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Former CMS head Slavitt: Minnesota can have its economy back — if it stays ‘hyper-vigilant’

During an appearance before a special select committee of the Minnesota House of Representatives Wednesday, the former acting director of the Centers for Medicare and Medicaid Services offered some hope for battling coronavirus. 

Former acting director of the Centers for Medicare and Medicaid Services Andy Slavitt
Former acting director of the Centers for Medicare and Medicaid Services Andy Slavitt spoke to a special select committee of the Minnesota House of Representatives Wednesday.

Andy Slavitt, one of the country’s most prominent voices on the battle with COVID-19, felt it was time for some good news.

From the start of the pandemic, Slavitt has been one of those saying the virus is more dangerous than some people think, and he often compares the needed response to fighting a war. He has said that elected officials should “risk the wrath of overreacting because that’s far preferable to risking the wrath of under-reacting.”

But during an appearance before a special select committee of the Minnesota House of Representatives Wednesday, the former acting director of the Centers for Medicare and Medicaid Services told members that there is hope for battling the virus … if the state is smart and vigilant.

“The good news is that with all the time I’ve spent with leaders around the country, with scientists, with epidemiologists, that with the right strategy and the right approach, we can get through this virus. We can live with this virus and we can indeed have our economy back,” Slavitt told the House’s Select Committee on Minnesota’s Pandemic Response and Rebuilding, which is chaired by House Speaker Melissa Hortman.

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Slavitt is an MBA with expertise in health management and currently serves as the board chair of United States of Care. He said he is encouraged because of the way the virus has been “tamed” in other countries, and because of how some states are doing in battling the pandemic.

What they have in common, he said, is “treating this as an attack on the population, taking it seriously, communicating often.” Those doing well have a clear plan that is science based and has been adjusted as facts change. They also exhibit a willingness to make short-term sacrifices for long-term success.

New cases “will be part of life,” he said, but how they are contained is the difference between what he termed “raging forest fires” or “small embers that we can put out.” That means adequate testing, the ability to isolate people and tracing those the infected have been in contact with.

“It means hyper-vigilance,” Slavitt told the committee. “It means not dismissing new cases as, ‘Oh, that’s just 1,000 new cases or those are just young people’ because with an asymptomatic-spreading disease, every case needs to be contained.”

He said he thinks governors in states like Arizona and Texas wish now they had reopened more slowly because of recent surges in cases and hospitalizations. On May 1, for example, Arizona had 8,000 COVID-19 cases while Minnesota had 6,000 cases. Now, Arizona has 100,000 cases and Minnesota has 38,000 cases. “I know it tried people’s patience because they wanted their lives back. I get that,” Slavitt said of Minnesota response regarding the pace of closures and reopening. “But the benefit is enormous.” 

Slavitt also warned that the infection rates could get worse in Minnesota. “I know people feel as though it has been bad here, but I don’t think we’ve seen anything yet,” he said. “We have time. We need to act and we need to stay urgent and we need to stay vigilant.”

Because of improvements in treatment techniques and development of drugs, survival rates of those who get COVID-19 are getting much better, he said. Even the use of ventilators, once a sign that a patient was likely to die, are being better employed or not used at all in order to produce better outcomes. “You have been giving your scientists time and they have made really good use of it,” he said.

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Slavitt also endorsed a mask mandate, something other states and some cities in Minnesota have imposed, but that Gov. Tim Walz has only said he is considering. “The problem with this virus is it does its worst damage when nobody sees it. It’s in the two to three weeks that you think you’re doing fine that it actually moves across the population,” he said.

He said wearing a mask not only slows infection rates, it is a sign of respect for the people who are required to work in jobs that involve contact with the public. “Do it for them,” he said. “Do it for their families. I can tell you in talking to a number of them that when someone comes in without a mask it feels very disrespectful. If someone is forced to see my face, the least I can do is put a mask on.”

But he acknowledged the political implications of a mask mandate. “I understand that people don’t like to be told what to do,” he said.

And while polling reveals that the majority of Americans favor wearing masks, there are vocal minorities that should be listened to. “Texas, which is a state that is culturally least likely to put in a mandate, realized that even with all the best intentions a mandate just makes it easier because it just takes the issue off the table.”

In response to questions from Hortman and Rep. Pat Garofalo, R-Farmington, Slavitt agreed that school reopenings should be done on a local district basis, guided by best practices by state and federal health agencies. Some research is showing that children are not as infectious and may not be infecting the adults they come in contact with. But it is far from conclusive. And while children haven’t suffered the worst outcomes, teachers and staff are older and some have underlying health conditions.

“The right thing to do is have them in school. We all want that,” he said. “We have to understand we’re going to have a suboptimal school year where everyone doesn’t get what they want.”

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The committee also heard some statistics from the head of Hennepin Healthcare System on racial disparities in the impact of the virus. Chief Executive Officer Jennifer DeCubellis said that the system has done 30,000 COVID-19 tests with 4,300 of those positive tests. Of those testing positive, half are in non-English speaking people, 42 percent are from the Latinx community with Latinx people representing 28 percent of the hospitalizations.

In addition, one-third of positive patients are Black or African born and they make up 38 percent of hospitalizations. Native Americans make up 14 percent of hospitalizations. Of the patients receiving the drug treatment Remdesivir, nearly 75% have been Black or Latinx. 

“As one of the largest facilities seeing COVID-19 patients, the disproportionality of whom we’re seeing, who need that ICU and acute care capacity has been eye opening,” she said.