Minnesota's first patient unlikely to spread virus; 42 Minnesotans remain quarantined on ship

The elderly Ramsey County resident who is Minnesota's first COVID-19 case came into contact with very few people after falling ill, greatly reducing the threat of infection to others, state health officials said Saturday.

But 42 Minnesotans who aren't even in the state face a higher risk of infection. They're among 3,500 passengers who remain in quarantine on the Grand Princess cruise ship off the coast of California.

Steve and Lynn Fuchs of Big Lake are among the 40 Minnesotans on the ship.

After departing Hawaii last week, they expected to cruise to Mexico and dock Thursday, but on Wednesday morning they got a note from Princess Cruises with the dreaded news that a passenger on a prior cruise had tested positive and that they were going to skip Mexico.

That day they were free to move around, but by the evening the situation had quickly changed. An evening theater show had been canceled and by Thursday after lunch, they were told to return to their cabins and not leave. They've been there ever since.

"I kind of suspected what was going to happen," Lynn Fuchs said.

Though they're getting meals delivered to their cabin and the captain makes regular announcements throughout the day, they're not getting what they want most: information about where they're going, when they'll arrive and what's next.

Physically, both are healthy. Mentally, they're growing weary. Neither have been tested and it's not clear when that will happen and what will happen after they get the test results.

"We feel like hostages," she said. "We're prisoners who have been sentenced without a trial and we're presumed to be guilty or sick."

Separately, the announcement that Minnesota's first patient, identified only as being over age 65, poses a very low risk to others came after an unusually swift investigation into the person's contact history.

Most such inquiries take days, with dozens of public health workers scrambling to interview hundreds of people in an attempt to outrace the spread of infection. Friday's contact investigation wrapped up in a couple of hours.

The patient is recovering at home under strict isolation protocols not to leave the house or interact closely with others, Kris Ehresmann, infectious disease director for the Minnesota Department of Health, said in a media briefing on Saturday.

"From an epidemiological standpoint," she said, "it is about as good as you could ask for."

Still, state health officials are readying for much more extensive contact investigations due to the rapid spread of the virus.

A $25 million state budget request is expected to receive legislative approval Monday and will allow the Health Department to repurpose grant-funded infectious disease specialists in areas such as HIV and foodborne illnesses to help out with investigations of future positive cases of COVID-19.

"We had epidemiologists standing by who came in [Friday] because you just don't know if the person is going to say, 'You know, I was at the Mall of America,' or whatever," Ehresmann said. "We absolutely did not have that situation. The person handled everything so perfectly."

The first Minnesota case involved someone who had been on the Grand Princess last month for a voyage between California and Mexico. After COVID-19 cases were discovered among passengers on that ship, the Minnesota Department of Health reached out to 26 passengers who had disembarked from that cruise on Feb. 21 and returned to Minnesota.

Only two people had symptoms, and the other traveler tested negative.

The other 24 travelers are now beyond the 14-day incubation period in which they would have suffered symptoms if they had been infected on the cruise.

As for the 42 Minnesotans from a subsequent Grand Princess cruise to Hawaii now quarantined off the California coast, health officials had no information on how many might be infected.

The fact that Minnesota's first case was linked to outstate travel allows the Health Department to continue its containment strategy of limiting the introduction of the virus into Minnesota, Ehresmann said.

"Once you get to the point where you have people who are positive and you cannot identify a link back [to the infection source], then that's a concern, because that is indicating that this is just spreading in our community indiscriminately," she said.

While the Minnesota patient became sick Feb. 25, the investigation determined that the individual hadn't been within 6 feet of anyone for more than 10 minutes at a time since returning home, health officials said.

The distance is roughly the zone in which someone could come in contact with droplets if another person coughed or sneezed. The coronavirus that causes COVID-19 illness also does not hang as long in the air as the measles virus, so health officials believe that transmission requires sustained contact between people.

Minnesota's first patient also reacted appropriately after state health officials reached out Thursday. The individual called ahead for testing at an M Health Fairview facility on Friday and showed up wearing a mask.

The state Health Department was lauded for its efforts in 2017 to limit the spread of measles from one child in a child-care facility to no more than 75 patients.

"[Parents had] brought the child to a football game and they had gone to the mall," Ehresmann recalled. "There were multiple exposures with large groups of people. That's the kind of thing that we're preparing for now."

While other coronaviruses cause common colds, this new version is concerning because nobody has immunity to it. It appears about as infectious as severe seasonal strains of influenza. Studies estimate one COVID-19 patient is likely to spread the virus to 2.2 others.

Given the rapid spread of this coronavirus from China, it is likely to pass from person to person in Minnesota at some point despite containment efforts, Ehresmann said. The state's public health lab tested at least another 11 samples from suspect patients in Minnesota on Saturday, but results weren't immediately available.

Even so, containment efforts serve a vital role in at least slowing down the spread, Ehresmann said, and preventing or reducing a spike in cases that could overwhelm hospitals.

"Our goal," she said, "is to slow everything down and make it manageable both for the health care system as well as for our infrastructure."

The ability of containment efforts to limit outbreaks depends on infected people agreeing to isolation, and others at risk agreeing to quarantines. Ehresmann said the state health commissioner can seek court-ordered quarantines, but that has never been needed during her career.

People in this outbreak appear to be complying with state recommendations to prepare for quarantines that could last up to two weeks — based on the number of shoppers who have wiped retail store shelves of toilet paper and bulked up on medicine, canned goods and bottled water.

"People might chafe a bit," Ehresmann said, "but they recognize what needs to be done."

Staff writers Glenn Howatt and Jim Buchta contributed to this report.