Healthcare workers across the nation, including in Minnesota, have faced a surge in COVID-19 and respiratory syncytial virus amidst a heavy flu season. According to the mostly recent report from the Minnesota Department of Health this past week, the state has so far recorded 1,857 flu-related hospitalizations in the 2022-2023 season.
Those hospitalizations have already outnumbered the 2021-2022 (901) and 2020-2021 (35) hospitalizations. By comparison, there were 4,022 cases in the 2019-20 season, 2,543 in the 2018-19 season and 6,446 in the 2017-18 season.
"The last two years there was barely any influenza activity in most places in the country," said Dr. Brian Pollmann, vice president of medical affairs at Hutchinson Health. "That's because of all the masking and social distancing."
But, he said, it appears to be spreading fast this season.
"Community immunity is really declined from lack of exposure," Pollmann said. "It's going to be a banner influenza year."
Data released late last week by the Centers for Disease Control show Minnesota has a low to medium COVID level, but McLeod County is one of five counties listed as having a "high" level, meaning mask use is advised when indoors in public or on public transportation. The CDC reports McLeod County has a case rate of 206.17 per 100,000 people, with 11.9 new COVID-19 admissions per 100,000 people. It said 7.5% of staffed inpatient beds were in use by patients with COVID-19.
Meeker County was still listed as having a "medium" COVID-19 level, which means residents are advised to wear masks on public transportation, and if they have symptoms or have been exposed to someone with COVID-19. The CDC reports Meeker County has 124.88 cases per 100,000 people, with 10.2 new COVID-19 admissions per 100,000 people. Staffed inpatient beds in use by patients with confirmed cases was reported to be 6.1%.
Around the state, hospitals are reporting bed shortages due to influenza stacking up with COVID and RSV. The story is similar in Hutchinson, but not the same.
"We have seen quite a bit of influenza and RSV activity in Hutchinson, that has definitely reflected the state and national trend," Pollmann said. "COVID, not as much, which no one is complaining about."
He said the most useful data to follow when tracking COVID throughout the state is wastewater surveillance through the University of Minnesota. The university studies samples of wastewater to determine how prevalent COVID is in different state regions, including the South-Central Region, in which McLeod and Meeker are located.
"It's been fairly flat," Pollmann said. "Maybe a hint of a slight upward trend over the last couple of weeks. But certainly not a huge spike."
Influenza, however, has had a significant local presence.
"Normally we'll start to see our peak influenza time starting now," he said this past week. "We have had a fairly significant spike over the last couple of weeks. It was very early this year."
Local access to hospital beds has been tight, but not as tight as hospitals in the Twin Cities area.
"The bigger hospitals have been tight, short of beds for many months," Pollmann said. "That's for a lot of reasons. There is no one thing.
In addition to the flu, RSV and COVID, he pointed to inadequate staffing, and hospital care, such as surgeries, taking place after having been delayed due to COVID the past few years.
Alexis Kramer, the district nurse at Hutchinson Public Schools, reported the school was also seeing high rates of influenza-like illness symptoms, including fever, cough and sore throat. But it has not recently seen many positive cases of COVID among students and staff.
"RSV cases have been seen at our elementary schools over the past month," Kramer said. "We do not report RSV numbers, so it is difficult to compare to previous years."
When the school sees influenza-like illnesses in excess of 5% enrollment for each building, it reports it to the MDH.
"According to the MDH guidelines, we are seeing an outbreak of influenza-like illnesses at some schools in the district," Kramer said. "For example, if a school has 100 students and 5 are absent with fever, cough, or sore throat, then that school is considered to have an outbreak for influenza-like illness per MDH. With that being said, not all the cases we are seeing are positive influenza, but similar symptoms to influenza."
Overall, she described the cases of COVID, influenza-like illness and RSV as "sporadic." She said they have not created much classroom disruption.
"Our school policy does direct parents/guardians to keep students home if they have a fever over (100-degrees Fahrenheit), vomiting in the last 24 hours, eye infections, sore throat, or generally not feeling well. There have been absences due to our school policy being followed to keep students feeling unwell at home to reduce the spread of infection," Kramer said.
Lorie Garland, Litchfield Public Schools nurse, also reported cases earlier this month. She said RSV, influenza and COVID cases had been isolated, and that the district had not reported any outbreaks.
"We continue to monitor daily," Garland said. "But thankfully, at this point in time, we don't have any big news to share."
In Hutchinson, the hospital has recently had to "go on divert," which means it can't take care of more patients in the hospital. This is not an isolated situation, but it is happening more frequently. Ordinarily, Hutchinson Health is on divert roughly 15% of the time. Pollmann said his most recent data from Nov. 1 showed the hospital was recently on divert about 50% of the time.
"The worst we ever were was back more than a year ago, when delta was here (last December)," Pollmann said. "There was a one-month period where we were on divert 86% of the time."
However, not everyone who has the flu, or suspects they may have the flu, needs to be treated for it, he said. Healthy individuals not likely to face ongoing adverse effects do not have to get tested. However, those with significant shortage of breath, chest pain or low oxygen should seek medical assistance. As should those at high risk of developing complications, including adults older than 65. Others who should seek medical assistance with influenza are:
- children younger than 5, especially younger than 2,
- people who are pregnant or up to two weeks postpartum,
- residents of nursing homes and long-term care facilities
- non-Hispanic Black persons, Hispanic or Latino persons, and American Indian or Alaska native persons, and
- those with ongoing medical conditions.
"If you're not high risk, and doing OK, control your fever and symptoms," Pollmann said. "it's better for everybody if we can keep you home. On the other hand, if you're really sick or at high risk ... then absolutely come in and we'll take care of you."
