11-6 MN COVID-19 Update from the Minnesota Department of Health

MN COVID-19 Update from the Minnesota Department of Health 11-6-2020

Read the 11-4-2020 COVID-19 Update from the Minnesota Department of Health Here

The Minnesota Department of Health held a conference call on Friday at 2 p.m. to brief members of the media on the latest public health information regarding COVID-19. This is a summary of that call. 

MDH Commissioner Jan Malcolm:

• 9.6 million cases of COVID-19 in the U.S. and over 234,000 total deaths
• 621,000 new cases globally
• In MN, we have new highs in both testing and positive cases.
• It’s our fourth consecutive day of setting a new record for new cases
• We received results on 45,769 lab tests yesterday, with 5,454 new cases in MN. Now 170,307 lab-confirmed cases in MN
• 986 Minnesotans are currently hospitalized, 56 more than the day prior. 
• 212 of those patients are in intensive care units, 15 fewer than the day prior
• Another 36 MN deaths reported yesterday across 20 counties; 13 in the metropolitan area and 23 in greater Minnesota
• Total number of deaths in MN is now at 2,563 
• The weekly change in cases has gone up by just under 16 percent, up from 12 percent the week prior.
• The rate of growth in our cases is double the rate of growth in our testing. These testing volumes are very high but continue to grow, even so, week over week.
• We had 8.3% more tests processed in the past week, up from 7.4% the week prior.
• The seven-day average testing positivity rate has jumped up to 9.8%, up from 7% the week prior.
• This test positivity rate clearly shows that finding more cases is not just a matter of testing more. We are testing a lot more and finding a lot more than we’re testing.
• Since well before the first COVID case was reported in MN, we’ve been working with long term care providers to share information about the COVID threat and what needed to be done in long term care settings to help protect residents and workers
• The reason for this focus has certainly been born out by the course of this epidemic. Residents of long-term care facilities include seniors, but as well younger adults living with injuries, etc. Together these are some of the most vulnerable Minnesotans who are contracting severe cases of COVID-19, and dying from it.
• In early May, we stepped up our work by rolling out a Five-Point Plan which focuses on people living in nursing homes and assisted living facilities. This plan has made facilities safer, and has helped to make outbreaks more of an exception than the norm.
• We have a full update on the long term care plan on the MDH website
• Even the best flood walls can fail if the waters rise high enough, and as community transmission has steadily marched upward, we are concerned.
• We know have 66 Minnesota counties with a 14-day county percent positivity rate above our caution threshold of 5%. We know that higher rates of virus transmission in the community increase the risk for all community members, and especially for residents and staff in long-term care facilities.
• We had 1,104 cases among staff and long-term care residents in the last week alone.
• And long-term care facilities, which include group homes, and other type of congregate care facilities, in addition to skilled nursing facilities and assisted-living.
• The last time we had over 1,000 cases in these congregate care facilities in a single week was back in May.
• As cases continue to rise, the residents and staff in these facilities are at serious risk. Even as these facilities continue to take aggressive action to limit infections
• Long-term care facilities, with our assistance, have truly made great efforts to keep the residents and safe. However, their good work cannot completely insulate facilities and residents from the high rate of viral transmission in the communities surrounding them.
• All to often, the virus enters a facility because staff are exposed through their community interactions, likely by other people who don’t even know they have it.
• And as the number of cases in the community continues to increase, it’s increasingly likely that these safeguards will be compromised. And the consequences of this can be grave, and we’re seeing that with an increasing number of hospitalizations among long-term care residents, and sadly, increasing deaths.
• We implore Minnesotans to do their part to slow the spread of COVID in our communities because we can. We’ve made really impressive progress in these high-risk environments in long-term care, but that progress is now at the risk of being undermined, if not undone. Not because of the facilities themselves, but by the communities around them. We need every single Minnesotan in all communities to share our common values, which I believe we do, to prioritize protecting our most vulnerable family members and neighbors. And to ensure that we are not transmitting the virus to long-term care residents and staff.
• We can all do our part and keep up with those core public health prevention principles of attending to distance between people, social distancing a minimum of 6 feet, wearing our masks when we’re in public or in close proximity to people (inside or outside), staying at home when we’re sick, avoiding large gatherings, and getting tested when it’s appropriate to do so.

