Minnesota health officials talk about ongoing response to coronavirus

Minnesota recently surpassed a new milestone: More than 40,000 people in the state have been diagnosed with COVID-19 since the start of the pandemic. While deaths and hospitalizations are holding steady, the number of confirmed cases and rate of positive tests have increased.

These developments come as communities around the state — like Winona, Rochester, Mankato and the Twin Cities — have set mask mandates and the Walz administration weighs a requirement on the statewide level.

MPR News host Kerri Miller spoke with Commissioner Jan Malcolm and Kris Ehresmann of the Minnesota Department of Health at 9 a.m. Monday to answer listener questions.

Here are a few of the questions they addressed during the hour.

What is behind the recent increase in infections?

The first large spike in cases for Minnesota was in the middle of April and continued through May before declining significantly, Malcolm began, but since the third week of June we have seen increases again. 

“We were actually expecting to see an increase” following the relaxation of the stay-at-home order and opening of businesses around the state, she said. However, it’s still concerning, in large part because the increases have been traced to people, especially younger populations, not following social distancing guidelines.

COVID-19 tends to have a greater health impact on those 50 years old and older, so younger populations may feel they are not in danger, Malcolm said, but the virus can be deadly even for people with no prior health issues. “It’s rare but it can happen,” she said.

People who do not experience a severe case can still spread it to others in their family and communities. Those not taking guidelines seriously may not realize how easily the virus is transmitted, Malcolm said, and it is essential that they understand the risks to themselves and others.

How effective would a mask mandate be?

It has been disappointing to see people treating the use of masks as a strictly personal choice, Ehresmann said. Wearing a mask is primarily about protecting those around you.

The comparison to the flu is also fraught with misconceptions. COVID-19 is significantly easier to spread than the flu, nobody has had it before and is different from the flu in many other ways, Malcolm said.

“There should be nothing political about this. This is a very serious public health threat where our behaviors are clearly affecting others,” Malcolm said, comparing the decision to wear a mask to the decision to smoke around others or drink and drive.

Malcolm supports a statewide mandate and has made that recommendation to Gov. Tim Walz. To inform their suggestions, the state Health Department has been compiling data on how mandates have been working in other states.

If I am infected, how soon am I contagious? When will I see symptoms?

Recent data suggests that you are first contagious about two days before you start experiencing symptoms and you continue to be contagious while experiencing those symptoms, Ehresmann said. About 10 days after you start to feel symptoms, the likelihood that you will infect others drops off significantly.

In general, symptoms will start to appear five to seven days after you were exposed to COVID-19.

Messaging on how to stay safe has changed a lot since the beginning of the pandemic, how do we make decisions when we can’t see the impacts?

When it comes to guidance like wearing masks and not gathering in large groups, “vigilance is what we’re looking for, not social shaming, but awareness,” Malcolm said.

At the beginning of the pandemic it wasn’t yet clear what kind of masks were going to be effective against spreading COVID-19, which prompted health officials to discourage using them in order to save that equipment for health care workers. Now that we know more about the ease at which the virus is transmitted it’s clear that even a homemade cloth mask is helpful, Malcolm said.

The science and research are building, and things will change.

Usually there is a body of literature with which to work with to at least give some idea of how the virus will progress, Ehresmann added. That is not the case with COVID-19.

Masks are still only suggested when people are indoors or in a situation where they cannot social distance.

How bad is this year’s flu season going to be?

“That’s certainly a scenario we are planning for and concerned about,” Malcolm said. The Health Department doesn’t know much yet about what the season will be like, which makes it even more important that everyone gets their flu vaccine.

There is evidence that you can have both the flu and COVID-19 at the same time.

“Oftentimes flu season deaths are due to opportunistic infections,” Ehresmann said. If you have influenza there’s a chance COVID-19 could be that infection.

Flu season will also be part of the consideration when figuring out how to make sure health care system is not overwhelmed later this year.

What is behind the long wait times for testing, especially for health care workers?

There is a testing command center that has been set up to advise the state, Ehresmann explained. There are several groups that have been prioritized for testing – including health care workers who have been exposed to the virus — but those priorities have not been adopted at the same rate within all hospitals.

Individual health care systems have their own limited capacity and they are setting priorities, Malcolm said, and while the Health Department has tried to organize in such a way that health care workers don’t hit up against those limitations, the work is ongoing.

What does the research say about long-term health implications?

The challenge is we’re only seven months out from initial cases so it’s difficult to talk about long-term impacts just yet, Ehresmann said. However, we do know that even as people are recovering many do have prolonged symptoms. There’s also evidence that even asymptomatic and mild infections cases can result in issues down the road.

“Every time we turn around there’s a new piece of information and it’s not usually positive,” Ehresmann said.

What precautions should you take when pregnant?

Data suggests pregnant people are at a greater risk, Ehresmann said. So, you’d want to be particularly cautious about where you’re going in public — limit interactions, make sure you’re socially distancing and asking loved ones to wear masks. “Limit exposure as much as you can,” she said.

What does the data suggest when it comes to reopening schools?

“There are so many issues to balance in all of these decisions,” Malcolm said. Everyone is aware of the many benefits of getting kids back to school, but it needs to be balanced with safety.

The Health Department is looking at examples in other countries and states, but the decision will ultimately be informed by how easy it is for children to contract and transmit the disease. That risk appears to be small, “not nonexistent, but small,” Malcolm said. The safety of teachers will also be key.

The suggestion is still for school districts to plan for three different scenarios because it’s possible that circumstances could change throughout the year.

Guests:

• Jan Malcolm is the commissioner of the Minnesota Department of Health.

• Kris Ehresmann is the director of the Infectious Disease Epidemiology, Prevention and Control Division at the Minnesota Department of Health.