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How one Minnesota county managed to limit the impact of a second wave of COVID-19

“I do really think it’s based on who we are and our health care culture,” said Rochester Mayor Kim Norton.

Rochester
A community that’s home to the Mayo Clinic and a robust health care industry has largely followed guidelines for preventing the spread of COVID-19.
MinnPost photo by Walker Orenstein

As COVID-19 spread across Minnesota in October and November, the disease caused a wave of deaths in counties large and small, particularly outside of the Twin Cities metro area. Minnesota reported 2,164 deaths since Oct. 1 with a disproportionate number of fatalities coming from places like St. Louis, Stearns and Mille Lacs counties.

Nowhere in the state has managed to completely prevent a rise in coronavirus cases. But one modest success story can be found in Olmsted County, where case rates are far below much of the state and deaths have not risen nearly as sharply as they have in much of Minnesota.

Local officials cited a combination of reasons for better outcomes in Olmsted County, but many point to one overriding theme: A community that’s home to the Mayo Clinic and a robust health care industry has largely followed guidelines for preventing the spread of COVID-19.

“I do really think it’s based on who we are and our health care culture,” said Rochester Mayor Kim Norton.

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Greater Minnesota hit hard by pandemic 

In the early months of the pandemic, the seven-county Twin Cities metro was hit particularly hard by COVID-19. But since October, the majority of deaths have been in Greater Minnesota.

Mayor Kim Norton
Stearns County, which is the state’s eighth-largest county by population, according to 2019 state estimates, had 114 deaths between Oct. 1 and Thursday, the highest death toll in the state behind Hennepin and Ramsey counties. St. Louis County, Minnesota’s sixth-largest county by population, had 104 deaths over that time period, the fifth most in the state. 

Some smaller counties have reported a vastly disproportionate amount of deaths. Benton County, which has Minnesota’s 24th-biggest population, has reported 58 deaths since October, the eighth-most among Minnesota counties. 

Olmsted County has been on the other end of that spectrum. Though it has an estimated population of roughly 160,000, the seventh-highest in the state, Olmsted County ranks 39th in deaths since October, with 13 deaths reported over the last two and a half months. 

By contrast, Chippewa County, with an estimated 2019 population of 11,858, has reported 15 deaths over that same time period.

Olmsted County also fares well on other metrics released by the state. It had the seventh-lowest cases per 10,000 people over the week of Nov. 22 — the latest data provided by the state — and ranked fourth the week prior. Counties lower on the list are sparsely populated. Olmsted County’s case rate also declined for two straight weeks in the most recent data.

The county also had a positivity rate per 10,000 people of 8.8 percent the week of Nov. 22, well below the statewide average of 11.1 percent. The week before it had the fourth-lowest positivity rate in the state.

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As is the case across Minnesota, deaths have risen in Olmsted County lately. Of the 13 deaths reported since Oct. 1, nine have come after Nov. 19. 

The county’s contact-tracing team also struggled to keep up with case investigations for a time during the fall, said Graham Briggs, Olmsted County’s director of public health, and there has been an increase in admissions to the hospital for COVID-19 and ICU use. 

Mayo Clinic told reporters Tuesday it had 83 patients with COVID-19 at its Rochester hospital, including 21 in the ICU, and staff absences due to COVID-19 remain a concern. The hospital serves more than Olmsted County, however.

“There’s caveats and disclaimers to saying we’re doing a good job,” Briggs said. “We’re at risk here just like everywhere else in the country right now because there’s not a vaccine.”

What did Olmsted do right?

Still, Briggs said Olmsted County has had some success this year. He said the county has a strong group of epidemiologists and a dedicated case-investigations team that worked to automate much of its work during the spike so it could keep the staff from being overwhelmed. 

Graham Briggs
Graham Briggs
Briggs said the county worked with Olmsted Medical Center and Mayo Clinic to open a testing site at a county fairgrounds early in the pandemic to make testing widely available at a central location, and was aggressive over the summer in recommending that anyone out at bars or social gatherings get tested regardless of whether they had symptoms. The state made similar suggestions to young people before Thanksgiving. 

Briggs also said the county was able to turn public health employees who work on things like restaurant inspections into extra help for businesses trying to make customers and workers safer.

Mayor Norton said Rochester has also tried to provide city activities through the summer and fall for people to get outside and socialize safely. She said she has had to keep some businesses in line for breaking regulations, and she drew attention for intervening to limit the size of a rally for President Donald Trump.

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More than anything, Briggs and Norton said Olmsted County’s relative success could be owed to one of the county’s most unique assets: a large medical community. Norton said Mayo Clinic employs roughly 36,000 people in Rochester, and there are more health care workers for other systems beyond that. Many deal directly with COVID-19 through the sector for a living, and hospitals are a large part of civic discourse.

Those workers and their families have been good about following guidance on masking and distancing, Norton said, even if there are still some who buck rules and don’t believe in science. Norton said the colleges in the city are also largely focused on health care and medicine and may have an easier time limiting disease spread than other schools. Briggs said Mayo, considered one of the best hospitals in the world, also provides “top-level care” for people with severe COVID-19 cases, which could be one reason for having fewer deaths.

“They call Rochester the Med City, and I think there’s a real attention to health and medicine here,” Briggs said.