With flu cases on the rise, hospitals brace for impact

A nurse gives a flu vaccination shot into someone's arm.
A nurse gives a flu vaccination shot to a woman at a free clinic held at a local library in October 2020 in Lakewood, Calif. The flu is reemerging after being almost dormant during the first year of the COVID-19 pandemic.
Mario Tama | Getty Images file 2020

Every week, Jeff Sanders tracks flu cases.

The Minnesota Department of Health epidemiologist noticed the cases are growing faster than before.

“Last [season], we were really only getting maybe three flu positives at most every week,” he said. “But this season, we're actually seeing that week over week growth."

In the most recent reporting period, about 18 percent of flu tests came back positive — up from about 12 percent the week before, he said.

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But Sanders is not surprised.

Last year, flu was practically nonexistent because people were still doing a lot of things to protect themselves against COVID-19: Masking was more consistent, many kids weren't in school, and people were still social-distancing and delaying travel.

Something else stands out to Sanders: So far, 166 people have been hospitalized with the flu this season.

But that's lower than in previous years when comparable strains of influenza were circulating. Sanders wonders if the unprecedented hospital capacity crunches due to COVID-19 are playing a role in flu admissions.

“We don't totally understand how people are being admitted for flu this year, versus maybe just being under observation or being sent home because of all the COVID,” he said.

As elsewhere in the United States, infectious disease experts in Minnesota anticipated a flu comeback.

“I think it was predictable that we would see a surge of flu partly because of the very mild flu season last year, partly because influenza vaccine uptake has been spotty at best across the country, and partly because of the just sort of inherent variability of flu from year to year,” said Dr. Mark Schleiss, a pediatric infectious disease specialist at the University of Minnesota.

But with the COVID-19 variants delta and the more contagious omicron circulating widely, Schleiss said it's a complicated flu season.

"It's a great, great challenge right now in the midst of this surge in COVID cases, largely in children due to the omicron variant, to decide at the bedside, or in the emergency room if a child has flu or COVID — or in some cases both,” he said.

In December, Minnesota's largest health care providers — including the University of Minnesota's M Health Fairview system and Mayo Clinic — took out a full-page newspaper ad pleading with people to get vaccinated.

They wrote that vaccination against COVID-19 keeps people out of the hospital, reducing the emotional toll on health care providers and allowing them to treat people promptly who are having heart attacks or strokes.

Though improving in recent weeks, hospital capacity in Minnesota is still tight. Schleiss is watching hospitalizations related to omicron surges in other parts of the country.

“I think currently we have the capacity to handle this. That isn't true in different parts around the country. Places like New York, Tennessee, Florida are seeing major surges in all of these viruses that are really bringing us right to the brink of capacity,” he said.

Health experts say there’s still time to get flu shots. A season typically peaks December through February, but can last until April or even May.