A look at Minnesota’s fight against COVID-19, one year in

Updated: March 9, 2021 | Posted: March 8, 2021

March 6, 2020 was the day the first known case of COVID-19 was reported in Minnesota.

By that point, the virus had already spread in 80 different countries and the United States had confirmed 233 cases within its own borders.

As time marched on, cases ratcheted up at an alarming rate, which led to shutdowns of businesses, schools and houses of worship.

In the year since, the state has tallied more than  487,300 known infections  and 6,500 deaths.

After rigorous trials, vaccines against COVID-19 were delivered to Minnesota hospitals last December, and last week the number of doses administered surpassed the total number of confirmed cases in the state throughout the entire pandemic.

Monday, MPR News host Kerri Miller spoke with two of Minnesota’s top public health officials about the state’s ongoing fight against COVID-19.

Guests:

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

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

The following is an edited selection of questions from listeners. To listen to the full conversation you can use the audio player above.

Mary in Brainerd: People who've had COVID, are they equivalent to people who've had the vaccine? Can they get COVID again? Can they share it if they get it again?

Malcolm: It's one of those things that we still just don't have enough information about to be able to give very definitive or satisfying answers.

We don't know yet how much immunity is conferred when somebody gets the virus naturally, how long it lasts, how much immunity it really takes to to fend off reinfection? And we don't know that critical question either about transmission. Those are all data that are going to come in — that keeps coming in — every month that goes by. We know more. We have more history with the people who had the virus early on.

Ehresmann: So we are understanding or the way we're treating people who have had COVID-19 that they would be expected to have protection for 90 days. We realize that that could be longer but right now, if you had COVID-19, we would say you don't need to quarantine if you're within that 90-day period. But after that 90-day period, we we are saying that people would need to quarantine.

And that's to what Malcolm’s point was — there's still a lot that we don't know. So there is some level of protection from natural disease, we don't have really good clear information about the duration of that protection. And the same thing is true for vaccination.

So that's why even as we're getting people vaccinated, you still need to mask, you still need to take all those mitigation measures into effect because it's going to be a combination of getting people vaccinated, and then seeing our case numbers really, really drop off.

The one unknown that we face is the variants. It's entirely possible that someone could have had COVID-19 and have protection from that strain of the virus and get exposed to a variant and be reinfected. So that's why we need to be particularly cautious right now.

Michael from St. Paul: I have two 18-year-olds, they both have 1B status as child care workers for the summer. And I found that some providers aren't giving aren't allowing 1B at this point. One provider had appointments, we set up appointments for them. And then they called and said, ‘They're only 18. So we won't vaccinate them.’ I'm wondering about the system, and what's expected of providers and what kind of leeway they have in deciding who they provide vaccinations for?

Malcolm: We know that there have been challenges along the way, with providers making different interpretations of the guidance, we try to be as clear as we can. We have guidance on our website that is communicated out to those who are giving vaccine about how we define the eligible categories.

But generally speaking, our providers have done a good job. They've had some differences in interpretation. When we learned about that, we try to follow up and clarify. We look for consistency. The good news is with vaccine supply increasing, we expect to start moving kind of more quickly through these various categories.

Ehresmann: I also wanted to just comment on Michael's vaccination for his kids. His kids being a summer camp child care are actually in a lower tier. They wouldn't be prioritized for vaccination at this time. They're in 1B, but they're not in the first tier, which is obviously our 65, and our original educator child care. They would be in the expanded category.

Will the state pivot if we don't get to 70 percent of people 65 and older vaccinated? And how quickly? There were several appointments that went unfilled last week, why?

Ehresmann: Yes, we're actually tracking that very closely. We want to make sure that obviously, all of our seniors have had the opportunity to be vaccinated and receive their first dose. But we also want to make sure that we are continuing to maintain a pace at keeping vaccine available within the state. So we are continuing to monitor that, and we’ll make adaptations.

I think the important thing to keep in mind is that even as we open up, that anyone that was in the previous priority group would still have priority. For instance, if you are a 65 year old and you just were not feeling comfortable to get vaccinated, and you decide, “Hey, now I want to do it.” Once it's open to some other groups, you would still be a priority for vaccination.

Gina in Roseville: I have a son who has Type 1 diabetes. About a week ago, I heard on the news that they were included in that priority group along with Type 2 diabetes. And in trying to register him on the Minnesota vaccination connector, I noticed that the category has not been added. So do we check Type 2? How do we make sure that he can get included in that group?

