While many people seek a return to normal after a year and a half of COVID-19 restrictions, the local medical community urges caution and patience in the face of what they fear could be a difficult fall.
“The situation has not demonstrated yet that we’ve peaked or are going on the way down,” Ann Lien, chief quality officer at Meeker Memorial Hospital in Litchfield, said last week. “Testing numbers, triage call numbers have not peaked. They’re still going up.”
Statistics from the Minnesota Department of Health’s COVID-19 web page support that notion. Meeker County hit triple digits in new cases for the first time last week in the most recent COVID-19 surge, which both state and local health officials say is linked to the more contagious delta variant of the virus. The health department reported 112 new cases in Meeker County for the week ending Oct. 1. Previous reports showed 90 new cases on Sept. 24, 83 new cases on Sept. 17 and 49 on Sept. 15. As of Oct. 1, the county has seen 3,189 COVID-19 cases since the pandemic began.
And it is not just the increasing case numbers that concern health care providers. It is the shifting nature of those cases, with the majority being reported among younger people.
“The patients who are being hospitalized are younger this time around,” Lien said. “We definitely are seeing younger patients now.”
Much of that, Lien said, is being attributed to the vaccination rate in the county. Less than half of the 18,154 residents eligilbe for the vaccine — 49.7% or 9,278 — have been fully vaccinated, according to Minnesota Department of Health. Nearly three-fourths of Meeker County’s 65-and-older population — 74.7% — has been fully vaccinated. Both numbers lag behind the state average of 91.5% for 65 and older, and 69.9% for 16 and older.
For local health care providers, there would be no better preemptive strike against another COVID-19 surge than an increase in vaccinations.
“We truly believe (the low vaccination rate) is contributing to why we’re seeing younger patients hospitalized,” Lien said.
Most in the local health care community are reluctant to use the term that some on the national stage have used — a pandemic of the unvaccinated — because the issue has become so politicized. But they do not hesitate to share the numbers.
“From what we’re experiencing, the majority (of the cases) are the unvaccinated,” Lien said. “We do see some breakthrough cases (vaccinated people getting sick), but they are not getting — as you see on the news — they aren’t getting the severe illness or being hospitalized.”
Dr. Deb Peterson wants to avoid political theater, as well, but she admits to a certain level of frustration over the situation.
The chief medical officer at Meeker Memorial Hospital in Litchfield and the physician executive for the southwest region of CentraCare is worried about what the future could hold if something doesn’t change.
“This is a bad deal,” Peterson said. “People seem to struggle to still realize that their actions could make things worse, or they could make things better. I’m not even sure how to say it and make things politically correct. It’s tough.”
The upward trajectory of COVID-19 case numbers is not likely to change, Peterson said, without a change in thinking by the general population.
“We have to stop pretending it’s not here,” Peterson said. “We have to go back to not having big gatherings. In big gatherings, at church or in school, we should be wearing a mask. Stay home if you’re sick. All the things that were talked about at the beginning of the pandemic —and people are tired of now, I know — but we need to do them.”
The staff at Meeker Memorial Hospital has noticed some concerning signs that indicate the potential for significant issues on the horizon. Among them, Peterson said, is that there’s never a day without a couple of COVID-19 patients in the hospital. And most of those patients have been younger, in the 30- to 50-year-old range, she said, “needing oxygen (and) quite ill.”
The story is the same throughout Minnesota, which has created a critical shortage of hospital beds. And that’s also one of the medical staff’s biggest worries, because the problem extends beyond caring for COVID-19 patients.
“If somebody comes to the ER right now, say, with injuries from a motor vehicle accident, or they’re horribly ill and need a ventilator, or if they have anything that requires a higher level of care, they are likely not going to get to go somewhere else,” Peterson said.
As of Friday, there had not been an intensive care bed available in Minnesota for four consecutive days, she said, and medical-surgical beds, used for a higher level of care, were at single digits in the state.
Two weeks ago, Meeker Memorial Hospital staff spent two hours calling around looking for a bed for a patient, “while the patient was really unstable,” Peterson said. They eventually found a bed, but instances like that leave providers feeling helpless at times.
“If you can’t find a bed, you just have to do the best you can, which doesn’t always feel that good,” Peterson said.
She praised the work done by staff at Meeker Memorial Hospital under difficult situations. She said the hospital’s doctors changed their rotation schedule during last fall’s COVID-19 surge, so each physician takes a one-week round, working 12-hour shifts from Wednesday morning through the next Tuesday.
That schedule has created consistency in care and a less-chaotic environment for nurses and patients, Peterson said.
But the stresses of caring for COVID-19 patients, as well as wondering how and when the pandemic will end have weighed on care providers throughout the state and country. And that has, in some respects, exacerbated the problem.
Those in the health care profession saw an impending shortage of nurses and other care providers before the pandemic arrived, Peterson said, and by late last year, that future shortage became one of the present.
“With the last big surge last fall, a lot of the workers that were close to retirement age retired,” Peterson said. “They decided it wasn’t worth it. There was a predicted shortage of nurses (and) that was hit.
“There are not enough nurses to go around,” she added. “There are beds sitting empty, but you can’t put a patient in a bed if there’s no one to take care of them.”
The crush for care has also grown worse, because many patients who delayed a visit to their health care provider because of worries about being exposed to COVID-19 have reached the point that they can no longer delay care.
“Some of them now are having critical medical issues that are bringing them in as well,” Peterson said.
She said she’s not aware of any providers in Minnesota having to ration care, as is happening in some places, like Idaho, where they are in a state of “crisis care.” However, Meeker Memorial and other providers in the state have begun to cut back on elective surgeries again.
“It’s not making life or death decisions,” Peterson said. “That is happening elsewhere.”
Health care providers do not want it to go in that direction, of course, but they would like people to be more aware of how dire the situation is now and could become if steps are not taken to lessen the spread.
“It’s real out there,” Lien said. “There are limited critical care beds. We do see challenges transferring patients who need a higher level of care … and that’s tragic.”
“We are, based on number of calls we’re getting … we’ve exceeded September of last year,” Lien said. “I’m just hoping we don’t exceed October and November of last year, because November was a really tough month. That was a tough surge.”
Peterson appeared at a Litchfield School Board meeting in August and recommended that the district start the school year with a mask mandate. The board voted not to abide that advice, instead passing a resolution that recommended but did not require mask wearing.
Peterson said she was “disappointed but not surprised” by that decision.
That lack of masks in schools and other venues where large numbers of people gather is among the risk factors of another surge.
“When I look at differences from this year over last year, we had a mask mandate, things got shut down again. We don’t have those things in place that we did last year at this time,” Lien added. “But I’m cautiously optimistic — because we do have people that are vaccinated — that we won’t have as severe a surge as we did (last) November.
“If we get more vaccinated individuals, that will really help,” Lien said. “So, I’d say, if you’re not vaccinated, get vaccinated. And if you’re due for a booster, get your booster, because I sure am.”
For her part, Peterson understands the “personal choice” argument many make when eschewing masks and vaccinations. But there’s more than one side to those choices, she said.
“We all have choices, but our choices can have consequences,” Peterson said. “What people need to remember is … do unto others as you would want them to do unto you.”