The worst of respiratory virus season is likely coming to Minnesota, infectious disease experts predicted Thursday, despite a recent drop in hospitalizations of children with respiratory syncytial virus, or RSV.
Minnesota’s 355 flu-related hospitalizations in the week ending Nov. 26 were up from 319 a week earlier, according to the state’s update Thursday. This trajectory means that Minnesota, at best, is a month or two ahead of typical flu patterns or, at worst, is on the verge of a severe virus season.
“Things are going to get worse before they get better,” said Patsy Stinchfield, a children’s nurse practitioner from Minnesota and president of the National Foundation for Infectious Diseases.
Stinchfield was unconvinced by a decline in RSV-related hospitalizations. The state’s weekly report showed 120 such hospitalizations last week in the Twin Cities Seven Counties area, mostly among infants. Although this is down from 200 hospitalizations two weeks ago, Stinchfield said it remains high.
“RSV can go up, it can go down, then it can go even higher than the first peak,” she said. “It’s impossible to predict, like it’s happening now, if it’s over.”
Respiratory diseases challenge Minnesota hospitals. More than 8,000 inpatient beds were filled in eight days in November — a rough marker for when hospitals across the state are at capacity, according to Thursday’s weekly pandemic update.
RSV has consumed pediatric intensive care beds. Only six of the 144 such beds were available on Monday.
“The surge we’re seeing now, I’ve never seen in my more than 20 years working in pediatrics,” said Dr. Sameer Gupta, vice president of medical affairs at Masonic Children’s Hospital at M Health Fairview. in Minneapolis.
The worry is that all of this happened before the holidays – when travelers congregate and spread germs. Flu levels typically spike after Christmas in Minnesota.
The dominant flu A strain is associated with severe seasons, but that same strain produced a weak flu season last winter amid outbreaks of COVID-19, said Melissa McMahon, senior epidemiologist at the Department of Health of the Minnesota.
“We had the ability to guess what the flu was going to do before the pandemic and now that pattern has been kind of thrown out the window,” she said. “We’ve had flu seasons that didn’t make sense with the knowledge we had for the past two years.”
COVID-19 levels have remained stable, but are contributing to hospital pressures. Minnesota’s 573 COVID-19 hospitalizations on Tuesday marked the highest total since Feb. 24 — although it was lower than the 1,533 hospitalizations on the same date in 2021.
COVID-19 death rates have declined in all age groups since then, but remain high among the elderly. Of the 75 COVID-19 deaths in the past three weeks, 72 were elderly.
Theories abound as to why RSV and influenza spread so early this year, after spreading at low levels during waves of COVID-19. Social distancing and mask-wearing measures could have protected people in 2020 and 2021.
Minnesota has seen an expected drop during the Thanksgiving holiday in flu-like outbreaks in schools, which are reported when 5% of children in a school or three children in the same elementary grade are absent with flu-like symptoms. The 142 households last week against 240 the previous week.
Influenza-related hospitalizations early in the season typically involve children and younger adults, whose mobility increases their risk of infection. Over time, the virus spreads to more older people at increased risk of serious illness, McMahon said. The median age for flu hospitalizations was just over 30 in Minnesota three weeks ago, but is now 58.
Health officials have urged people to take basic precautions, including staying home when sick, washing hands, covering coughs and getting recommended vaccinations. Social distancing and mask-wearing also provide protection against virus threats, McMahon said.
“That’s good advice,” she said, “for the flu, for RSV, and for COVID.”
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