Minnesota limits on crowds could last 'well beyond Easter,' Gov. Tim Walz says

Nearly 150,000 Minnesotans have sought jobless benefits since the coronavirus brought the state economy to a partial standstill.

The economic cost has been rising along with the number of COVID-19 illnesses and Gov. Tim Walz unveiled a strategy Tuesday that he thinks will help minimize the impact of both problems.

Walz said he will be leaning on data analytics by the Minnesota Department of Health and the University of Minnesota to evaluate tough decisions such as whether to issue sterner "stay-in-place" requirements to protect people from the pandemic, and guide when to loosen restrictions such as school and dine-in restaurant closures.

"Minnesota will do it the smart way," Walz said, though he braced people to be ready for restrictions that extend "well beyond Easter."

State health officials as of Tuesday confirmed 262 cases of COVID-19, the respiratory illness caused by the novel corona–virus that emerged in China in December and spread worldwide. Fifteen patients are currently hospitalized, with seven in intensive care. Those cases are viewed as the leading edge of a wave that over time could infect 40% to 80% of Minnesotans, although many might have only mild illness.

"At some point in time, those numbers will come true. The only question is, how long will it take us?" Walz said, adding that he remained symptom-free during his second day of home quarantine after a member of his security detail was infected.

That's where state health officials hope their data-driven strategies come in. Walz said he is awaiting predictive modeling on when Minnesota will see a peak in COVID-19 cases, and when hospitals could run out of intensive care services and ventilators for patients with severe level of illness.

"We hope that demand doesn't exceed our health care capacity, and we're in good shape now, but we need to be prepared to expand that system very quickly," said Joe Kelly, the state's emergency management director.

Asked to comment on the desire of President Donald Trump to ease social distancing restrictions by Easter, April 12, because of the economic consequences, Walz said it was wrong to "oscillate" between protecting health and the economy.

"It has to be both," he said.

The economic toll has been steep. The state Department of Employment and Economic Development reported Tuesday that it had received 149,443 unemployment insurance benefit applications between March 6 and 16. A third came from food service workers.

Walz said cellphone data and reports of reduced traffic suggest that people are complying with social distancing recommendations, which "buy time" for hospitals to prepare and for manufacturers to produce more ventilators and personal protective equipment to keep health care workers from getting infected.

Hospitals are nonetheless accelerating plans for surges of COVID-19 cases in the next month and the creation of spillover locations for patients.

"Early April is kind of going to be our tipping point," said Dr. John Hick, medical director of Hennepin Healthcare and the Metro Health & Medical Preparedness Coalition that is mapping out a metro-wide response to the pandemic.

Hotels, closed nursing homes and high school gyms are all being considered as spillover sites for patients who don't need intensive care but still require hospital-level attention. Kelly said state leaders are coordinating with the Army Corps of Engineers and National Guard on ways to rapidly expand such facilities.

Even though most infections result in only mild symptoms, a statewide rate of even 40% would mean strong or severe symptoms for hundreds of thousands of Minnesotans. Some would suffer severe pneumonia or breathing problems and need intensive hospital care, perhaps with ventilators to maintain adequate oxygen.

The ebb of the flu season has helped, reducing usage of ventilators and intensive care beds. A week ago, only 5% of the Twin Cities' ICU beds were open. Now, that number is at 15%. The state's capacity also is being padded with the conversion of surgical anesthesia equipment and other devices into ventilators.

Preparations within hospitals include the doubling of bed capacity at the Bethesda long-term care hospital in St. Paul and its conversion into a single-purpose COVID-19 facility. The M Health Fairview hospital will be able to receive patients in two days. Contractors reconfigured 63 beds in Abbott Northwestern Hospital to treat COVID-19 patients — a conversion in days that normally would have taken months. All have been outfitted with negative-pressure airflow control because of the risk of patients coughing or spewing infectious droplets during procedures such as the removal of breathing tubes.

"Our medical ICU is now essentially going to become a respiratory COVID ICU because of these negative-airflow capabilities that we have," said Dr. Sarah Prebil, a medical technology specialist on the hospital's incident command team.

Hick said hospitals also are starting to discuss how they might use volunteers who have recovered from COVID-19 and have at least temporary immunization. So far, 88 of the state's confirmed cases are recovered.

Infusion of supplies

The availability of personal protective equipment has been a major concern for hospitals, where doctors and nurses have already been encouraged to reuse masks and gloves to the limits of their safety levels.

Hick said he is optimistic that hospitals won't run out, though, because of these conservation efforts as well as remarkable public donations of industrial-grade masks and respirators. The Minnesota Nurses Association alone received 70,000 donations of masks and other items it had delivered to the state operations center Tuesday.

Another good sign has been a stable supply of medications, many of which are derived from manufacturing or ingredients in China, the origin of the COVID-19 pandemic, Hick said. "I was very worried that even by this point we would be seeing very significant disruptions."

One drug that may be running short is hydroxychloroquine. The University of Minnesota doubled the size of its clinical trial Tuesday to see if this old malaria drug prevents or treats symptoms of COVID-19, but the problem is that some people are seeking it for off-label treatment of the illness.

Responding to a woman who can no longer find the drug to treat her rheumatoid arthritis, Cody Wiberg of the Minnesota Board of Pharmacy said he is coordinating with the state attorney general to prevent the drug's misuse.

Another concern is the spread of COVID-19 to at least four Minnesota long-term care facilities — with more likely to be reported Wednesday, health officials said — because COVID-19 has caused the most deaths and complications in people who are older or have other health problems.

Ramsey County officials confirmed that a worker at the county's 164-bed Maplewood Care Center had a confirmed case, though he was screened on the way into work and placed in quarantine.

Hick said there are signs here and even in hard-hit cities like Seattle that social distancing is working. It's too late once hospitals are full, he said, because by then many more people are infected and likely to need high-level care.

Staff writers Chris Snowbeck, Glenn Howatt and Shannon Prather contributed to this report.

Jeremy Olson • 612-673-7744