Ehresmann: The connector is being updated, and so should be updated on Wednesday. So, he can certainly go in as of Wednesday to put as information in or he could choose, The Type 2, even though it's not accurate, If you wanted to get it in right now, but we are updating the connector to to cover that. And then obviously, his health care provider will likely be reaching out as well.

From Mike: I’m 72, I’m getting my vaccine today. And I live with my wife who is 64. Why didn’t you include spouses of over 65 people in this vaccination group?

Malcolm: That’s an interesting question, and I'm very glad that that folks are having more and more success getting vaccinated. I think we just simply were trying to get to the most vulnerable people first. Certainly, we've had some of that feedback that it would be more convenient for folks if they could get vaccinated as a family.

That's certainly one of the things that again, as vaccine supply opens up, we'll see more of that ability for people who are in different risk categories to be getting vaccinated at the same time and together.

John in East Bethel: My dad has Alzheimer's. I'm his personal care attendant. I'm nervous about getting him out to the clinic. I'm wondering when it might be possible to have people do home vaccinations? He's gotten that for his flu shot.

Ehresmann: That's something that we're talking about and looking at. But that is incredibly labor- and time-intensive. So as we plan for that, we have to also be maintaining the systems that we have in place that are able to vaccinate large numbers of people.

It's balancing the need to be able to offer vaccine. It may be a situation where a drive by vaccination may be appropriate. So the things that we can do to make sure that individuals in that situation have access to vaccine, that's really important. But we need to also think about how we can do it in a manner that helps us to get as many people vaccinated as possible.

Pete in Roseau: My question goes to those who choose not to be vaccinated. If, like me, I get a vaccination. I've had one. I'm going to get the next one. Once I've been vaccinated, and everybody in the state has been offered a vaccine, how long should we be expected to wear masks to protect those who have said, ‘No, I don't want to get a vaccine‘?

Malcolm: I think everybody's wondering — when can we not feel constrained by wearing masks and paying attention to social distancing? Dr. [Anthony] Fauci and others, you know, continue to tell us to be prepared to keep doing this for a while.

I think it goes back to what Kris was saying earlier. It's just things that we don't know yet about whether there might be some vulnerability to new variants that are circulating, even if vaccinated, and then that question about transmission risk.

That may be at the heart of Pete's question about if you're wearing a mask to protect other people who may not be vaccinated. Those are all things that we will learn a lot more about in the coming months, but I think just that it's not very satisfying.

I think what Dr. Fauci and others are saying is just, while we're still gathering information, while we can't answer some of these critical questions yet with really clear data about how much protection there may be, it's just kind of that extra measure of caution. That still makes sense, just given the, you know, given what we've been through, and the desire to hang on to our gains and get all the way through this.

Ehresmann: There's a couple factors here. One is, we need to reach a certain level of population immunity through vaccination, to really be able to tamp down the spread of COVID so that we get to the point where its more background than dominant.

Even if every single person in Minnesota who is eligible for vaccine got vaccinated by the time that President Joe Biden's said we have the vaccine, we still have our under [age] 18 or under 16 population that cannot be vaccinated yet, because there is not a vaccine. That's the population that can continue to spread COVID-19, and in the process of that spreading and transmission that allows for the virus to mutate.

So until we have the ability to get the full population vaccinated, which I want to say, on the optimistic side, there are trials underway for kids now, and so we anticipate that there will be vaccines coming. But until that is taken care of that that's sort of a gap in our protection.

Then the fact that variants and how they mutate, and what role that mutation has in making them less amenable to the work of the vaccine, those are all things that we have to look at. So I think things will get better, but there'll be some things that we may have to continue to we are certain that we are out of the woods.

Jim from Mankato (teaches at collegiate level): With March being sort of the spring break week or spring break month, with kids coming back from potentially traveling, for instance, to Texas. We're face to face constantly, you know, we're in small labs with students. And so you're curious why college professors weren't included with the educators group in the phase?

Ehresmann: When at the federal level, they were discussing, you know, making sure that we had child care, and educators vaccinated, the focus was on early childhood to 12 because of the necessity for maintaining societal function. And there were a couple of reasons.

One was that in person learning was so essential to younger learners, and the devastating impact of, of not being able to be in person on that age group in that population. Also, the fact that that age group was less likely to be compliant with masking It would be more difficult to social distance, and that they had greater difficulty with, you know, distance learning or with online learning.

Whereas with the older populations that are in the post secondary setting, they're adults. So you can do a better job of indicating they have to mask, they need to social distance. And they also, in many settings, are able to also have some of their education online, or at least when it's necessary, and do a better job with that.

In terms of educators, they would likely be in 1C. That's the the place that post secondary would be.

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