State officials expressed frustration with a continuing shortage of testing supplies Wednesday, as they reported that COVID-19 had claimed five more lives and sickened at least 60 more Minnesotans.
Even as the number of infections has grown by 400 in just a week, to 689, officials continue to emphasize that the confirmed case count is not telling the whole picture of how many Minnesotans have the virus.
With the federal government not responding to the state's request for emergency supplies, it does not appear that broader access to testing will increase soon.
Because of an ongoing shortage of the materials needed to process COVID-19 tests in the state laboratory, priority has been given to samples for those at the highest risk, including hospital patients, health care workers and long-term care residents.
The restrictions were introduced two weeks ago because of a supply shortage. The state lab had a backlog of 1,800 untested samples, which has since been cleared with help from the Mayo Clinic lab, which increased its capacity.
The state expects to be able to process the high-priority samples, but it might take longer to get results because the materials needed for their high-capacity testing methods are in short supply and are on back order for at least a month.
Requests to the U.S. Department of Health and Human Services for emergency supplies have gone unfilled and unanswered.
"None of the lab supplies that we have asked HHS about have materialized in Minnesota at this point," Health Commissioner Jan Malcolm said.
Gov. Tim Walz said many governors expressed frustration on a conference call Wednesday about the lack of supplies.
"Governors are really, really focusing on this, and it is challenging," he said.
In the meantime, Walz will deliver his annual State of the State speech Sunday night on his YouTube channel. He will speak from his official residence in St. Paul.
While COVID-19 is likely to take up part of the address, it is unclear whether Walz will announce any decision about the stay-at-home order, which is set to expire April 10.
Walz also canceled the Governor's Fishing Opener scheduled for May 7-10 in Otter Tail County but said the fishing season will go on as planned.
Walz said he and other governors were "deeply concerned" about the lack of personal protective equipment, including masks and face shields.
State officials put out a call Wednesday for handmade masks, asking people to donate them to local hospitals, nursing homes, correctional facilities and transit operators.
"A homemade cloth mask can help prevent the spread," said Joe Kelly, Minnesota's emergency management director.
The move comes as federal officials are discussing whether the general public should wear masks as another precaution to contain the virus.
Among state health officials, the first step would be to direct cloth masks to health care settings, including nursing homes.
"It is something that we will have more conversations about down the road," said Kris Ehresmann, infectious disease director at the Health Department.
The department recently issued guidance on its website on the appropriate use of masks that are not approved by the FDA.
Most of the Minnesota COVID-19 deaths have been among long-term care residents, who account for 11 of the 17 deaths in the state.
COVID-19 has spread to at least three more long-term care facilities, with 42 now having at least one confirmed case. One location has six cases.
Outbreaks in nursing homes have been a problem in other states, and state officials say they are closely monitoring each facility that has cases.
"They do represent both a vulnerable population and a population that could easily overwhelm the health care system," Ehresmann said.
There have been 38 confirmed cases in long-term care residents and another 22 cases in long-term care workers.
Hospitals are caring for 54 COVID-19 patients, with three patients discharged since Tuesday. But one more person was admitted to intensive care, bringing that total to 27.
Among all Minnesotans who were confirmed to have COVID-19, 342 have since recovered and no longer need to be isolated.
Minnesota is expected to see a peak in COVID-19 cases sometime between early May and early June, Malcolm said Tuesday. That would be followed a few weeks later by the highest need for hospital beds.
Malcolm said that the modeling, conducted by her staff along with University of Minnesota researchers, was done to help the state prepare for the surge in cases.
The model, which is being updated, is likely to tell a different story as more is learned about how the disease is spreading in Minnesota and more is known about the effect of the community mitigation measures.
"We are right now just starting to be able to compare the rate of growth in our cases to what we are seeing in other communities," she said.
The model also does not incorporate the anticipated impacts that the recent stay-at-home order, which took effect Saturday, will have on new infections. Public health officials hope that keeping as many people at home as possible will reduce COVID-19 transmissions by 80%.
If that happens, the peak in infections might come later, giving the state time to get more medical equipment and expand hospital capacity.
Several hospitals are adding more beds on their campuses.
"The limiting factor is the availability of ventilators to be able to equip those rooms," Malcolm said.
Operating rooms could also be converted to intensive care because many of them have ventilators. Some operating rooms are not being used because elective surgeries have been canceled.
The state is also scouting locations for temporary hospitals using buildings, such as closed nursing homes, that could house patients who don't need critical care and are not infected with the coronavirus.
The goal is to add 2,750 temporary beds, with 1,000 of them in the metro area.
"We are not going to immediately build out all of these identified spaces and put stuff in them," Kelly said.
Once the need is there, Kelly said, the new hospitals will be developed quickly with the help of the Army Corps of Engineers.
"I hope that we never need any of the alternate care sites," Kelly said. "We hope that the additional capacity that the hospitals are generating right now will be adequate."
With the stay-at-home order, as well as previous actions that limited crowd sizes, and closed dine-in restaurants, bars and entertainment venues, traffic on Minnesota's roads continues to decline.
As of Monday, traffic volumes were down 34% statewide from last year's average. In the metro area, traffic fell 40%.