Minnesota considers shorter CDC quarantine guidelines

Minnesota health officials are considering shortening quarantines for people exposed to the novel coronavirus that causes COVID-19 — even if it slightly elevates the risk of viral transmission.

The U.S. Centers for Disease Control and Prevention on Wednesday announced that local public health agencies could opt to shorten 14-day quarantines to 10 days if people have no symptoms, or seven days if they have no symptoms and test negative for COVID-19.

While that makes some practical sense, Minnesota infectious disease director Kris Ehresmann said it isn't a "slam dunk" for a state that is at the peak of a pandemic wave. Minnesota's rate of new infections has been falling but was listed as highest in the nation on Wednesday by the COVID Exit Strategy website.

"We are currently in the peak of transmission right now," Ehresmann said. "So even if you're talking about a small proportion [of increased risk], when you've got so much viral activity that is something you need to consider."

Ehresmann said a decision in Minnesota on shorter quarantines would be made in the next couple of days, but that people for now need to stick with 14 days.

Minnesota leaders this week also will be deciding how to phase in CDC vaccination plans that prioritize limited initial doses for health care workers.

States have discretion as to whether they give blanket COVID-19 vaccine to all workers or start with those who have the most close contact with infected patients.

Limited vaccinations could begin this month, assuming U.S. Food and Drug Administration approval on Dec. 11 of Pfizer's experimental vaccine, Gov. Tim Walz said. "We always thought a best case timeline would be somewhere before Christmas."

Broad community vaccination isn't expected until late winter or early spring 2021, though, and state health officials said mask-wearing, social distancing and quarantines due to viral exposures will remain critical to containing the pandemic.

Minnesota has tallied 327,477 lab-confirmed infections and 3,692 COVID-19 deaths, including 77 deaths reported Wednesday.

While people 70 or older have suffered more than 80% of the deaths, Wednesday's report was unusual in that it included two victims in their 30s.

Shortening quarantines offers the potential benefit of hastening the time people can return to work or school after exposures — including doctors and nurses who are urgently needed amid the COVID-19 wave.

Mayo Clinic alone has more than 1,200 people sidelined due to active COVID-19 cases or quarantines due to viral exposures.

The latest research showed a 1% risk that people without symptoms would spread the virus if they exited quarantines at only 10 days, or 5% if they exited at seven days with a negative test result, said Dr. John Brooks, chief medical officer for CDC's COVID response.

Those time frames ease the burden of quarantines at a tolerable risk level, compared with a 14-day quarantine that results in almost zero risk of spreading the virus, he said.

"Ten days is where that risk got into a sweet spot we liked, at about 1%," he said. "That's a very acceptable risk, I think, for many people."

Brooks added that shorter quarantines might be easier for people to tolerate and that could result in fewer infections if more people comply.

"If we can reduce the burden a little bit, accepting that it comes at a small cost, we may get a greater compliance overall," he said.

The CDC advises people to continue to monitor for symptoms for 14 days and take precautions, even if they end their quarantines earlier.

Walz said he has kept tabs on the effectiveness of shorter seven-day quarantines in Germany, but said it's unclear whether Minnesota could expect similar results at a time when it has such high viral transmission.

The governor on Wednesday highlighted how the increasing spread of COVID-19 has burdened police, fire and ambulance personnel — and urged people to protect them by doing their part to slow the spread of the virus.

"If you're thinking about [not] wearing that mask, or you're thinking about whether to go to that little gathering, stop and think about that firefighter, that police officer, that paramedic, and give them a little bit of a break today," Walz said. "Make their job just a little bit easier."

Police and fire officials discussed how widespread outbreaks and viral exposures disrupted operations.

Lengthy absences have presented challenges for the Eagan Police Department, said Chief Roger New, but his department is thinking cautiously about whether it would shorten quarantines and send officers back on duty if they still carry even small risks of spreading the virus.

"We start from a place of caution, first and foremost," he said.

Ehresmann said Minnesota's decision about quarantine length could vary by setting — because an elevated risk of a shorter quarantine might not be worth it in the confines of a prison or nursing home.

"It may not be appropriate to even take that lesser risk just because of the vulnerability of the population," she said.

The CDC on Wednesday also discouraged holiday season travels due to the risk of spreading the virus.

Minnesota is seeing some encouraging signs of reduced viral activity, including a drop in the positivity rate of diagnostic testing from a peak of 15.5% on Nov. 11 to 10.9% on Nov. 23, according to the state's pandemic dashboard.

That rate is a key measure of the outbreak, because it indicates viral activity regardless of the number of tests performed.

Even so, the rate of transmission is high right now, and people are likely to encounter others who have COVID-19 at stores, churches, parties and public places, said Dr. John Hick, a Hennepin Healthcare physician who has helped coordinate the statewide response to the pandemic.

"We cannot afford to continue these levels going into the major holiday season," he said.

Jeremy Olson • 612-673-7744