more pronounced than the numbers suggest, Westbrook said.
“We always have known that the number of positive cases is not a full picture of what transmission looks like in our community,” she said. “We certainly know that there’s more COVID transmission circulating, because not everybody will be going in to get tested, or some people will have very mild symptoms and don’t know they have COVID.”
While Westbrook stopped short of making a causative link between vaccination rates and cases in the county’s three regions, she readily pointed out that there’s a clear correlation.
Numbers from the dashboard show that the Duluth region has the highest rate of vaccinations among those 12 and older at 74.3 percent and the lowest number of cases per 100,000, at 467.7. In the northern part of the county, where 67.7 percent of residents are vaccinated, the case rate is currently 860.7 per 100,000. The central/southwest, which has the lowest vaccination rate, at 61.8 percent, has highest percent case rate, at 1,192.4 per 100,000.
“It certainly is correlated that where we see vaccination rates rise, we have seen case rates decline,” Westbrook said.
Health officials continue to support vaccination as the single most important solution to stemming the tide of COVID cases, but also emphasize that an overall strategy of layered mitigation including wearing masks indoors regardless of vaccination status, practicing social distancing, getting tested quickly when exhibiting COVID symptoms, and staying at home when ill is ultimately the most successful one for limiting community spread.
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