Osterholm: Minnesota was hit by a “virus storm”; care systems tight

Across Minnesota, many schools are returning to distance education and some restaurants are closing again, all again due to the new COVID-19 wave time due to the spread of the rapidly spreading omicron transformation.

The number of positive tests in the state reached a new record last week, at 15.6 percent, according to calculations by the Minnesota Department of Health.

Dr. Michael Osterholm

Michael Osterholm

Courtesy of the University of Minnesota

According to Michael Osterholm of the University of Minnesota, the next few weeks may be like a viral storm. Osterholm heads the Center for Infectious Disease Research and Policy at the University of Minnesota. Osterholm spoke with Cathy Wurzer, MPR News presenter.

The following text has been slightly modified for clarity. Listen to the whole conversation with the player above.

We heard from M Health, Fairview [that] the system is not loose. And at the same time [they have] beds, [they don’t] get people to treat patients. It doesn’t seem to be long ago when we talked about the lack of bed space, what’s on the horizon with the spread of the omicron?

Well, we all understand that we have just gone through two very difficult times in terms of healthcare … And what we can do to provide quality healthcare today is: How many healthcare workers do we have? Who is trained for this? Are they there? And we’ve been sticking to the number of healthcare workers who can treat the skin of our teeth.

So it’s not about the beds. You may have more beds if you have them in your hospital, but they will become empty because you have no one to treat the patients. Or what has made the current situation so difficult is this widespread infection in the communities – which now means that we are certainly increasing the number of people seeking health care. But at the same time, we have many health workers who are fully vaccinated – who are, in principle, well protected against serious illness, hospitalization and death – but who have to be out of work because they have become infected.

And that’s why we can expect to see – and see this now in several states – 20-30 percent of health care workers all of a sudden [are] not there. And it is a huge challenge.

In fact, we already have examples of several states where they have gone to crisis management standards. Where they ask healthcare workers who test positive – who have mild symptoms (flu-like symptoms) – whether they will continue to work with the N95 respirator and cohort them, or whether they will place them on patients who are already infected with COVID. So it is unlikely that they can cause any harm other than their own infection.

But that’s where we are now. This, I have not seen in my entire career, this type of situation.

So I assume you are then in the position recommended by the CDC. The isolation time of those who test positive should be shortened. But what about the requirement that you don’t have to take a negative test to get back to work? Many people have questions about this.

Yes, this has been a communication problem. I think it has been a challenge at best.

But first, I just want to justify the fact that we are currently in crisis management standards. I would prefer someone who has been infected with COVID, who is relatively well and who has an N95 respirator, someone (who) had no one next to it for eight hours. That is what we are opposed to. This is indeed, as we call it in the language of Military Medicine, this is triage medicine. So this is the challenge we have now.

I therefore support the CDC’s position. Another thing is that we have almost debated how many angels can dance at the needle end of these tests. Because many of these lateral flow tests – the kind of tests we’re talking about the antigen test you can get out of hand – may not be as reliable in telling you if you’re really infected or not. We know we have a lot of false negatives that are actually infected – which don’t basically look positive. So if someone takes the test in five or six days, I’m not sure what that means.

And I think it was a huge challenge at first, how far can we use this testing to tell you: are you contagious or not? We do not know.

So I think the ultimate message is: we don’t want infected people to be in work areas, if at all possible. Of course, we don’t want them in our schools. We don’t want them in health care. We don’t want them for everyday business. But when you have a crisis situation where you may not be getting life-saving drugs for people, you may not have access to life-saving health care for people. I think we have no choice but to do this.

You mentioned schools, early data showed that the omicron transformation has led to an increase in hospitalizations for unvaccinated children. Is now the time to return to distance learning to curb the spread?

I have even more, could say in-your-face criteria. Are there even teachers, support staff and bus drivers who can safely supervise your children at school on a given day? We are currently seeing many places where 25-30% of teachers are away because they are really sick or sick at home. So I think now is the time to take a step backwards with regard to schools. We all want our kids to go to school, they should be in school. But at the same time, if you don’t even have the staff to run schools safely – and with good supervision – how can you say it’s positive for the kids to get them to school?

At the same time, I fully agree that infection problems in the community are a real challenge if children are at home, but now we are seeing a big spread in schools. We have several states that have documented major epidemics in schools. So you can’t say schools are safer.

Finally, people say, “Well, but you know, we need our kids to go to school, I have to work.” And I understand that very well. The problem is that you are at home anyway, at least part of the time, because it is inevitable that most of these children will get infected and get sick. And so that challenge is also just realistic…

So I think at this point – for me – the first standard I look at with children is: Can you really open a school with adequate supervision and educational experience with uninfected or recovered adults? And if you can’t, that’s the first sign [that] school is not the place you want your kids to be today.

Some people with a weakened immune system can get a fourth dose of the vaccine as early as this week. Israel has already started offering a fourth dose to at-risk groups. What do you like about this store?

I think that is the thing we should be doing right now. We continue to try to understand how these vaccines work best, which means: what is the difference? How many doses?

We cannot spend the rest of our days dosing the world every six months. It will not happen. But at least so far, data from Israel support the fact that those with a weakened immune response actually have a better response after the first three and one after the other.

I urge them to get it and get it as soon as possible, because – again – the challenge is that the rise is here right now. And when you get vaccinated, you’re really talking about 10 to 14 days before you see the immune system we’re looking for strengthen. And so time is of the essence. You can’t get vaccinated today and expect to get protection tonight.

So it sounds like this could get pretty intense over the next three or four weeks?

It’s intense now and it’s only getting worse, and I think if everyone could just take a step back; depoliticize it.

Just know we’re in a virus storm. As I told you a month ago, “a viral storm is coming,” it’s here, and it’s getting worse long before it gets better.

But it is short-lived, I think after three or four weeks, the number of cases will start to level off, unless you start to fall sharply. So that’s good news.

People wait, this is not going to take months and months. This wave will be in the coming weeks.

Listen to the whole conversation with the player above.

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