On Monday, Minnesota health officials predicted rising hospitalizations in the coming weeks as younger people who have recently been infected with COVID-19 spread it to people who are more vulnerable to serious symptoms.
Two days later, another Minnesota health expert says that an increase in COVID-19 deaths is also likely on the way.
"We are starting to see an increase in hospitalizations and if Minnesota is similar to other states – they are now starting to see an increase in deaths – I am sad to say, but I do expect to see an increase in deaths in the coming weeks," said Minnesota State Epidemiologist, Dr. Ruth Lynfield.
The number of coronavirus patients in Minnesota hospitals peaked at just over 600 in late May and has since dropped into the 200s. But Wednesday's situation report from the state health department shows that the number of hospitalized patients has increased from 236 as of 4 p.m. Monday to 254 as of 4 p.m. Tuesday.
However, the number of patients requiring ICU care dropped day-over-day from 107 to 106, which is the lowest total since April 23.
Jan Malcolm, commissioner of the Minnesota Department of Health, says there has been a 10.5% increase in cases this week over last, which she said is "one of the larger week-to-week increases" since late spring.
"We are in fact at a worrisome point that our numbers are going up," Lynfield said, noting that 41 states are currently experiencing increasing case volumes.
Case fatality rates, long-term recovery issues
According to MDH infectious disease specialist Kris Ehresmann, the case fatality rate in Minnesota rises with age.
- Ages 0-19: 0.00% (no deaths)
- Ages 20-29: 0.02% (2 deaths from 10,097 cases)
- Ages 30-39: 0.13% (11 deaths from 8,256 cases)
- Ages 40-49: 0.31% (20 deaths from 6,441 cases)
- Ages 50-59: 1.36% (78 deaths from 5,741 cases)
- Ages 60-69: 5.47% (184 deaths from 3,366 cases)
- Ages 70-79: 15.3% (287 deaths from 1,881 cases)
- Ages 80-89: 30.8% (516 deaths from 1,674 cases)
- Ages 90-99: 44.5% (391 deaths from 879 cases)
- Ages 100+: 58% (29 deaths from 50 cases)
"The case fatality rate increases with age, but there are consequences for individuals who are younger, in terms of long-term sequelae. And cases in those age groups can impact spread in the greater community and ultimately impact our most vulnerable populations," said Ehresmann.
Vox spoke with numerous medical experts about the long-term issues experienced by both older, frailer patients who had lengthy hospital stays and younger COVID-19 patients, some of who dealt with symptoms at home. .Among the long-term effects Vox describes:
"Being bed-bound can cause muscle weakness, known as deconditioning, which can result in prolonged shortness of breath. After a severe illness, many people also experience anxiety, depression, and PTSD.
"A stay in the ICU not uncommonly leads to delirium, a serious mental disorder sometimes resulting in confused thinking, hallucinations, and reduced awareness of surroundings."
Long wait for vaccine, but treatment options improving
Lynfield pointed out that while there is encouraging news on the pursuit of a vaccine, the best-case scenario is that it will be "many months" before an effective vaccine is widely available.
At the same time, treatments for seriously ill patients have improved since COVID-19 was first confirmed in Minnesota more than four months ago. Malcolm said physicians have learned more effective techniques to care for patients, including providing oxygen support earlier in the course of treatment.
"There are a number of factors involved," Lynfield explained. "We do have some treatments that are being used now that do appear to improve the course of illness."
She says Minnesotans need to do their part to help slow the spread of the virus by social distancing, washing hands, wearing a mask in public, getting tested if you have symptoms or are exposed to someone with a known case of COVID-19, and then isolating until you get your test results.