MDH Health Regulation Director Michelle Larson:

• Providing an update on the five-point plan announced by the Governor in May
• We’ve been working for many months to increase outreach and support our long term care facilities.
• From March to October, the department has helped more than 2,320 facilities helped with their infection control measures.
• Over 435 visits both on-site and remote have been made for infection control and technical assistance.
• All nursing homes in MN have regulatory on-site visits, with a special focus on infection control.
• More details on the five-point plan can be found at health.state.mn.us
• First Point — Expand COVID-19 testing for residents and workers in long-term care facilities.
  • We have developed testing criteria and a process for facilities to request testing services for residents and workers 
  • Testing capacity initially was made possible through the MN National Guard, and has now transitioned to using eight contracted swabbing teams that operate around the state
  • Since April, the state the state emergency operations center has coordinated testing for more than 750 facilities and 170,000 staff and residents.
  • On average, the state emergency operations team swabbed roughly 50 facilities per week.
  • We’ve partnered with laboratories within and outside Minnesota to ensure long-term care facilities have timely access to testing services.
  • By late Oct., at least 40,000 tests were happening each week in long term care.
• Second Point — Provide Testing Support and Troubleshooting to Clear Barriers
  • We’ve created streamlined processes for facilities needing state assistance to get testing resources and support, and we’ve established a standing physician order ready for long-term care facilities that do not have a medical director so that facilities can order their RT PCR Tests more easily.
  • We’ve started a nurse triage line for those facilities using a state-provided ordering physician. The triage line provides COVID-19 test results to facilities and individuals, and advises them on potential next steps, after receiving test results.
  • We continue to provide extensive guidance, education and technical assistance to facilities to implement new state and federal requirements for testing to understand how to access and when to use new testing platforms, such as antigen and saliva. And to address barriers that arise to facilities conducting testing.
• Point Three — Get PPE to facilities when needed
  • We’ve pushed out personal protective equipment to long-term care facilities in waves, starting in April.
  • This included gowns, hundreds of thousands of face masks, and millions of gloves.
  • We’ve provided testing to health care coalitions to support long-term care facilities with testing for N-95 respirators, and we’ve provided caches of personal protective equipment to health care coalitions from the state warehouse to support long-term care facilities with PPE needs.
• Point Four — Ensure Adequate Staffing Levels for even the Hardest-Hit Facilities
  • Created a crisis-staff management team to give technical assistance to facilities. Crisis staff managers are available to address issues and connect facilities to staffing resources.
  • At-risk facilities are identified through a special ranking and prioritization process. Outreach and education was provided to facilities to aid in development of contingency, as well as crisis staffing plan prior to the occurrence of a crisis.
  • Launched a process to deploy National Guard and federal staffing support teams to facilities in staffing crisis.
  • Over the last four weeks, these teams have assisted seven facilities.
  • We’ve partnered with the Dept. of Human Services and Development on a staffing pool implementation and provided assistance with a triage process to facilitate services to those eligible.
  • We’ve worked with Dept. of Human Services and our Dept. of Economic and Employee Development to help grow the pool of employees available in the staffing pool.
  • Notice of the work opportunity was distributed to nearly 80,000 unemployment insurance recipients targeting the hospitality and health care industry.
  • A media campaign highlighted the need and amplified the message statewide
• Fifth Point — Leverage our Partnerships to Better Apply their Skills and Talents
  • We are working with the statewide regional health care coalitions. This includes local public health, hospitals, health care systems, emergency medical services, and emergency managers.
  • this partnership is really important because health care coalitions serve as a centralized regional response organization to ensure effective coordination among local and state partners, transparent and frequent communication and fulfillment of resource requests. 
  • To varying degrees across the state, local public health has provided outreach to, consultation with, and support for their long-term care partners by providing support with testing and staffing, facilitating connections between long term care and health care coalitions, and offering infection control consultation to long-term care facilities.
• Update on Visitation guidance:
  • In addition to the challenge of protecting residents and workers from COVID,  the state has worked hard to protect residents’ mental, emotional, and social well-being by keeping them connected with family and friends. 
  • In July, MN was one of the first states to roll out an essential caregiver program, understanding the toll prolonged separation of the visitor restrictions were having on residents’ overall health and well-being.
  • This guidance allows family members and other close outside caregivers to provide care and companionship to residents in person.
  • In Aug., Minnesota rolled out broader visitation guidance to allow for more visitation, which was further revised and updated in October.
  • The results of this in trying to balance emotional well-being and infection control continues to be a priority for us as we see an explosion of COVID-19 in the communities surrounding our long-term care facilities.
  • While the state as a whole saw new cases skyrocket by 73% from the beginning of September to the end of October, new cases in long-term care facilities increased 15 percent at that same time period.
  • As of Nov. 3, our data shows that 8% of Minnesota’s 368 nursing home have never had a reported COVID-19 case
  • Fifty-three percent of Minnesota’s nursing homes currently have an active outbreak (meaning that they’ve had a case in the past 14 days).
  • Only 10% of Minnesota’s assisted living facilities currently have an active outbreak
  • Of Minnesota’s 1,692 assisted living facilities, 60% have never had a reported case.
  • The number of new cases in congregate care facilities, including nursing homes and assisted living facilities, have slowed significantly over the summer, but we are concerned to see that activity has been increasing amid the overall increase in the state.
  • Even one death is too many. Deaths have not reached former peak levels, but they are increasing

