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Amid a statewide coronavirus surge, central Minnesota has been hit especially hard

In early November, Benton, Mille Lacs, Sherburne and Stearns counties had four of the state’s top five highest weekly case rates, leading to a rapid rise in hospitalizations and putting acute pressure on the region’s health systems. 

Deaths are rising everywhere, though the majority — and a disproportionate amount — are coming in Greater Minnesota.
Deaths are rising everywhere, though the majority — and a disproportionate amount — are coming in Greater Minnesota.
REUTERS/Lucy Nicholson

Coronavirus cases and deaths have spiked widely across Greater Minnesota in October and November, but one area has been hit particularly hard. Since the start of October, disease transmission has sharply escalated in central Minnesota — specifically Stearns, Benton, Sherburne and Mille Lacs counties — making their outbreaks among the worst in the state and straining the area’s hospitals.

Dr. George Morris, incident command physician for CentraCare, which serves St. Cloud and much of the region, said his system has more than four times the number of hospitalized COVID-19 patients than it did during a May peak. And roughly 10 percent of CentraCare’s staff is out because they have COVID-19, were exposed to the disease or are caring for a sick family member. 

“I have concerns that we will be able to continue to meet the needs of our region,” Morris said Friday.

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Multiple reasons for rapid rise in cases, deaths

In the first wave of COVID-19, the disease hit the seven-county Twin Cities metro area hard but largely spared the rest of the state. 

Since then, however, the picture has changed. Deaths are rising everywhere, though the majority — and a disproportionate amount — are coming in Greater Minnesota. 

That’s especially true in central Minnesota. There were 25 COVID-19 deaths in Stearns County between March and Oct 1. Yet only two months later, the county reported 89 total deaths, according to data from Sunday. Neighboring Benton and Mille Lacs counties have seen even larger spikes. Both reported three deaths each in the first seven months of the pandemic, but now have 38 and 30 deaths respectively as of Sunday. (At least 17 of those deaths in Mille Lacs County have come from just one nursing home in Milaca.)

The death tolls in Benton and Mille Lacs are higher or similar to counties that have far more people. Benton County had 40,895 people in 2019, according to state estimates, which makes it the 24th-largest county population in Minnesota. Yet Benton County has reported the 11th-most deaths. Mille Lacs County ranks 15th in deaths but 39th in population with just 26,227 people.

Deaths per week by select Minnesota county, October and November (to date) 2020
Source: Minnesota Department of Health

By comparison, southern Minnesota’s Olmsted County, which includes Rochester, has more than 160,000 people and 30 deaths.

The central Minnesota region isn’t reporting only an outsized number of deaths. The Minnesota Department of Health says Benton, Mille Lacs, Sherburne and Stearns counties had four of the state’s top five highest weekly case counts per 10,000 people during the first week of November, which is the most recent data available. Nearby Todd and Kandiyohi counties don’t trail far behind.

Weekly case rate for Minnesota and select counties
Source: Minnesota Department of Health

Those numbers represent a recent shift. None of the four central Minnesota counties were in the top five for highest case rates during the first week of October and only Mille Lacs County was in the top 15. 

According to the most recent data, however, Benton County has a state-high 127 cases per 10,000 people, up from 26.1 the week of Oct. 4. By comparison, Hennepin County had a weekly case rate of 58.3 in the latest data and the statewide rate was 70.1.

Local officials in the region said there is no one reason for the uptick in COVID-19 spread and deaths. Nicole Ruhoff, community health services administrator in Benton County, said in an interview there have been transmission clusters tied to everything from work offices to celebrations, bars, restaurants and, to a lesser degree, school athletics. 

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She told county commissioners last week that cases had jumped among kids as school opened. Broadly, Ruhoff said she was concerned about people in the region simply becoming fatigued with physical distancing and mask-wearing guidelines and choosing not to follow them.

Amanda Larson, health and human services director for Sherburne County, told her county board last week that it took 225 days to record 2,000 cases and then only 14 days to tally another 2,000. Larson said the county has seen a rise in transmission among families, as well as in small gatherings, and a jump in cases among younger people. Between Sept. 1 and Nov. 16, the number of school-aged children with COVID-19 grew by 500 percent, Larson said. 

The rise in cases has been so fast, contact tracers can’t keep up. “If folks have been diagnosed with COVID and haven’t gotten a call, you might not,” Larson said.

In her presentation to the Benton County board, Ruhoff said St. Cloud’s free COVID-19 testing site had the highest positivity rate of any state-run saliva testing site in early November.

Erin Tufte, emergency manager for Stearns County, told her county board on Tuesday that they were on pace to have more cases in November than had been recorded in the prior eight months of the pandemic combined.

A ‘really hard three months’ could be ahead

As in many parts of the state, the spike in cases in central Minnesota has led to a rapid rise in hospitalizations, pressuring the region’s health systems.

Morris, the incident command physician at CentraCare, said the system treated all COVID-19 patients during the surge around May at its flagship hospital in St. Cloud. Since the state opened up, a “rocketship” rise in cases has forced CentraCare to change course.

CentraCare is now spreading out COVID-19 patients, including by using Carris Health in Willmar as a major center for treating people with coronavirus. That’s in part to reserve space for patients who need a higher level of COVID-19 care at the St. Cloud hospital, as well as to keep the site available for people with other critical medical needs.

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Still, Morris said Friday that roughly 35 percent of the St. Cloud hospital is filled with COVID-19 patients, and more than 50 percent of patients in the ICU have coronavirus. While the hospital has more than doubled its ICU capacity, “they are still full,” he said.

Morris said CentraCare has been treating a “ton” of elderly, long-term care patients at hospitals and facilities like nursing homes run by the health system. Those long-term care facilities are also struggling to maintain adequate staffing.

CentraCare looked for backup workers from other states and different regions of Minnesota but said they’re all busy. Even with Gov. Tim Walz’s new restrictions on bars, restaurants and gatherings, hospitalizations are expected to rise over the next month. That’s because it takes time for people who were infected prior to the shutdowns to get sick enough to require hospitalization.

Morris said it will be a difficult next few weeks with CentraCare’s staffing issues. But he said if people don’t adhere to health guidelines, they could experience a similar overload of cases that swamped hospitals in New York City and Italy earlier in the pandemic. “If we can’t slow this curve down and it continues to shoot up straight, it will be a really hard three months,” he said.