5-11-2020 COVID-19 Update from the MN Department of Health

Minnesota Department of Health COVID-19 Update 5-11-2020

Read the COVID-19 Update for 5-8-2020 MN Governor Walz and the Minnesota Department of Health Here

On Monday, May 11, the Minnesota Department of Health held a conference call to brief members of the media on the latest public health information regarding COVID-19.

This is the summary of that media briefing.

Update from MDH Commissioner Jan Malcolm:

• COVID-19 global totals: 4.1 million cases, and 283,000 deaths
• In the U.S., 1.33 million cases and 79,500 deaths
• In Minnesota, the statewide case count is 11,799, and the death total is 591
• The median age of infected people is 44.1 years old, evenly split between male and female 
• We are still at 9 days for the doubling rate of total confirmed cases in Minnesota
• There are 452 patients in the hospital and 194 in intensive care 
• The third version of the updated model will be coming out this week. It incorporates new factors and updated data. 
• Test volume — 4,700 tests processed by labs that reported on Sunday. We anticipate that number continue to grow as we get into this week.
• People who are experiencing any symptoms of COVID-19 can and should be getting tested now that we have that testing capacity.
• The seven counties with food processing plants account for a third of the new cases reported yesterday 

Update from MDH State Epidemiologist Ruth Lynfield:

• Remdesivir is an antiviral medication and the FDA issued an emergency use authorization of Remdesivir for treating COVID-19 on May 1. 
• This drug offers a treatment option for people with severe COVID-19 infections and preliminary data found that it reduces the time it takes for patients to recover. 
• According to the National Institutes of Health, a large study recently showed that people receiving the drug were able to be discharged from the hospital after 11 days on average, compared to 15 days for the placebo group
• Minnesota received a small initial shipment of Remdesivir this weekend from the federal government. It came in on Saturday and the MDH distributed it Saturday night and Sunday morning.
• MDH allocated it to health care facilities for the treatment of people hospitalized with severe COVID-19 cases.
• MDH worked with infectious disease physicians, critical care physicians and the ethics group (the MN COVID-19 Ethics Collaborative); to come up with the guidance. That information is posted on the MDH website along with an info sheet about Remdesivir, and the MDH has also posted a link to the emergency use authorization from the FDA.
• MDH expects to get an additional allotment of Remdesivir tomorrow
• MDH is making this allocation with the idea of maximizing the number of lives saved, taking into account both risk and expectation of benefits.

Update from MDH Infectious Disease Division Director Kris Ehresmann:

• Case investigations — they’re really a core element of a public health response to an outbreak of an infectious disease 
• MDH uses this tool with a number of different outbreaks (such as the 2017 measles outbreak)
• What MDH does is, they interview someone who’s ill and learn about their illness. The MDN also gets information about settings where they may have spent time, and individuals with whom they may have had close contact.
• This is a tool to find out whether there’s any high risk or vulnerable populations who may have been exposed to the illness. For instance, was that individual a health care worker?
• A response involves “person, place and time” to fully understand an outbreak
• Challenges with this outbreak: We’re still learning about COVID-19. When MDH first started doing COVID-19 investigations, they were looking at settings and potential exposures from the date of a person’s onset of symptoms. As the MDH has learned more about COVID and found out that people could spread it prior to developing symptoms. Now, the MDH is looking at the 48 hours prior to the onset of symptoms.
• Another challenge: MDH has had to reach out to people for whom English is a second language, so the challenge of finding case investigators who can communicate in the language they’re most comfortable is a big one
• MDH has ramped up case investigator employees — goal of having 460 new case investigators on-boarded by the end of this week to help with the increase in the number of cases.
• The MDH approach to case investigation is evolving. Right now, the MDH contacts positive cases when they’re reported to them. 
• As the testing ramps up, we anticipate that there will be many, many more positive cases identified and we want to make sure we’re doing outreach before an individual receives their test results. MDH is now evaluating a model that would contact high risk cases when they’re being tested, in addition to all the positive cases. So in other words, the MDH would not wait until they receive test results. 
• One of the important elements of this, however, is we need Minnesotans to participate in these interviews 
• There have been cases where people don’t accept our calls or return our calls. In order for our work to be effective, we need people to be responsive when we reach out to them. 
• While all of this is happening, children still need to do their wellness visits. We have seen a decline in the administration of recommended vaccines for children. So it’s a reminder that even as parents are addressing COVID in the community and working with a lack of child care, the MDH wants to make sure that parents are keeping their children up to date with their vaccinations.
• As social distancing requirements are relaxed, children who are not protected by vaccines should get those vaccines so they’re not vulnerable to diseases like measles. 
• Dental offices — they are allowed to resume elective care as of today, but prioritize patient needs based on staffing and availability of PPE. Urgent needs at dental offices will be given priority. 

Additional notes from briefing:

• Malcolm asked about recent case trends, which have been down the past couple of days after being in the 700s late last week. “It’s too early to declare it a new trend,” she says. Ehresmann says tests last week were heavy in areas where virus was known to be spreading.
• When asked about when people not showing symptoms can get tested, Commissioner Malcolm said Minnesota would be focused on the “best uses” of testing technology. “There are times and ways in which testing would be not helpful. If just anybody who wants a test comes to get a test, it’s frankly not gonna tell you much, depending on the quality of the test, the accuracy of the test. Even if it’s a great test, you can test negative one day and positive the next.” Malcolm went on to say, “I don’t foresee a time in which anyone, whether they have any symptoms or not, just come on and get tested with a PCR test because it’s not gonna be that valuable.” Although for people in congregate care settings, there should be a low threshold used over what symptoms should call for a test. Ehresmann added that Minnesota has many facilities where the MDH wants to do testing, as it relates to the governor’s five-point plan for long-term care. The state is working on operationalizing that, and it will use a large number of tests.
• Ehresmann said we’re still seeing cases in manufacturing and food processing plants across the state. In many of those facilities, there has been testing of all employees, but the first bit of guidance is that they do aggressive and robust employee screening prior to them entering the facility. MDH encourages robust screening and testing of any employee with any symptoms.
• Remdesivir — on Saturday the MDH received 1,200 vials. Those with the highest priority would receive it, such as those who were laboratory confirmed, who are not already on Remdesivir, people who were on ventilators for five days or less, etc. Tomorrow Minnesota is expecting another 400 vials which would be enough for 36 patients. 

Current status of MN Governor’s safety dials to reopen the state:

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