5-26-2020 COVID-19 Update from the MN Department of Health

Minnesota Department of Health COVID-19 Update 5-26-2020

Read the 5-22-2020 COVID-19 Update from MN Governor Walz and the Minnesota Department of Health Here

On Tuesday, May 26, 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 a summary of that call.

Update from MDH Commissioner Jan Malcolm:

• Globally, 5.54 million cases of COVID-19 and 346,000 deaths
• In the U.S., 1.6 million cases and 98,000 deaths
• In Minnesota, 21,960 cases (650 more cases from the previous day), and 899 deaths (an increase of 18 deaths from the previous day)
• 15 of the 18 deaths were people who resided in long-term care facilities.
• Minnesota’s doubling rate for COVID-19 is 16 days 
• The median age of cases is 42 years old. There’s a common perception that this is an illness that only affects the elderly, but that is certainly not the case. The elderly and people with underlying health conditions are at significantly higher risk for severe disease, it’s important to note that 17% of all cases are people in their 20s, and 20% are between the ages of 30-39.
• 570 patients in the hospital, 258 of those in long-term care
• Hospitalization in the ICU units has continued to increase by a significant degree.
• Testing volume continues to grow — 5,800 tests completed on Memorial Day. Almost 8,500 tests on Saturday and over 6,100 on Sunday. 
• Free testing at six National Guard armory locations were a big reason for the increased testing volume. The guard provided 10,000 tests at those six sites.
• Even people without symptoms were given the COVID-19 tests from the National Guard.
• The National Guard testing operation was a “very successful initiative” and came with a lot of really hard work. MDH plans to review the lessons learned and see what data they’re able to get from the initiative. Communication will come in the coming days on how the MDH plans to do more of this mobile community-based testing around the state. 
• Minnesota’s health plans will extend the agreements that were previously reached with the departments of commerce and health to waive co-pays for COVID-19 testing and hospitalization. Most health plans will wave co-pays through Sept. 30. The original expiration date was June 1. 
• $97.6 million in MDH emergency health care grants awarded to nearly 360 provider organizations across MN to support their preparation and response to the COVID-19 pandemic. About half of the funds went to organizations for additional staffing costs. The rest of the money went toward purchase of supplies such as PPE.
• Providers can also use the money to establish temporary sites to provide testing or treatment services, to expand the number of beds available for COVID-19 treatment, to isolate affected patients or staff, and to support emergency transportation.
• The money can also fund temporary IT support for triage screening and telemedicine. 
• With this round of funding, MDH prioritized assisted living facilities, health care systems, hospitals, emergency medical transport, and primary care clinics. The goal is to prepare these providers for caring for COVID-19 patients and for preparing for the ongoing rise in cases. 
• Also prioritized funding smaller providers in the metro and greater MN, because larger systems are benefiting from federal funding.
• In addition to those grants, there are funds left in this fund. The state invested $200 million for this grant program. The money will be granted in waves to fund needs that might emerge later in the pandemic. The application process is an ongoing one.
• Organizations should submit an application as soon as they can.
• More grants will be announced in the coming weeks.
• The legislature also awarded $50 million to help providers fight COVID-19. This money was awarded in April.

Update from MDH Infectious Disease Division Director Kris Ehresmann:

• Jump in ICU bed use over the weekend
• Minnesota had its largest single-day increase of 41 for COVID-specific ICU bed use from Sunday to Monday. The next highest increase was 25 back on May 16.
• Some hospitals are at or near ICU capacity at the end of last week. In addition, MDH has heard of isolated staffing concerns.
• This level of ICU use has not been unexpected. MDH tracks COVID-specific admissions, as well as overall hospital, medial, surgical, ICU and ventilator availability. 
• This past weekend, 87% of the ICU beds in the metro was being used. Other regions of the state had more availability. 
• For comparison, it isn’t unusual for ICU beds to be 95% full during flu season. That said, MDH is keeping a close eye on this, and they’re in contact with hospital leadership to address issues as they arise.

Additional notes from the conference call:

• The University of Minnesota model suggests that there could have been 1,400-2,000 deaths by the end of May. We are nowhere near that number. Malcolm said the real number is more conservative than what had been projected. She said it’s not unexpected and it’s good news. “We certainly would rather have the model be not overly optimistic but get more precise as time goes on with more Minnesota data.” People shouldn’t think that the model is what is  determining the governor’s policy decisions. The model helps the MDH understand and quantify the degree to which more ICU capacity was important for minimizing mortality and long-term negative health outcomes. 
• Malcolm was asked whether the coronavirus response may be overblown, considering that the doubling rate is slowing. She said, “Perhaps among people who don’t know anyone yet — and I stress “yet” — who’ve been directly personally affected by COVID or had a severe bout of illness or even had lost loved-ones to this disease, folks might think that this is only a problem in ‘certain populations but not for me.’ And that’s just not the case.” Some of us may actually be carrying the virus and have very subtle symptoms or no symptoms at all, but still be capable of spreading the virus and are spreading the virus. 
• Malcolm said all of the things we think are isolated cases (such as the outbreaks in the food processing plants) actually are driving community spread.
• Malcolm received a question as to when restaurants might be able to start letting customers come inside. She said she can’t provide a specific date, and the state needs to keep an eye on the data. It could take 2-3 weeks to see the results of the new policies (such as opening retail and restaurants) and how it relates to health care utilization and confirmed tests. She said we would be doing restaurants a disservice if the state set a date for letting people inside and then proceed with that plan despite the warning signs.
• Malcolm said she would be comfortable eating on a restaurant patio or sidewalk come June 1. But she wants to make sure that the restaurant has proper guidelines in place.
• Malcolm received a question as to why the Minneapolis metro area has such a high rate of positive COVID-19 tests. She said it’s important to know that testing has considerably ramped up in recent weeks and that the state is aggressively testing long-term care facilities and food processing plant outbreaks (the people who work in those plants could be coming back home to the Twin Cities on the weekends). Ehresmann says testing has mostly happened in settings where a high positivity rate was expected, and a number of those settings have been in long-term care facilities in Hennepin County and Minneapolis. As testing expands beyond high-risk settings, the test-to-positive ratio should go down some.
• Long-term care staffing “is a real conundrum,” according to Malcolm. MDH is doing what they can to line up willing volunteers. The state is using all the tools in the toolbox to create incentives so that people would do this work.
• The Critical Care Coordinating Center was activated last week. It wasn’t necessarily activated because there was a crisis situation.
• The MDH is working on building a dashboard to show the data on testing at long-term care facilities. There are hundreds of those types of facilities where testing could occur. Testing in a facility occurs at “baseline” and again at 7 and 14 days. It takes a while to accomplish all that testing. 
• Stadiums will likely not be used as alternative care sites if needed. From a clinical perspective, that would be the last resort. 

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