New Minnesota COVID-19 milestone shows significant amount of virus transmission, health officials say

Minnesota reported more than 1,500 newly confirmed coronavirus infections on Saturday, a record high for new cases that comes amid worries about the sharp rise in COVID-19 counts in neighboring states.

The tally, off one of the highest single-day test totals, reflects significant virus transmission across the state at a time other pandemic indicators are signaling trouble, health officials said.

State data released last week showed that the number of COVID-19 patients in hospitals has been increasing. The average age of those infected is starting to rise as well, and more cases are being found in long-term care workers.

"I think a lot of people are worried that the Upper Midwest is becoming a real hot spot," said Dr. Timothy Schacker, the vice dean for research at the University of Minnesota Medical School.

"In Minnesota, the hospitalization rate appears to be climbing. So people are worried we're making the shift with coronavirus from the 20-year-olds to the 70-year-olds again."

As case rates in three neighboring states led the nation last week, Minnesota ranked No. 17 in population-adjusted case growth over a recent seven-day period, according to a tracking website from Brown University. North and South Dakota and Wisconsin reported more than 40 new cases each day per 100,000 people, whereas the Minnesota rate was about 20 cases per 100,000 people.

Transmission is widespread, occurring at family reunions and neighborhood get-togethers along with bars, restaurants and college campuses, said Michael Osterholm of the U's Center for Infectious Disease Research and Policy.

"We're surrounded right now by houses on fire in Wisconsin, Iowa and the Dakotas," Osterholm said.

"Between pandemic fatigue and pandemic anger, people are out doing all those things that put them at greatly increased risk for transmission. We're just getting started here. We haven't even begun to see how bad this is going to get."

On Thursday, the state Department of Health unveiled a revamped dashboard for tracking COVID-19 hospitalizations and ICU cases across Minnesota. The data showed that during a 15-day period ending Oct. 7, COVID-19 hospitalizations increased in Minnesota by more than one-third, said Pinar Karaca-Mandic, a health researcher at the Carlson School of Management at the U.

"It's probably OK still in terms of the capacity we have, but it is concerning that it is going up faster," said Karaca-Mandic, who runs a website that tracks COVID-19 hospitalizations across dozens of states.

While COVID-19 hospitalizations are on the rise, the magnitude of increase is "slight," said Dr. Rahul Koranne, president and chief executive of the Minnesota Hospital Association. The percentage increase varies depending on dates of comparison, he said, and looks highest when including data from the previous week that has not been completely verified.

"The hospitals and health care systems across Minnesota are feeling prepared," he said, noting that the dashboard shows COVID-19 patients account for just 12% of all ICU beds. Capacity within intensive care units is at typical levels, Koranne said, including for those in the Twin Cities metro.

The Health Department on Saturday reported another 10 deaths, bringing the toll for the week to 60 — slightly less than the previous week. Five of the newly reported deaths were residents of long-term care or assisted living facilities.

Since the start of the pandemic, Minnesota has reported 110,828 confirmed cases and 8,302 hospitalizations. The state has seen 2,131 deaths from COVID-19, including 1,518 in long-term care residents.

Factoring in cases reported Saturday, the seven-day average for new infections in Minnesota also hit a new high. In the past week, the state averaged about 1,149 new cases per day on a daily average of about 24,494 tests.

The share of positive test results held at about 5%. A "positivity rate" of less than 5% for two weeks is one of several criteria that should be met to consider easing pandemic restrictions, according to the World Health Organization.

"The fact that we are continuing to see the high test positivity rate, despite the large amount of testing that we're doing — that says that there's a lot of virus circulating in the state," said Kris Ehresmann, the state's director of infectious disease. "There's so much COVID that even though we're doing a lot of testing ... it's not [diluting things] because there's so much out there."

Infections among young adults were driving case growth this summer, Ehresmann said, but that's beginning to shift toward older people. That fits with a shift in outbreaks at settings that draw an older crowd, she said, including weddings, funerals and rallies.

COVID-19 is a viral respiratory illness caused by a new coronavirus that was found circulating late last year. Since the first case was reported in Minnesota in early March, hospital stays have been required in 8,302 cases.

The illness usually causes mild or moderate sickness. But people with a variety of health problems, as well as those who are older or live in long-term care settings, are at greater risk for serious cases that could drive hospitalizations.

The state's hospital capacity dashboard was not updated by Saturday afternoon. In the Twin Cities metro area, hospital space is running much tighter than normal for this time of year, but COVID-19 cases aren't the only factor, said Dr. John Hick, an emergency physician at Hennepin Healthcare who advises the state on its pandemic response.

The pandemic has forced many delays in routine care, but those patients are now returning for treatment — sometimes with more complications, Hick said. Many health systems operate medical centers in Minnesota and surrounding states, so Hick worries that trends elsewhere might eventually result in patients being transferred to Minnesota.

Mayo Clinic has seen a "gentle uptick" in patients over the past two weeks, but there's been no need to transfer patients or pause nonemergency care to create space, said Dr. Daniel Brown, an anesthesiologist who directs a program to coordinate critical care resources at the Rochester-based clinic.

HealthPartners, which operates seven hospitals, has seen an increase in patient volumes that appears to reflect rising case counts, said Dr. Mark Sannes, an infectious disease physician at the Bloomington-based health system. A growing share of COVID-19 hospitalizations is coming from the health system's medical centers outside the Twin Cities metro area.

"It certainly gives everyone pause to see the huge numbers per capita across the Dakotas and Wisconsin right now," Sannes said. "What is concerning is that Wisconsin was where we are right now [in terms of cases] as recently as a month ago. So this can move very quickly."