Cluster of COVID-19 cases in southern Minnesota tied to reopened bars

A cluster of COVID-19 cases tied to young adults drinking at southern Minnesota bars has raised concerns for state health officials, though it's unclear whether the infections will cause more hospitalizations and deaths.

While young adults are less likely to suffer severe cases, they could be the catalysts for a second wave of COVID-19 in Minnesota and the spreading of the infectious disease to people at greater risk, said Kris Ehresmann, state infectious disease director.

"As people are out, you know, enjoying a bit of freedom that we have now, [we want to make sure] that they're cognizant of the fact that they could be a risk factor for someone else," Ehresmann said. "Even though they may not be at risk for complications, they can still get COVID just as easily as anyone else and as a result they can spread it to others inadvertently."

Some of the roughly 100 young adults infected during visits to bars on June 12 and 13 — the first weekend they reopened — work in child care. Others work in health care facilities and with people at greater risk of severe COVID-19.

The Minnesota Department of Health reported five more deaths on Wednesday, bringing the total for the pandemic to 1,397 — with 1,102 occurring in long-term care facilities.

The state also reported a total of 33,763 lab-confirmed cases of COVID-19, and a slight uptick this week in hospitalizations — with 340 people admitted due to their infections and 160 needing intensive care.

Daily case growth has ebbed in Minnesota this month, with the 304 cases reported on Wednesday being below the peak of 847 cases reported on May 23. This occurred despite the limited reopening in June of restaurants, bars, fitness centers, salons and entertainment venues, and the mass protests and riots following the police killing of George Floyd that could have spread the virus.

Blue Earth County is among the counties affected by transmission in bars of the novel coronavirus that causes COVID-19. Activity nearly doubled there from 142 COVID-19 cases and zero deaths at the start of this month to 265 cases and two deaths as of Wednesday.

Free testing at four community sites in Minneapolis and St. Paul ended on Wednesday, with partial results showing a negligible impact of the protest activities on COVID-19 case growth. Roughly 1.5% of 7,706 tests from the first two weeks at these sites turned up positive for the virus.

The results did reveal a disparity in the spread of the virus, though. The positivity rate for white people at these test sites was only .2%, compared to 1.3% among black people, 5% among Asians, and 7.4% among Latinos.

Minorities only made up 40% of the tests but 90% of the positive cases identified at these sites. They probably weren't infected during the protests, Ehresmann said, but many work in lower-wage jobs that don't present work-from-home options and increase their infection risks.

"We need to make sure we are making testing available to our populations of color and Indigenous populations," Ehresmann said.

The recent influx of younger people with COVID-19 might not lead to more deaths, unless those people spread the virus to others at greater risk. Minnesotans 70 and older make up 12% of known cases and 82% of deaths, whereas Minnesotans 40 and younger make up 66% of known cases but 2% of deaths.

A report on Wednesday from the CDC highlighted how young people spread the virus, noting infections of 60 of 183 students from the University of Texas who were tested for COVID-19 after spring break travels to Cabo San Lucas in Mexico.

One-fifth of the students who tested positive had no symptoms, which is a concern because it means they were carrying and potentially spreading the virus without knowing it.

The Institute for Health Metrics and Evaluation (IHME) on Wednesday reduced its COVID-19 estimate for Minnesota from 3,191 deaths to 1,797 by Oct. 1.

The reduction occurred because growth in cases and deaths slowed more than expected in the past week, said Dr. Theo Vos, a professor of health metrics science at IHME in Washington state. "That of course is a good thing, and bucks the pattern that we unfortunately see in quite a few other states in the South and West."

The lack of a surge in cases due to the Floyd protests in Minneapolis and St. Paul supports the theory that people are at less risk of exposure to the novel coronavirus that causes COVID-19 when outdoors.

Health officials worried despite the lower risks of outdoor transmission because the protesters had been singing and chanting while packed together, and gasping and coughing when tear gas was used to disperse crowds.

The lack of a significant uptick in cases related to the protests was surprising to Dr. Bill Roberts, a professor of family medicine at the University of Minnesota, but will help inform understanding about transmission risks and the environments that are safer than others.

"The safest position is outdoors along with a good breeze, and the least safe is a small room packed with people with someone who is breathing the disease on you," he said. "In between, there's got to be a tipping point where it's safer to be than not to be. I think we'll start to learn that over time."

The lower outdoor risk partly informs the latest decision by Gov. Tim Walz and state health authorities to permit more outdoor youth sports activities.

State guidance allowed full practices and scrimmage starting Wednesday, and games against opponents from other communities in two weeks. Indoor sports can resume July 1.

Ehresmann said wind and outdoor airflow can diffuse the virus, reducing exposure risks.

A study last week in the Journal of Infectious Diseases also found that sunlight could make a difference.

It simulated the decay of aerosolized droplets carrying the virus and found it would take six minutes under summer sun, 19 minutes under fall/winter sunshine levels, and 125 minutes without sunlight.

Ehresmann said she hoped people would consider this protective benefit when congregating this summer, and that bars could steer crowds of people outdoors when possible.

People should also take precautions such as wearing masks and practicing social distancing, she added.

"I realize it's difficult to consume adult beverages wearing a mask," she said, "but please then social distance and make sure you that you are cognizant of the risk of COVID transmission in a group setting."