COVID-19 care winding down at St. Joseph's Hospital in St. Paul

Fairview Health plans to cease COVID-19 inpatient care at St. Joseph's Hospital in St. Paul by the end of May, predicting that vaccination progress will reduce the need for that level of pandemic care.

COVID-19 care is one of the last remaining inpatient services at the money-losing downtown hospital, which has undergone a gradual shutdown. Fairview Health leaders said they are starting the transition to give doctors, nurses and others time to find jobs elsewhere in the system.

St. Joseph's will provide inpatient COVID-19 care as long as needed, but pandemic modeling suggests that need won't last much longer, said Dr. Andrew Olson, medical director for COVID-19 hospital medicine for M Health Fairview, the clinical partnership between Fairview and the University of Minnesota.

"We're in the midst of a surge now," he said, "but we have enough experience with surges to know ... We have learned what the natural history of a (COVID-19) wave looks like — that it climbs for weeks, stays, and then decreases."

St. Joseph's had the fourth-highest number of COVID-19 patients among Minnesota hospitals in the week ending April 8, according to federal hospital tracking data. The St. Paul hospital had an average daily census of 36 COVID-19 patients that week, including 19 receiving intensive care, out of a total of 41 available beds.

St. Joseph's had been operating as many as 68 beds at the start of the year but shut down two COVID-19 units that weren't needed as Minnesota emerged from its most severe pandemic wave in late 2020. Allina Health's Abbott Northwestern Hospital in Minneapolis and Mercy Hospital in Coon Rapids both admitted more COVID-19 patients than St. Joseph's in the week ending April 8, along with CentraCare's St. Cloud Hospital, according to the federal data.

Fairview's announcement comes as Minnesota is seeing a resurgence in COVID-19 hospitalizations. The number of inpatient beds filled with COVID-19 patients in Minnesota increased from a low of 210 on March 6 to 681 on Tuesday.

The state reported an increase to 7.2% in the positivity rate of diagnostic testing on Wednesday along with 16 more COVID-19 deaths and 1,715 more infections with the novel coronavirus that causes the respiratory disease. That bring the state's totals to 6,978 deaths and 547,101 known SARS-CoV-2 infections.

At the same time, more than 46% of eligible Minnesotans have received COVID-19 vaccine, including 84% of senior citizens who are at greatest risk of severe illness. Continued progress should bring Minnesota closer to "herd immunity," by which the virus is unable to spread and cause widespread illnesses and hospitalizations.

Vaccine changes the outlook compared to the late 2020 COVID-19 wave, when "it was like, 'I don't know how we're going to get through this. What does the future hold for us?,' " Olson said. "Now we know, and that's in our control."

The shutdown will affect 325 positions, but the health system has 1,700 openings so the goal is to move people into those jobs, according to a memo announcing the move.

"We are keeping a close eye on our numbers as we begin our transition process," the memo stated, "and will continue to do so as the process moves forward to ensure we can safely and adequately care for COVID patients."

Rising financial pressures prompted Fairview leaders in a series of war-room sessions in late 2019 to propose closing St. Joseph's as well as the Bethesda long-term acute care hospital in St. Paul.

The pandemic altered those plans, as Fairview converted Bethesda into one of the nation's first COVID-19-only hospitals last spring. It was shut down last fall and converted through a partnership with Ramsey County into transitional housing.

Bethesda's shutdown occurred at the peak of pandemic activity in Minnesota, so Fairview expanded COVID-19 inpatient care at St. Joseph's. Olson said there were advantages to "cohorting" all COVID-19 care into a single location to treat a new and mysterious pandemic, but that the knowledge and personal protective equipment amassed since that time allows for equivalent care in general hospitals.

St. Joseph's will continue to provide inpatient psychiatric care and long-term acute care beds at least through 2021. Fairview also is planning to open a COVID-19 vaccine clinic at St. Joseph's, and Olson said there is a certain symmetry in that.

"We can transition from being a site that's caring for people who got sick from this thing," he said, "to preventing it and preventing it among the most vulnerable."

Staff writer Glenn Howatt contributed to this article.

Jeremy Olson • 612-673-7744