Feds in town to assess Minnesota's COVID-19 response

A federal COVID-19 response team is in Minnesota this week to review state pandemic strategies and offer recommendations to prevent a recent uptick in cases from producing a surge of hospitalizations and deaths.

U.S. Health and Human Services Secretary Alex Azar announced in a call with state leaders late last week that he was sending a team, and it arrived Monday. Azar's concern is that Minnesota might be following the pattern of Southern and Western states that have seen rising cases followed by more deaths and hospitalizations, said Kris Ehresmann, state infectious disease director.

"You've got states like Minnesota where we've been kind of flying under the radar through June and things were quiet, and then we're starting to see this uptick and increase in our cases," Ehresmann said. "And so the federal goal is to say, 'Let's reach out to Minnesota and talk through stuff ... so that Minnesota and Minneapolis don't turn into Arizona, Texas, California, Florida.'"

Minnesota appears to be at yet another juncture in the life cycle of the pandemic — with daily COVID-19 case counts rising but hospitalization levels remaining stable. The state on Thursday reported an above-average 763 lab-confirmed infections with the coronavirus that causes COVID-19, and a total count of 48,721 cases and 1,561 deaths.

A new mask-wearing mandate that takes effect Saturday could slow the spread of the virus, though health officials and Gov. Tim Walz warned that any such impact might not show up for weeks.

Minneapolis was one of 11 cities identified this week by Dr. Deborah Birx, the White House's COVID-19 task force leader, as needing "aggressive" actions because of rising COVID-19 case counts, according to a report by the Center for Public Integrity, a nonprofit journalism organization.

Minneapolis had been cited by Birx as a COVID-19 hot spot earlier this spring, when health officials discovered an outbreak in the Cedar-Riverside neighborhood that had tentacles to the rest of the state because of infected residents there who worked in nursing homes and food processing facilities.

Minneapolis health officials had not been contacted by Birx this week, though, and were surprised to be singled out at a time when the positivity rate of diagnostic tests in Hennepin County overall has been stable or declining.

The city is reporting a rate of 16.5 new cases of COVID-19 per 100,000 per day, compared with the state rate of around 11 per 100,000.

That higher rate is due to young singles who have been infected at bars, low-income workers who can't stay home, and large families in crowded dwellings who get sick once one person is infected, said Luisa Pessoa-Brandão, an epidemiology manager at the Minneapolis Health Department.

"When someone in a large household is positive, it's very hard for the [rest of the]household not to become positive," she said, noting that city health officials guide them on how to make their homes safe and functional in quarantines.

Ehresmann said it's unclear if Birx was referring to the need for aggressive action in Minneapolis only or if she was mentioning it as a proxy for the metro area or state. Regardless, the HHS COVID-19 Response Assistance Field Team (CRAFT) has taken a broader look at Minnesota's response and will offer suggestions at a briefing on Friday, she said.

"We want to know" what they find, she said, "and we will take action."

The visit during the week has been collaborative, Ehresmann said, with the federal officials learning from and commending some aspects of Minnesota's pandemic response — such as its organization of contact tracing teams with unique expertise on outbreaks in bars or workplaces.

Hospitalizations for COVID-19 had declined in Minnesota from a May 28 peak of 606, but they started to increase in July. The state reported 282 hospitalizations Thursday — the highest single-day total this month. However, the number of patients requiring intensive care declined from 119 on Wednesday to 107.

Minnesota has reported fewer than 10 COVID-19 deaths for 21 consecutive days, compared with the single-day high of 35 deaths reported during a peak of the pandemic on May 28. Nine deaths were reported Thursday.

Walz earlier this week urged people to follow the simple, low-cost strategy of wearing masks, washing hands and following social distancing guidelines to reduce virus transmission.

"We're going to see this disease spread" until a vaccine emerges, Walz said. "We are certainly not going to go down the route of states like Arizona and Florida where we get in a situation" of exponential case growth.

Compliance could expedite further business reopenings and increase the likelihood of in-school classes this fall, he said. Walz is scheduled to announce a school reopening strategy next Thursday.

The uncertain tack of the pandemic in Minnesota is reflected in national data. A leaked White House report on states listed Minnesota in the "yellow zone" for moderate case growth for its current COVID-19 threat. Eighteen states were listed in red zones for rapid case growth, including Iowa and Wisconsin.

New York enacted a travel restriction for Minnesota last week, when the state's COVID-19 case rate was just above its minimum threshold. It removed Minnesota this week after the case rate dropped slightly below that threshold but could put the state back on the restriction list next week.

Ehresmann said outbreaks are growing in diversity beyond those identified at bars and restaurants after those establishments were allowed on June 10 to resume limited indoor service.

Among identified outbreaks in July, there have been 237 people infected in 48 workplaces, 336 people infected in 18 restaurants or bars, and 108 people infected at 14 social events, Ehresmann said.

The events ranged from a group tubing event to funerals and graduation celebrations.

This is the second federal team to come to Minnesota amid the pandemic. The first was made up of experts from the U.S. Centers for Disease Control and Prevention in response to the specific threat of COVID-19 among residents of long-term care facilities.

Among all COVID-19 deaths in Minnesota, 77% involved residents of such facilities.

Age and underlying health conditions, such as diabetes and heart disease, increase the risks of COVID-19 infections. People 70 and older now make up less than 10% of all diagnosed COVID-19 cases in Minnesota, but 80% of the deaths.