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The daily coronavirus update: 6 new Minnesota cases; Health Department narrows testing criteria

COVID-19
Photo: CDC/Alissa Eckert
COVID-19

For the foreseeable future, MinnPost will be providing daily updates on coronavirus in Minnesota, published following the press phone call conducted by the Minnesota Department of Health (MDH) each afternoon.

Here are the latest updates from March 17, 2020:

6 new confirmed cases, 60 total

MDH announced six new confirmed COVID-19 cases Tuesday, for a total of 60 in Minnesota.

Two of the cases are in Hennepin County, two are in Olmsted, one is in Dakota County and one is in Ramsey. They range in age from 37 to 71 and MDH’s initial investigations indicate they are at home and all had a history of travel to other states.

Three Minnesotans remain hospitalized, one in critical condition.

Infectious Disease Director Kris Ehresmann said with the closing of bars and restaurants and other mitigation strategies, Minnesota is modeling its actions on Singapore, “which includes a great deal of community mediation as well as really thorough and extensive case investigation and contact tracing.”

Updated testing guidelines

MDH announced updated guidelines for COVID-19 testing Tuesday afternoon. Health officials say a limited supply of materials means hospitalized people should be prioritized for COVID-19 tests. Health care workers and those living in close quarters, like long-term care and homeless shelter settings, should also be given priority over regular, healthy patients.

“We have not run out of tests but we are looking ahead and when we look at the availability of the tests we [have] had to limit the testing we are doing to make sure it’s just for the highest risk individuals,” Ehresmann said.


Why these groups?

When someone is hospitalized and tests positive for COVID-19, it has implications for their level of isolation in the hospital, as well as the level of infection prevention that needs to be taken with them. They may also be eligible to participate in clinical trials for antivirals that could treat COVID-19.

Health care workers can spread the infection to other people in medical facilities, so it’s important for them to know whether they are harboring the virus.

At least two Minnesota health care providers have tested positive, per Mukhtar Ibrahim at Sahan Journal: a physician at HCMC in Minneapolis and a nurse at M Health Fairview.

People in congregate settings tend to be at higher risk of severe illness from COVID-19. They also live in close proximity to others who may be at high-risk.

Tracking the spread

One question that came up on the MDH press call was how we’ll know how much COVID-19 is in Minnesota if we’re not testing lots of people. The answer: influenza surveillance.

MDH tracks how many people at sentinel providers throughout Minnesota show up with flu-like symptoms, a category COVID-19 symptoms (generally coughing, fever, shortness of breath) fall into. They also know what share of flu tests come back positive. If flu-like illnesses are going up while flu test positives go down, that would suggest COVID is circulating.

How long COVID-19 is around remains to be seen: it could decline in the summer and ramp up in the fall, Ehresmann said: “We are preparing for that eventuality.”

What to do if you’re sick, relatively OK and can’t get tested

For people who have upper-respiratory symptoms but are managing OK at home, MDH has said to only seek care if you would have sought it based on your symptoms before the COVID-19 outbreak. In terms of testing, Ehresmann said: “Having a positive COVID test for someone who is not hospitalized, who has mild symptoms, is not a magic bullet. It doesn’t inform the treatment because there is no treatment, and it doesn’t change our recommendations for staying home when you’re sick.”

Only people who have severe cases of COVID-19 are eligible to participate in antiviral clinical trials.

People who have acute respiratory symptoms like coughing and shortness of breath, and fever, should self-quarantine for seven days after illness onset or wait three days after their fever has resolved without the aid of medication and respiratory symptoms have improved to circulate in public again — whichever is longer.

People who have COVID-19-like symptoms can’t be tested should stay away from household and intimate contacts as much as they can. These contacts should self-solate for 14 days after being in contact with the sick person and monitor themselves for symptoms.

More from MDH here.

Medical supplies

Some health care providers are reporting they’re running low on personal protective equipment (like masks). Ehresmann says this is a concern for MDH.

“We have reached out on the federal level and put in some requests for assistance related to PPE. There’s also a strategic national stockpile that is available at the federal level that will be made available to states, so we’re looking at how that can be utilized, but certainly the use of PPE is very important for our health care providers so we’re making every effort that they have access for it and it’s prioritized for them,” she said.

Could things get worse?

Reporters put the question to Ehresmann on the press briefing. She said they could.

“Yes, absolutely we anticipate that the situation could get worse and we want to be prepared so that we can test hospitalized individuals but it really, what happens next really depends to a large extent on the behavior of Minnesotans. Certainly the governor has made decisions and enacted things that limit people’s opportunity for exposure but ultimately it’s Minenstoans themselves that need to comply with that, and need to stay home if they’re sick and that’s what’s going to make a difference in our ability to tamp down the spread of COVID-19.”

Bar and restaurant, etc. restrictions

Infectious Disease Director Kris Ehresmann
MinnPost photo by Peter Callaghan
Infectious Disease Director Kris Ehresmann
On Monday, Gov. Tim Walz issued an executive order closing bars, restaurants and other public places (you can still get takeout). In a phone call with MinnPost, Ehresmann said MDH will evaluate how things go in Minnesota with the closures over the next week-plus they’re in place.