Annette Greely, President of Jones-Harrison Residence in Minneapolis:

• Have been doing testing of our Jones-Harrison staff weekly. Almost every week we have one or two positive employees.
• These staff are usually asymptomatic and go home to quarantine for a two-week period.
• We feel testing has been an effective tool to keep COVID out of our buildings
• We also continue to test residents as needed to follow up after our staff results.
• We’re grateful for the relationship our governor and Commissioner Malcolm have created with the labs such as Mayo, to help us be able to test adequately.
• In terms of PPE, we are in a continual state of procuring masks, gloves and gowns
• We’re working on a having an adequate supply in case of another outbreak, knowing we have the support of the MDH and the governor’s team to help with reimbursement of these supplies is a huge relief. 
• We know that even as the virus spreads, and the demands at the MDH have grown, they have always been available and supportive to us.
• As we head into the winter months, we plan on using the same tactics with testing, using proper PPE, and infection control to help keep COVID-19 out of our building.
• The only other tactic we need is the support of citizens of Minnesota to take measures such as social distancing and masks, to help curb the spread and keep our seniors safe; whether in our facility or in home in their own community.
• Regarding visitation, that has been a tricky balance. We started visitations at Jones-Harrison, but we had to suspend it due to a positive staff person. Our assisted living was able to have visitation longer, but that is currently suspended due to a positive staff person.
• We still have visitations over video at our essential caregiver program. And we try to balance, cause we know that our families absolutely need to visit and they need that connection with each other. But we also have a priority of keeping our residents healthy and minimizing our risks to them.
• Lastly, prior to COVID-19, our industry was facing staffing shortages. And today, we estimate there’s still about 10,000 jobs available to help care for seniors in Minnesota.
• We are glad the governor’s team, with DEED, is working to help educate people on this great career area in health care.
• During this time, I would encourage anyone looking to make a career change to look into caring for seniors in a variety of settings. Our seniors would love to meet you, and you would love knowing that they want to see you. You would make a difference in someone’s life.

Additional Notes from Today’s Media Briefing:

• Hospitals have been running full all summer and fall. The added COVID-19 cases are putting hospitals close to capacity
• Health systems are working closely together. It’s an unprecedented level of collaboration and data-sharing.
• We’re hoping that we won’t have to dial-back. “If Minnesotans were following the guidance that currently exists, we wouldn’t need the dial backs,” according to MDH Commissioner Jan Malcolm.
• Does the state have a plan to recruit other staff, or will individual hospital systems have to do that? Malcolm says MDH will look at how to think creatively about ways to providing staffing.
• Malcolm says dial-backs have always been part of the discussion. But if people aren’t following the current rules, what additional rules could be put in place that people would actually adhere to? “It’s a very active conversation.”
• Despite our growth and testing capacity, we still have more demand. Getting the tests available to people, and getting them to take the tests, are part of what we’re doing. We will continue to push on expanding testing availability and on diversifying the type of testing we have available, according to Malcolm.

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