Another plea for college COVID safety amid uptick in Minnesota deaths

Seventeen new COVID-19 deaths in Minnesota and news of college shutdowns in other states should serve as warnings, Minnesota health officials said, of the risks that could undermine recent progress in the pandemic.

Death numbers had been in single digits every day in Minnesota since July 2, until 12 were reported on Aug. 12 and 17 on Wednesday.

Though one or two bad days isn't enough proof, health officials said an uptick in deaths in Minnesota could be a lagging consequence of the growth in infections this summer and a reason for concern about outbreaks among college-bound students this fall.

It took only days for the University of North Carolina, Notre Dame and Michigan State to suspend in-person classes this month following outbreaks in their first weeks of the fall semester. And some of those campus outbreaks were tied to large parties with few students wearing masks to protect one another from the spread of the novel coronavirus that causes COVID-19.

"We're already seeing some dramatic examples of what is at stake," said Dr. Ruth Lynfield, state epidemiologist, during a media briefing on Wednesday — the third straight in which a state health official emphasized concerns about college campus risks.

Institutions such as the University of Minnesota in Minneapolis and University of St. Thomas in St. Paul are moving students back to campus with blended online and in-person classes, and they are opening campus facilities with capacity and social distancing restrictions.

Guidance from the Minnesota Department of Health has set criteria for increasing campus restrictions, including if more than 3% of students test positive for infections in a two-week period, or if more than 75% of available quarantine beds on campus are full.

State health officials have asked college students to avoid large gatherings in the two weeks before they return to campus. That should increase the chances that they are virus-free when they start classes.

College students are at low risk of COVID-19 deaths; only five of Minnesota's total 1,738 COVID-19 deaths have involved people 20 or younger. But mobile college students could spread the virus to others at greater risk, such as people 70 and older who make up only 9% of known infections but 80% of the state's COVID-19 deaths.

All but one of the 17 deaths reported Wednesday involved people 70 or older — with eight involving residents of long-term care or assisted-living facilities and one involving a resident of a behavioral health group home.

Lynfield stressed that death isn't the only consequence of COVID-19 and that many people young and old have suffered lingering problems ranging from fatigue to foggy thinking to a racing heart to shortness of breath.

The doctor urged Minnesotans to continue to take the pandemic seriously — despite the fatigue of enduring it for six months — and discouraged efforts to avoid or ignore state safety recommendations.

A few parents reportedly have been hiding potential illnesses in their families and not seeking testing because they don't want to increase the COVID-19 case counts in their counties, which could then influence decisions by their local K-12 schools on whether to remain open, Lynfield said.

"People ignoring protective recommendations are likely to prolong the outbreak, making it worse and making it more likely that we will all have to deal with a longer period of impact on schools and other communities and institutions, businesses and our economy," she said. "The way out of this mess is clear."

The warnings come even as signs point to declining case growth in Minnesota.

Minnesota is still falling short on three of five goals for its COVID-19 response but is showing its first weeklong decline since mid-June in new infections, according to an update on the state's COVID-19 dashboard.

The rate of new lab-confirmed infections per 100,000 people per day dipped from 12 on Aug. 1 to 11 on Aug. 11. The rate had been increasing from a low of six per 100,000 on June 16, but still remains above the state's target goal of five.

The state is meeting its goals for its diagnostic testing rate and the positivity rate for those tests. The goal is for no more than 15% of tests to be positive for the infection. The rate had increased from 3% in mid-June to nearly 6% earlier this month, but it is now roughly 5%.

The state reported 567 newly lab-confirmed infections on Wednesday, raising the state's case count to 66,618.

Hospitalizations for COVID-19 also increased to 321 Wednesday, including 152 patients in intensive care.

No vaccines exist for this infection yet, though some are in clinical trials.

Drug treatments include the antiviral remdesivir to prevent virus growth in hospitalized patients and the steroid dexamethasone to prevent a potentially fatal overreaction by the immune system in severe COVID-19 cases.

The anti-malaria drug hydroxychloroquine has fallen short in studies, including two clinical trials at the University of Minnesota, and had its emergency use authorization as a COVID-19 therapy revoked by the U.S. Food and Drug Administration.

Gov. Tim Walz last week rescinded an executive order restricting hydroxychloroquine prescriptions, which some proponents of the drug took as a sign that it could be prescribed more aggressively. However, state officials said it was rescinded primarily because prescription levels had diminished to the point that it was unnecessary.

A new U study released this week in advance of publication in a peer-reviewed journal showed that hydroxychloroquine was safe for COVID-19 patients to take, although it caused some nausea.

However, a third trial by the U of its effectiveness — this time seeing whether the drug could prevent symptom onset in advance of patients being exposed to the virus — is expected when it is published to agree with the first two trials and not show much benefit.

Mayo Clinic has led efforts to test the use of antibodies from the plasma of recovered COVID-19 patients, infusing more than 66,000 patients with the experimental therapy.

However, the FDA has delayed approval of an emergency use authorization to expand use of plasma therapy until it can review more data about its effectiveness.

Mayo is collecting blood serum samples stored at blood banks from another 2,000 to 3,000 patients who received convalescent plasma to expand its recent findings that high-dose plasma infusions had a greater impact on COVID-19 mortality than low-dose infusions.

FDA officials might feel "burned" by having had to rescind their decision on hydroxychloroquine and are right to seek as much data as possible before making a decision on plasma, said Dr. R. Scott Wright, who is coordinating Mayo's national COVID-19 convalescent plasma program.

"I think they're just being cautious and methodical," he said, "and double-checking everything with plasma."