Minnesota expands COVID-19 antiviral access, closes some testing sites

Minnesota will close eight testing sites amid declines in COVID-19 testing but expand two others that will soon offer rapid access to antiviral treatment.

The Minnesota Department of Health announced the change Wednesday in response to improving COVID-19 trends, including a steady decline in infections and hospitalizations. The number of inpatient beds occupied by COVID-19 patients in Minnesota dropped from 475 on June 1 to 373 on Tuesday.

Health officials said they need to simultaneously expand access to COVID-19 antiviral treatment, which has helped to reduce the severity of this spring's pandemic wave, and react to the declining testing demand. The total of 7,300 tests at Minnesota sites last week was down 92% from peak demand in January and 33% from a month ago.

"Minnesotans who feel ill and are at high-risk of severe COVID-19 should visit a test-to-treat site or speak to their health care provider to see if medication is right for them," said Jan Malcolm, state health commissioner, in a statement.

State testing sites in Brooklyn Park, Duluth and Moorhead already have federally supplied test-to-treat programs. People who test positive at those sites are screened for their risk levels of severe COVID-19 and given free prescriptions for antivirals if they qualify.

Test-to-treat options will be added Thursday at the Minneapolis-St. Paul International Airport and June 27 at the St. Paul Midway center. Testing centers will close by June 29 in Albert Lea, Bemidji, Bloomington, Marshall, Morris, North Branch, Wadena and Winona.

Minnesota invested aggressively in testing early in the pandemic, reaching a contract with Vault Health to expand access to saliva-based PCR tests through the community sites. Demand has dropped with the rising popularity of at-home rapid antigen tests, though they are prone to higher rates of false negative results.

Minnesota is still accepting online orders for free at-home tests and announced Wednesday that it is diverting 240,000 rapid tests to community agencies throughout the state to maintain access.

The transition came Wednesday as newly eligible preschoolers received their first doses of COVID-19 vaccine at the state's Mall of America site.

Other providers were still arranging vaccinations as supplies arrived in Minnesota. M Health Fairview on June 28 will start offering appointments for the three-dose course of Pfizer COVID-19 vaccine to eligible preschoolers and will offer the two-dose Moderna alternative at a future date.

Children have been at substantially lower risk of severe COVID-19. Out of 12,756 COVID-19 deaths in Minnesota, 10 have involved residents 19 or younger. Three deaths have been reported in children 9 or younger.

The federal Advisory Committee on Immunization Practices (ACIP) nonetheless on Saturday recommended lower-dose vaccine for children age 6 months to 5 years, noting that vaccines are commonly accepted to combat infectious diseases that cause far fewer deaths. More than 200 COVID-19 deaths have occurred in the U.S. in the newly eligible age group.

"Getting vaccinated outweighs any potential harms," said Patsy Stinchfield, a former ACIP member and retired Children's Minnesota infectious disease specialist. She now serves as a liaison between ACIP and a national association of pediatric nurse practitioners. "To skip vaccinating children is to take a risk for a severe COVID disease outcome."

Seven COVID-19 deaths were reported in Minnesota on Wednesday, and six involved seniors. Deaths have declined steadily across all age groups in Minnesota this spring, but not as much among seniors. They made up 72% of COVID-19 deaths since last summer but 88% since May 1. Wednesday's report included one COVID-19 death of a St. Louis County resident in the 35- to 39-age range.

Health officials point to several factors for the reduced severity of COVID-19 this spring, including that the circulating omicron subvariants of the coronavirus don't produce as many serious illnesses. Vaccinations have played a role along with immunity from recent infections, with federal estimates that 61% of Minnesotans have already been infected at least once.

Broad access to antivirals, including the most-effective Paxlovid, have helped. In addition to federal supplies at the state's test-to-treat centers, Minnesota has received more than 60,000 courses of Paxlovid that are available through medical clinics. Around 25,000 courses remain available.

Fairview providers had ordered more than 4,200 courses of Paxlovid for patients with COVID-19 through late May. About 30% went to patients 70 and older while 40% went to patients between the ages of 50 and 70.

Equitable access has been a problem nationally, though, according to a report Tuesday by the Centers for Disease Control and Prevention. While the medical facilities providing antiviral therapy are mostly in ZIP codes with high levels of social vulnerability, a larger share of their patients are coming from areas with moderate or low levels of vulnerability.

COVID-19 rates have generally been higher in higher vulnerability ZIP codes, which also tend to have higher rates of chronic disease that put people at greater risk for severe infections.