Maria Belen-Perez had postponed the COVID-19 vaccination for months – thinking her relative youth at 36 as well as wearing a mask and washing hands would be enough – then the coronavirus found her.
Breathless, the Minneapolis woman panicked when her 15-year-old son called the ambulance on September 1 which rushed her to HCMC.
“I noticed my son’s face. He was worried, ”Belen-Perez said through an interpreter. “I had to say goodbye to my family. “
As Minnesota hospitals filled up amid a fourth wave of COVID-19 in 18 months, doctors reported something different – an increase in the number of younger, mostly unvaccinated, adult patients and generally surprised that the coronavirus is hitting them as hard as it does.
The median age of COVID-19 hospitalizations in the state was 65, with a typical range of 50 to 77, last winter, but has fallen to 50 since June, with a typical range of 30 at 76, according to a September COVID-19. Minnesota Department of Health Hospital Outcome Report. An increase in the number of young adult patients also occurred in the spring when a rapidly spreading alpha variant of the coronavirus was circulating, but doctors said the trend is more noticeable with the faster spreading delta variant now dominant in the disease. Minnesota.
“The age distribution is really different,” said Dr Matthew Prekker, an emergency and intensive care specialist from HCMC who has treated Belen-Perez. “It’s almost everyone under the age of 50 that we admit – day in and day out now. “
Minnesota reached the weekend with some hope of a peak from the latest wave and the strain it put on hospitals. COVID-19 hospitalizations in the state reached 791 on Monday before dropping to 752 on Thursday.
Hospital executives don’t expect a peak until early in mid-October, however, based on modeling estimates and previous delta waves in other countries. Some hospitals are postponing elective procedures for the next few weeks, while all are reporting patient transfers across the state or even out of state when their own beds are full.
The pandemic has caused 697,182 coronavirus infections and 8,076 deaths from COVID-19 in Minnesota. The state has used a variety of strategies including $ 100 incentives to try to protect more people through vaccination. Minnesota ranks 21st among states with a first-dose vaccination rate of 74.4% among eligible residents ages 12 and older, according to the Centers for Disease Control and Prevention. However, the rate declines steadily with age and explains to many hospital managers the age change in their inpatient departments.
“People who haven’t received the vaccine come in sicker and tend to stay longer,” said Dr. Jeremy Cauwels, chief medical officer of Sanford Health, which operates hospitals in the Dakotas and Minnesota.
Sanford’s unvaccinated patients are on average 57 while its vaccinated patients are around 72 – and have other issues contributing to their hospital needs, Cauwels said. “Really, with our 57 year old unvaccinated, COVID may be their only problem or they may have obesity as another big risk factor. “
Belen-Perez thought her job as a housekeeper left her with few close contacts that would put her at risk for infection, but she made vaccine appointments for herself and her son after a month-long trip. last to see relatives in Pennsylvania. Aches started when she got home, followed by nausea and headaches, then shortness of breath she had never felt before.
Her son was also infected with mild flu-like symptoms, while her 10-year-old daughter briefly lost her senses of taste and smell. Patients from homes filled with COVID-19 appear to be another trend in the pandemic due to the ease with which the delta variant spreads.
“It wasn’t as common with some of the other variants,” said Dr Heidi Erickson, intensive care specialist at HCMV, who, along with Prekker, contributed to national research showing COVID-19 vaccines remain highly protective. against hospitalizations.
Monitoring Belen-Perez in the emergency room showed a telltale drop in blood oxygen levels, which led to her being admitted to hospital and being treated with the antiviral remdesivir. Belen-Perez felt scared and confused, grabbing her oxygen mask and rolling around in bed – each movement causing a coughing fit and low blood oxygen.
“I felt like I wasn’t breathing,” she said. “Even when they put me on oxygen, I felt like I wasn’t breathing. “
Doctors were considering putting her on a ventilator to catch her breathing when a Costa Rican resident doctor spoke to her in Spanish and calmed her down. The treatment team decided to try treating her without ventilation and prescribed the steroid dexamethasone to reduce inflammation and support her lungs.
Chances of survival in the hospital have improved, in part because of COVID-19 treatments standardized over conjectures from early 2020 – when ventilators were used early and aggressively to prevent violent coughing fits that could spread the virus to doctors and nurses.
Minnesota’s first report on COVID-19 results in the spring of 2020 showed an 11% death rate for hospitalized patients, but the pandemic total has fallen to 9% – with recent rates even higher low.
Monoclonal antibody therapies were underused in the spring and summer, but contributed to the latest wave of COVID-19 – with the caveat that they must be provided within 10 days of onset of symptoms for function. More than 1,100 courses of monoclonal antibodies were administered in the seven-day period ending Thursday, according to data from the COVID-19 Federal Hospital for Minnesota, up from less than 20 per week in June at one point low of pandemic activity.
One of the challenges is that young, unvaccinated patients tend to wait as long as possible before seeing a doctor, Cauwels said. Monoclonal therapies don’t work if they’re taken too late, “because all this inflammation, all this reaction to the virus, is already in their system.”
Younger patients have the advantage of youth, which usually means a stronger immune system and a better chance of recovery. The increase in serious illnesses among young Minnesotans, however, has coincided with a drop in the average age of deaths from COVID-19. A review of state death certificate data showed the average age of deaths from COVID-19 in Minnesota was 80 before August 1, but 71 since then.
Prekker said a challenge in treating Belen-Perez without a ventilator was to keep her hydrated and nourished without making her vomit or have a coughing fit. Nurses gave him protein shakes when possible, but Prekker said another benefit of youth is that patients have nutritional reserves that can last for days.
Belen-Perez spent 15 days in the hospital – including a week in intensive care – but gradually began to breathe without additional oxygen. She was desperate to see her children, who had been watched by a relative at home and had not been allowed to visit her.
“I made a big mistake by not getting the vaccine when I could have done it,” she said.
Still feeling weak and sometimes dizzy, she planned to take some time before returning to work. Belen-Perez returned home on September 15.
Four days later, Emanuel Moreno woke up at his home in Saint-Paul with pressure on his chest that made him unable to breathe. Her parents had COVID-19, but mild cases possibly from their vaccinations, and her 9-year-old sister was also ill.
At 26, Moreno was wary of advice about the COVID-19 vaccine and didn’t think he would get sick without the vaccine. Speaking on Friday on his fifth day of recovery at St. Paul’s Regional Hospital, Moreno said he was wrong.
“I didn’t think it was going to hit me like that,” he said.
Jeremy Olson • 612-673-7744