5-12-2020 COVID-19 Update from the MN Department of Health

Minnesota Department of Health COVID-19 Update 5-12-2020

Read the COVID-19 Update for 5-11-2020 from the Minnesota Department of Health Here

On Tuesday, May 12, the Minnesota Department of Health held a conference call to brief members of the media on the latest public health information regarding COVID-19. 

The following is a summary of that conference call.

Update from MDH Commissioner Jan Malcolm:

• Global COVID-19 Cases 4.2 million cases and 286,000 deaths
• In the U.S., there are 1.34 million cases and 80,600 deaths
• In Minnesota, 12,494 cases and 614 deaths
• Minnesota now has a 10-day case doubling rate 
• 496 patients currently hospitalized and 199 in intensive care
• We hit the 5,000 mark in testing yesterday. We hope that number will continue to rise now that we have additional capacity. People with symptoms of COVID-19 can and should be getting tested. 
• We have benefited from a supply of Remdesivir that was distributed by the federal government. 
• Progress report on ramping up long-term care plan announced by the governor last week — the comprehensive approach involved five key pillars:
  • expanded testing protocol
  • creating logistical support to help facilities activate that enhanced testing when they can’t do it on their own
  • enhancing our support for infection prevention in those facilities and working with those facilities to make sure they have preparedness plans
  • Pushing for procurement of PPE supplies
  • Doing everything to help those facilities with adequate staffing 
• The plan is clear in its goals, but the plan now needs to be implemented and that takes some time. 
• The plan is a high priority for the MDH and the state emergency operations center 
• Received calls that the plan is not in place yet in the facilities where they work or where they have loved-ones 
• Malcolm says it will take weeks before the plan is implemented statewide

COVID-19 Update from MDH Infectious Disease Division Director Kris Ehresmann:

• MDH will be making updates to their website regarding COVID-19 statistics 
• Making updates to the situation update page tomorrow
• At the top of the page there will be a box highlighting the overall cumulative case count for the state as well as information on new cases and new deaths being reported that day. This information has been on the site, but it will now be at the top of the page to make it easier to find at a glance.
• The data on new cases for the day will also include a note when cases have fallen off the list. For example, all data are preliminary and may change as case investigations progress. Sometimes during case interviews, investigators find out that information initially received needs to change, such as discovering a person who tested positive in Minnesota actually lives in a different state. Or, a test turned out to be a false positive or a duplicate record. This data quality assurance is important to make sure the final counts are as accurate as can be.
• During any outbreak situation, cases can come off the overall count when new information is discovered, so this isn’t something new. It’s just that the MDH is providing data on a daily basis, and very quickly. So MDH doesn’t have the luxury of saying “these are the numbers from 2019 or 2020.” MDH is reporting things as it’s happening, and as a result, they will let people know if there’s a change in the count based on the new information they receive.
• Since the beginning of the outbreak, just under 70 cases have come off the total.
• MDH will also add details about newly-reported deaths on the website. The details include county, age group, and residence type. Whether they lived in a long-term care facility, a private residence or another setting. 
• MDH will also update information they provide on specimen collection date instead of reported date. So what that means is, for their graph that shows the total positive cases over time, the MDH has been displaying this graph based on the date that the case was confirmed at MDH. They’re going to make a change, and that graph will now show cases by the date their specimen was collected. That’s the specimen that was tested and determined that they were positive for COVID-19. Using the date that a specimen was collected is a measure that’s more relevant to each case, and is in line with how other disease data is reported. It gives the MDH a better picture of what’s happening in Minnesota over time. Reporting cases this way removes the factor of reporting delays. In other words, for some out of state laboratories, it can take up to a week to get results. So it removes the factor of reporting delays and investigation timing, and more accurately reports when people in Minnesota have COVID. This does not change the MDH’s total case count, just the day that the case shows up on the graph.
• If, for example, the MDH confirmed a case on May 5 that actually had its specimen collected on May 1, that case would now move from showing up on May 5 to May 1 in this new graph.
• MDH will also make some changes to data related to release from isolation. “We know that there was some confusion related to the patients’ release from isolation measure, this number includes people who no longer need to be isolated, meaning they were sick and are now not considered to be infectious.” This number also includes deaths. The new image on the website will better indicate these two things.  
• MDH will also include information on probable deaths. Deaths reported on the website includes deaths for those who have died from COVID-19. We know they had COVID-19 because there was a positive test result to confirm this. There have been some instances where a death certificate lists COVID-19 as the cause of death, but the MDH does not have a positive lab test to confirm this. Those deaths are now being counted as “probable COVID-19 deaths.” And this number will be listed separately on the website. Since there is not a positive lab test to confirm these probable deaths, this number is not included in our total positive case count. 
• The other item that the MDH will be starting on Thursday is a weekly data report that will include some additional information for Minnesota cases that will be updated on a weekly basis. Some of the information in the report includes more demographic information, data on reported symptoms, and more information on cases among health care workers.
• The MDH acknowledges that their ability to test has just recently increased, so the numbers do not represent the total number of people in Minnesota who have or at some point, had, COVID-19.
• The positive cases are just the tip of the iceberg. The MDH will continue to track and analyze data as they do with other diseases and use that information to teach more about COVID-19 and its impact on the people of Minnesota. 

Additional notes from today’s conference call:

• Ehresmann says there was targeted testing in Nobles County and Stearns County related to processing plants, and the MDH is seeing increases in Kandiyohi and Chippewa Counties for the same reason.
• Commissioner Malcolm would not confirm when the Governor would make an update on the stay at home order. She referred a reporter to the governor’s office.
• Malcolm said that as we start to see more interactions in the community, more contacts among people, it’s quite natural to expect that with as little exposure as we think the population has had so far to the pathogen, that we will see increased cases as that happens. “Our whole goal is to make sure that happens in a way that is measured and the health care system is prepared to respond to.”
• MDH is monitoring the inflammatory disease that is popping up in children, which is potentially linked to COVID-19. “It’s an extremely rare complication” and MN is setting up surveillance to monitor for this, according to Ehresmann. 
• In terms of testing, the guidance the MDH has given to all providers is to be testing all symptomatic individuals. There shouldn’t be any confusion about what the guidance from MDH is. Malcolm says that some providers will not be able to test a person on a given day for various reasons, but ideally they would be helping to refer that person to a site where they could be tested. MDH apologies for the frustrations people face if they’re having trouble getting connected to a test. But the criteria is still that a person must have symptoms. Sometimes people wonder, “why is that important?” It is certainly possible that if somebody is asymptomatic, they could get the test and be shown to be negative because they don’t have enough detectable virus yet. So there’s a clinical reason why waiting to test until you’re symptomatic makes sense. It isn’t just a matter of conserving resources, it’s also considered best practice in terms of the accuracy of the results. 
• The MDH is looking at outreach strategies to make sure vulnerable populations, such as those in high-rise apartments or public housing, can get tested.
• Health Care systems have, so far, taken the lead on putting up drive-through testing systems in places where they have patient populations or where their own data suggests to them that there is a demand. The MDH has not, to this point, set up drive-through testing, although Malcolm said they might consider doing so at some point. 

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