“Clearly that is a community mitigation strategy that has many consequences so we’re going to be evaluating where we’re at and providing the governor with that information and he’ll be able to determine if that’s something that needs to continue or not,” she said. “Some of the studies have said you do these strategies and then you stop them and you may see a rebound in cases, so we’re trying to weigh all the information there is, it’s definitely an imperfect situation but the intent is to evaluate where we’re at in Minnesota over the next week or so and that will help to inform the decision.”

Twin Cities restaurants looking for help helping

Second Harvest Heartland is teaming up with Twin Cities restaurants to feed community members in need during the coronavirus outbreak. Chowgirls Killer Catering, Restaurant Alma and the Bachelor Farmer are donating their kitchens, food and/or staff to the effort. Called “Minnesota’s Central Kitchen,” the partners will prepare food for takeout and get it delivered to hunger relief programs. Second Harvest noted it’s looking for other restaurants interested in participating.

Mall of America closing for COVID

The Mega Mall is closing from 5 p.m. Tuesday through at least March 31, per a statement.

In MinnPost today:

MDH’s coronavirus website: https://www.health.state.mn.us/diseases/coronavirus/index.html

Hotline, 7 a.m. to 7 p.m.: 651-201-3920

Comments (5)

  1. Submitted by Henk Tobias on 03/18/2020 - 08:22 am.

    The fact that we don’t have test kits for this virus, three months in, is a national disgrace. So. Korea is testing 10s of thousands of people a day and we are limiting testing? We aren’t as savvy as So Korea, really? Without testing, people are walking around maybe contagious maybe not, we just don’t know. We don’t know how many people have it or are spreading it. Its nuts.

    Early on the administration refused to use the World Health Organization’s test kits and decided to develop their own. The one we developed had a huge false positive rate, 48% I heard, basically it didn’t work. Once they got it working they sent a large number of incomplete tests to California so those tests were useless.

    Despite giving himself a 10 out of 10, reality dictates that the Administration’s handling of this has been a total disaster. So while So. Korea, who kept their Governmental Pandemic Response Unit in place after H1N1, this admin disbanded ours, is seeing the number of cases go down, we are looking like we’re going to be Italy in a couple weeks. Right now over 300 people a day are dying in Italy.

    • Submitted by Bob Barnes on 03/18/2020 - 03:05 pm.

      It’s complicated. For one, private businesses in the US were not allowed to make tests without first registering with the FDA then getting FDA approval on the tests (that’s an Obama admin change that Trump finally got rid of). Secondly, it’s been reported by medical personnel that the tests offered early on had very poor results (up to 48% false negatives). Those tests would have made things worse because people would have wrongly thought they were negative and wouldn’t have taken precautions.

      The tests are really only useful for gathering data on infection rates etc. If you test positive they just send you home to get better like they do for the flu. There is nothing they can give you to cure you. For those with a severe case they need hospitalization anyway so the test only confirms that they have it. And since we are now seeing abstracts and data suggesting 85% of those infected never report it means that for most that do get it, they don’t get sick enough to need a doctor.

      The best thing people can do is if they feel sick, stay home and treat the symptoms. They will recover in a few days and go back to their normal routines. For the select few who get a severe case, contact your doctor and go to the hospital if necessary. We are seeing effective treatments from all over the world that are greatly reducing the viral load and lowering the severity of the illness.

      • Submitted by Donna Saggia on 03/19/2020 - 01:43 pm.

        Actually, testing is critical for at least three reasons:
        1. First responders need to know if they are infected, so they don’t pass the virus to the public. They also need to know if people they are caring for are infected, so the public needs to be tested widely.
        2. Individuals need to know if their symptoms are caused by the virus or some other illness, especially if they are in a high-risk group.
        3. Everyone needs to know the extent of the virus in their communities, their states, and the country. Businesses are closing, workers are being laid off, supplies are flying off the shelves. Without an accurate idea of the extent of the spread, how will we know what actions to take, and when it will be safe to resume normal activities?

  2. Submitted by Bill Davnie on 03/18/2020 - 01:31 pm.

    The world appears to have plenty of COVID-9 testing kits. 500,00 came from Italy to Memphis on Monday. There are many more. There’s good reason to test high-risk people, but without broader surveillance testing we have no grasp of the scope of the pandemic, meaning ‘stay at home’ is the only response, worsening the economic damage. I know this isn’t Minnesota’s fault, exactly, but with Mayo right here, and its new test — what’s the problem? Walz/Klobuchar/etc. – get on the phone to the FDA and get this sorted our!

  3. Submitted by Donna Saggia on 03/19/2020 - 01:40 pm.

    Maybe it’s time for Kris Ehresmann to resign and let someone more capable take her place. A global pandemic is no place to train health care personnel. It’s appalling that Minnesota doesn’t have the equipment — or the labs — to do the amount of testing required by this pandemic. But it is even more appalling that Ehresmann downplays the necessity of testing. Yes, we know that testing doesn’t change the treatment protocol, but it does allow us to determine just how pervasive this virus is in MN. With businesses and schools closing, and people left without jobs and income, we deserve to know the real numbers so we can plan our lives to the best of our ability, rather than being told just to “stay inside.” Without widespread testing, how do we know when the virus has reached its peak or when it will begin to recede? Overall, the MDH doesn’t seem to be doing its job and getting Minnesotans the equipment and testing that, despite Ehresmann’s denials, are absolutely critical.

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