COVID, flu and RSV squeeze hospitals already struggling with staffing – Twin Cities

If you feel like everyone you know is sick with something — COVID-19, the flu or some other virus — you are not alone.

“There is no question, the number of respiratory illnesses is significant across the board,” said Dr. Mark Sannes, HealthPartners co-executive medical director. “It’s an earlier season than we are used to. Fortunately, it hasn’t been severe illness, but there’s no question there’s plenty of it.”

COVID-19 hasn’t gone away. Additionally, Minnesota has been dealing with high rates of respiratory syncytial virus, or RSV, in children since summer and the flu season has gotten an unusually early start by most measures.

The result: full hospitals, long waits in emergency rooms, and health officials once again urging residents to do everything they can to stay healthy and protect their families heading into the holiday gathering season.

For much of the last few months, Minnesota’s roughly 585 pediatric and 7,650 adult hospital beds have been close to 95 percent full. Staffing shortages make it hard to add more beds to an already-stressed system and health officials are hoping to avoid the skyrocketing demand that flooded hospitals early this year.

“I am worried about hospital capacity, especially pediatrics, which is very tight right now,” said Dr. Ruth Lynfield, state epidemiologist. “That’s why we need to do everything we can to protect one another.”

Once again, Lynfield and other health experts are pleading with Minnesotans to get vaccinated, get tested if they have symptoms and stay home if they’re sick.

Infection rates

It’s tough to pinpoint exactly how prevalent COVID-19 is right now in Minnesota communities because so many people are testing at home and those results are not reported to state officials. Nevertheless, the Minnesota Department of Health continues to record about 750 infections per day, or about 5,250 each week.

The amount of coronavirus genetic material in wastewater and the number of patients hospitalized with COVID-19 has largely replaced testing as a gauge of the outbreak. The amount of COVID in sewage has been relatively flat in the Twin Cities in recent weeks and coronavirus hospitalizations have plateaued at just under 500 people.

Minnesota tracks influenza and RSV differently and state data show both typically seasonal illnesses are already at high levels throughout the state.

Last week, almost 25 percent of flu tests came back positive, with Influenza A the dominant strain. There were 324 schools and six long-term care facilities with reported outbreaks.

There have already been 439 people hospitalized with the flu, nearly half of all of those reported last season, an early spike occurring weeks before it is normally seen. Influenza rates were very low during the pandemic because of coronavirus mitigation measures, but in the three years before COVID-19, hospitalizations varied from 2,500 to more than 6,400 each flu season.

RSV is even more prevalent, with about 46 percent of rapid tests coming back positive. The vast majority of those hospitalized with RSV are children under 4, but it can also infect older people who are high-risk.

Dr. Kari Schneider, a pediatric emergency medicine physician at M Health Fairview Masonic Children’s Hospital in Minneapolis, said influenza and RSV tend to hit younger children harder than COVID-19. More than two years of pandemic restrictions limited many kids’ virus exposure and they’re picking up highly-contagious viruses at school and day care.

“I think a lot of parents forget what it is like for their kids to be sick,” Schneider said, noting that emergency rooms and clinics are filled with worried parents. She recommends trying a telehealth appointment or visit with a primary care provider before turning to a clinic or ER.

Schneider noted that children struggling to breathe or who are showing signs of dehydration likely need to be seen by a doctor.

What it means for hospitals

Minnesota’s hospital system was designed to minimize the number of beds that sit vacant in order to maximize efficiency. But widespread staffing shortages — with one in five hospital jobs currently vacant — have upended a typically delicately-balanced system.

That’s led to waits of multiple hours at some emergency rooms, including at Children’s Hospital in St. Paul, according to Laura Myers, who’s been a nurse there since the late 1980s. Myers spoke at a Minnesota Nurses Association event Thursday where the union’s leaders announced plans to hold a strike authorization vote Nov. 30 as they push for pay increases, more staff and better safety protections.

“It has steadily gotten worse as far as the number of kids we are seeing in our emergency department,” Myers said in a follow-up interview. “The kids who are coming in are much, much sicker than we have seen in previous years.”

Schneider, at Children’s Hospital in Minneapolis, said they’ve not had to turn patients away, but she noted that the emergency room is not a “first-come, first-serve” facility. “We triage the sickest patients first,” she said.

Sannes, HealthPartners’ co-executive health director, agreed that pediatric hospitals have been among the hardest hit because of the unusually persistent RSV outbreak. He noted that flu cases are mirroring what was seen in the Southern Hemisphere over the summer where infection levels returned to pre-pandemic levels or higher.

“We are starting to head to a peak that we haven’t seen since 2018,” Sannes said. He noted that while illness hasn’t been especially severe, the flu is circulating easily because most pandemic protections have lapsed.

Sannes added that, so far this fall, COVID-19 hasn’t been as bad as many feared. He suspects vaccines and exposure rates have helped to keep the number of severely ill coronavirus patients at a manageable level.

How to stay safe

Good hygiene is the first line of defense against all respiratory viruses, which are typically spread through droplets when a person coughs, sneezes or talks. Regular hand washing, covering coughs and sneezes and staying home when sick goes a long way.

Lynfield says masks, social distancing and avoiding crowds also continue to slow the spread of respiratory diseases and can be good ways to protect the most vulnerable.

Most importantly, vaccines — both for COVID-19 and the flu — will keep most people from getting sick enough that they need to be hospitalized. Lynfield urged Minnesotans to get the latest bivalent COVID-19 booster designed to protect against the omicron strain — only 17 percent of Minnesotans are up-to-date on their COVID shots.

Finally, Lynfield notes that antiviral treatments, both for influenza and COVID-19, remain readily available. They are most effective when taken early, so testing at the first sign of symptoms and contacting a provider is key.

“Everyone is so eager to see each other in person. It’s been a long time,” Lynfield said. “We do need to remember that, right now, there are a lot of viruses circulating. Keep in mind who you are gathering with. Make sure, going into it, you are fully ready, meaning you’ve had your vaccines, you’re up-to-date.”

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