Steep rise in virus cases could lead to shutdown over holidays, Minnesota health leaders warn

Minnesota leaders hope a record-breaking Friday of COVID-19 infections, hospitalizations and deaths will motivate people to wear masks and slow the spread of the virus before any new lockdown restrictions are needed.

The day's records included more than 1,000 Minnesota hospital beds being filled with COVID-19 patients and increasing shortages of intensive care beds and staff — especially in the Twin Cities.

"If people don't limit their social circle and wear masks, it's going to mean we have to lock down again — likely across the holiday season," said Dr. John Hick, an HCMC physician who is coordinating regional hospital response efforts. "[It] would be regrettable, because we can take actions to limit spread — but we're losing control of the infections right now."

The Minnesota Department of Health on Friday reported 36 deaths along with a record-shattering one-day total of 5,454 diagnosed infections with the novel coronavirus that causes COVID-19. Totals in the pandemic increased to 2,591 COVID-19 deaths and 170,307 diagnosed infections.

Dwindling hospital capacity is a concern, though state Health Commissioner Jan Malcolm said coordination among Minnesota hospitals is allowing for the transfer of patients to open beds across the state. All strategies are being considered to keep pressure off hospitals, but she said state leaders hope to avoid draconian measures such as the 51-day lockdown that Gov. Tim Walz ordered in the spring.

"We're looking at the data literally daily and hourly and in conversations about what things are likely to have the greatest effect," she said. "We just never can say it enough: If Minnesotans were following the guidance that currently exists, we wouldn't need further dial-backs. However, just given the fact that we have not seen some of those behavior changes, we just need to keep getting that message out."

The state's pandemic dashboard on Friday showed that 1,038 people with COVID-19 were inpatients in Minnesota hospitals, and 224 needed intensive care.

The dashboard had listed 1,501 available ICU beds earlier this week, but state health officials said an updated count revealed fewer were available.

"We are working with hospitals to get better data and make sure they are including only staffed beds," said Marie Dotseth, state assistant health commissioner. "It is hard … to tell if the drop is a result of better reporting to comply with the definitions or if they have fewer staffed beds because staff are out sick or otherwise not available."

At least 15,610 Minnesota health care workers have tested positive — a number that includes nursing home workers — while many more have suffered exposures resulting in 14-day quarantines. That has left hospitals understaffed at times when patient demand has increased.

Hick agreed that statewide cooperation has helped hospitals weather the pandemic, but he said they are going to have to repurpose beds and noncritical care staff to keep up with rising demand.

"We really need to start treating this as the disaster situation it is becoming," Hick said. "Given the fact that we're not taking any real actions to stop COVID-19 transmission, this is going to keep getting worse. In the next few weeks we're going to be seeing a lot more cases and a very different standard of care than usual in our hospitals. We're going to make the safest compromises that we can, but we're making compromises."

However, the state dashboard also showed that the seven-day positivity rate of diagnostic testing has risen to 10% — an indication of broadening spread of the virus regardless of increased testing.

Leaders at M Health Fairview, Mayo Clinic and Centra­Care said they are making changes, such as deferring some surgeries or moving them to smaller hospitals to preserve space at bigger ones for COVID-19 care.

"In circumstances where we are facing capacity issues at some of our acute-care locations, we are rescheduling elective procedures to better align with the availability of our care teams," said Dr. Greg Beilman, incident commander for Fairview's COVID-19 response.

Walz had issued an emergency order this spring that deferred elective surgeries to free up hospital bed space. Hospitals learned from that experience about which procedures can be deferred and which must continue, said Dr. Pritish Tosh, Mayo's medical director for emergency management.

"People were putting off what we thought were elective procedures and diagnostics. and [we were] finding out that we were affecting people's health — that things that were preventable weren't being prevented," Tosh said.

Walz this week asked the Federal Emergency Management Agency for 10 more medical professionals to join an existing pool of 23 to address spot shortages in Minnesota hospitals and nursing homes.

As part of COVID-19 preparations this spring, Minnesota renovated a long-term care facility in Roseville as an overflow hospital site. A spokesperson for the Minnesota Department of Public Safety said that facility hasn't been activated and would not be activated unless hospitals reported all beds in use and no ability to transfer patients.

M Health Fairview is shutting down the COVID-only Bethesda Hospital in St. Paul and transferred the last patient with the infectious disease to St. Joseph's Hospital on Thursday. Beilman said Bethesda's closure is being offset by the opening of COVID-19 beds at St. Joseph's, and the transition won't reduce the state's capacity amid the pandemic.

Jeremy Olson • 612-673-7744