Urban vs. rural divide in ICU beds

For those thinking they can get away from the novel coronavirus, by escaping to the cabin, Minnesota Health Commissioner Jan Malcolm had a warning about the availability of critical health care.

“Lots of us are heading to retreat to spots up north,” said Malcolm in a conference call with reporters.  “A reminder to folks, those communities don’t have the capacity to absorb a large number of people.”

When it comes to critical care in Minnesota there is a rural vs. urban divide. 

Sixty percent of the counties in Minnesota don’t have an intensive care unit (ICU) bed, and eight counties don’t even have a hospital, according to data from Kaiser Health News. 

There were only 243 intensive care unit (ICU) beds available in Minnesota as of Wednesday, and more than half are located in the Twin Cities metro. 

Health officials say ICU care, and access to a ventilator to help a patient breathe, makes it ten times more likely the most critically ill COVID-19 patients will survive.   

One third of those testing positive the coronavirus in Minnesota live outside the Twin Cities seven-county metropolitan area, where the population is generally older, and more susceptible to CoVid-19.

Consider Aitkin County, where 41% of the population is over 60 years of age, estimated at 6,467 people. But there are only four ICU beds in Aitkin County, according to the Kaiser Health data.  That means there are 1,600 people who are 60-plus, for every ICU bed. 

Even some metro counties, like Anoka County, have demographics that make them more susceptible to hospital capacity issues. Anoka County has 35 ICU beds, but 18 percent of the population, 63,313 people, are over the age of 60.

Hospitals across Minnesota are trying to expand their capacity, in part by cancelling optional surgeries, and moving non-COVID-19 patients to longer care facilities. 

But Joe Kelly, Director of Homeland Security and Emergency Management, said his wife who is a nurse has reminded him how important it will be to hospitalize the most critically ill with COVID-19 in an ICU. 

“We need to keep those critical care services in house, in the hospital where patients can be best cared for by physicians, nurses, and other staff,” said Kelly.  

Through eight regional coalitions MDH is tracking the number of ICU beds and ventilators in the state, as well as the ability of hospitals to cope with a ‘medical surge.’