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Should Minnesota be doing more to slow the spread of COVID-19 in the state?

Minnesota let many of its COVID-19 mitigation measures lapse over the summer. Is it time to bring them back?

Gov. Tim Walz shown touring a vaccine clinic at the Mall of America on November 3.
Gov. Tim Walz shown touring a vaccine clinic at the Mall of America on November 3.
MinnPost photo by Peter Callaghan

Heading into Thanksgiving, Minnesota remains a COVID-19 hotspot relative to other U.S. states. Even as other states begin to see the end of a fall swell, case rates here remain high and intensive care hospitalizations due to the virus are at levels not seen since last December.

Amid the ongoing surge, some are suggesting Gov. Tim Walz reinstate COVID-19 mitigation measures, such as a mask mandate or restrictions on large gatherings.

Asked about it during a press call during an overseas trip last week, Walz demurred, saying he didn’t think pursuing such strategies — some of which could require him to declare a politically polarizing peacetime emergency — would be particularly effective.

“If I believed I could declare a peacetime emergency and save a life by doing it, I would certainly do it,” he said, arguing mandates were effective pre-vaccine, but that they come with political and public costs.

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“The data doesn’t seem to support that that tool would mitigate where we’re at right now,” he said.

Minnesota, like many states, let most of its COVID-19 reduction measures lapse over the summer. But would reinstating them, as Walz said, really make no difference in the state’s current surge?

What measures Minnesota has in place

For many months, Minnesota has been without any statewide COVID-19 mitigation measures that affect the entire population, like the mask mandate and the capacity restrictions on events and businesses that marked much of the earlier pandemic.

Minnesota’s COVID-19 mask mandate ended on May 14. Federal guidelines still require masks in some settings, such as transportation facilities, including airports, airplanes and public transit. Additionally the Centers for Disease Control still recommend masks for unvaccinated people in indoor public settings and suggest them for vaccinated people in places where COVID-19 transmission rates are high.

Restrictions on the size of crowds that can gather at events like concerts and sports ended over the summer.

The state of Minnesota does require state workers to be vaccinated against COVID-19 or be tested regularly. They are also required under federal mandate for many health care workers and individually by many employers. Federal OSHA regulations that would require employers with 100 or more workers to require vaccines or regular testing is currently halted from being enforced.

What other states are doing

Minnesota wasn’t alone in relaxing its pandemic restrictions this year. Over the summer, as case levels dropped, states started to unwind their COVID-19 mitigation strategies, said Jennifer Tolbert, the director of state health reform at the Henry J. Kaiser Family Foundation, which is keeping track of state COVID-19 policies.

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Currently, nine states have some kind of statewide mask order in place, according to the Kaiser Family Foundation. Four — including California, Nevada, Connecticut and New York — only require them for unvaccinated people. Oregon has the broadest mask mandate, requiring masks for everyone in both indoor and outdoor public spaces where physical distancing isn’t possible. Four states, including Washington, Illinois, Hawaii and New Mexico, require masks for everyone indoors.

What these states that have some form of mask requirement have in common is that, in most cases, their mask requirements were not rescinded over the summer, Tolbert said, though they were tweaked in some cases.

“We have not seen really many states re-adopt these statewide masked mandates,” Tolbert said. Two exceptions are Louisiana, where a mask mandate was reinstated during a surge, and Oregon. Some localities have also instituted their own mask requirements, while others are banned from doing so under their states’ laws.

When it comes to vaccine mandates, Tolbert said 22 states have some sort of one in place, whether for state, health care, school or large event attendees.

According to the Kaiser Family Foundation, Minnesota is one of 19 states and the District of Columbia that has some COVID-19 vaccine requirement for state employees. Fifteen states require vaccinations for at least some health care workers, while 10 require them for school workers. Four states have had some requirement that attendees of large events be vaccinated against COVID-19.

Do these things work?

Different states have taken different tacks when it comes to COVID-19 mitigation strategies. As Minnesota continues to see a surge in cases, a natural question to ask is whether, at this point in the pandemic, the strategies used in some states to slow COVID-19 spread continue to be effective.

That’s a complicated question without any clear-cut answers, said Ryan Demmer, an epidemiologist and associate professor in the  division of epidemiology and community health at the University of Minnesota’s School of Public Health.

Big-picture, we know that vaccines and masks are both effective tools for slowing the spread of COVID-19.

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“We know that wearing masks [is] effective, and therefore anything that gets more people wearing a mask is going to have some level of effectiveness as well. But the degree of effectiveness can really vary a great deal based on a number of complex factors,” Demmer said.

But sometimes whether these things work or not comes secondary to whether people comply — and furthermore, who complies.

Since vaccines became widely available, COVID-19 has shifted to becoming more of a problem for the unvaccinated, who are hospitalized and die of COVID-19 at much higher rates than vaccinated people, Tolbert said.

“So I think there is a compliance issue — you can impose a statewide mask mandate but if the only people who are wearing the masks are people who are already vaccinated, that is certainly going to help control any breakthrough infections, but it may not do a whole lot to control overall spread,” Tolbert said.

Given the ever-increasing number of people who have some protection from COVID-19 through vaccination or prior infection, plus who is likely to comply with restrictions and who isn’t, the number of people who can potentially benefit from broad COVID-19 mitigation strategies is also likely shrinking, Demmer said. Vaccine mandates can be effective at getting more people vaccinated, but they are often unpopular.

Demmer said leaders seem to be weighing these issues at this point in the pandemic. “I guess they’re thinking [the] best way to strike that balance is to not invoke broad-scale mandates on things like masking at this particular moment,” he said.

For the average person who isn’t immunocompromised or at high risk of severe COVID-19 complications, the good news is it’s much easier to protect yourself than it was a year ago, Demmer said.

“For people who want to keep themselves safe, they can do a lot by getting vaccinated, wearing an N95 and somewhat limiting where they go and what they do,” Demmer said. “Their risk of a bad COVID outcome, big picture, is probably much lower than their risk of bad outcomes from other normal daily activities, like driving.”

Peter Callaghan contributed to this report.