Severe COVID-19, flu cases decline, easing pressure on Minnesota hospitals

Declines in severe COVID-19 and flu cases eased pressure over the past week on Minnesota hospitals as they cope with a workforce shortage and high patient volumes overall.

Only 378 COVID-19 cases filled inpatient beds in Minnesota hospitals Monday, the lowest count since Oct. 15, according to Thursday's weekly pandemic update. New coronavirus infections also dropped below 600 per week in Minnesota for the first time since last April, despite the emergence of an XBB viral variant that might evade vaccine- and infection-induced immunity.

The progress defies historical patterns in which the holiday season increases the spread of germs and infectious diseases. It also coincides with this weekend's shutdown of four state COVID-19 testing centers in the Twin Cities and Duluth as Minnesota turns more of the diagnostic and treatment responsibility of the pandemic over to clinics and pharmacies.

While the testing sites were a "cornerstone" of the state's early pandemic response, "COVID-19 tests will continue to be widely available to Minnesotans from a variety of sources," said Dr. Brooke Cunningham, state health commissioner. Options include a virtual test-to-treat app by which people can show results of at-home tests and receive prescriptions for COVID-19 antiviral therapy.

The closures could reduce the number of publicly reported tests Minnesota uses to monitor COVID-19 trends, but wastewater analysis can provide more immediate surveillance anyway. Viral levels in sewage have seesawed in the Twin Cities all fall and winter, increasing last week. Updated results Friday morning could show if the XBB variant is causing a more significant shift.

Pandemic risks remain highest in the elderly, who have made up 83% of the state's 14,162 COVID-19 deaths and 92% of the 141 deaths reported so far in 2023. A brief rise in COVID-19 cases in early December preceded an increase in deaths in early January. The state averaged 10 COVID-19 deaths per day in the seven-day period ending Jan. 6 — when it reported 15 deaths, the highest single-day total since last February.

Influenza risks remain tilted toward the elderly as well; the median age of Minnesota's 138 flu-related deaths so far this season is over 80. However, Minnesota appears to have encountered an early flu season, rather than a prolonged one. New flu-related hospitalizations peaked at nearly 200 per week in mid-November — unexpectedly before the holidays — and then dropped to a low of 30 in the seven-day period ending Jan. 21.

Public health officials remain bullish about vaccinations against both infectious diseases — including booster doses of COVID-19 vaccine that protect against some of the latest variants. The Centers for Disease Control and Prevention on Thursday reported 30% to 50% higher risks of coronavirus infections this winter in U.S. nursing home residents who were not up to date with the latest COVID-19 boosters.

Declining COVID-19 risks have contributed to public apathy over vaccine, even among seniors. While 95% of Minnesota seniors have received some vaccine, only 61% are up to date with recommended boosters.

Minnesota has tracked vaccine effectiveness by examining COVID-19 cases, hospitalizations and deaths by whether people received any of the recommended shots. The breakthrough data has lost some relevance, though, because it no longer differentiates people who received boosters months ago from those who are up to date with the latest variant-specific options.

The data still shows some protection, particularly for seniors. Booster recipients made up about 87% of the senior population but just 69% of the COVID-19 hospitalizations among seniors since October. Unvaccinated Minnesotans made up only 8% of the senior population but 20% of the hospitalizations among seniors.

Hospitals remain busy despite an easing of the pandemic. More than 7,600 patients have filled inpatient beds in Minnesota each day this month, compared with an average of 7,700 patients per day in the last three months of 2022.

The long pandemic has caused burnout and reduced worker retention in hospitals, but also in the nursing homes where hospitals transfer recovering patients. The Minnesota Hospital Association analyzed one week in December and found nearly 2,000 patients ready for transfers could not be moved out of their hospital beds, causing backups that resulted in overcrowded emergency rooms and delayed care.

"The safety net for our communities – hospitals and health systems – is severely frayed," said Dr. Rahul Koranne, the association's chief executive.