Minnesota's COVID-19 status is 'quite precarious'

Coronavirus case counts in Minnesota cracked the 300,000 mark on Saturday, capping an alarming 16-day run that saw 100,000 new infections and more than 700 reported deaths.

The totals prompted state officials to stress that Minnesota still has a long way to go in trying to control the pandemic. While the number of new cases appears to have leveled off over the past week, deaths are soaring, with the state reporting 320 fatalities during that time — the second highest weekly total since the virus first hit.

"We took 29 weeks to get to the first 100,000 cases and six weeks to get to the next 100,000 ... and just over two weeks to add 100,000 more," said Kris Ehresmann, the state's director of infectious diseases. "Our status is quite precarious."

A mix of factors could result in Minnesota holding the line on new cases at elevated levels or further inflating them in ways that "would be an absolute tragedy in many of our hospitals," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Public concern over recent trends plus state orders to close bars and restaurants to in-person dining should help reduce transmission, Osterholm said. But with people traveling and congregating for Thanksgiving, and more holidays to come, there remains reason for concern.

'Fork in the road'

"Right now is probably, for me, the most unknown time since the pandemic began — because I don't know: Are we going to go right or left at the fork in the road?" Osterholm said.

"I think Thanksgiving and then building into the Christmas holiday season could see increased cases. On the other hand, if people begin to take this much more seriously — and, as I say, they stop swapping air — then we could see cases level off and start to come down. And I think surely we're seeing evidence of that in Iowa, the Dakotas and Wisconsin."

Saturday readings for recent population-adjusted case growth were lower than a week ago across the Upper Midwest, although the region continued to report nation-leading numbers.

Compared with the previous week, Wisconsin and Minnesota had slightly lower seven-day averages for case growth, according to a tracking website from Brown University. Even so, Wisconsin moved up four spots to number three while Minnesota ranked fourth, a jump of two places from last week.

The rate of case growth over the same period slowed even more in North Dakota, which dropped from the top spot to second. South Dakota dropped to seventh while Iowa fell out of the top 10.

Still, with the regional run-up in COVID-19 cases this fall, states across the Upper Midwest are now reporting very high numbers of deaths.

North Dakota surpassed 900 deaths this month, with more than one-third of the fatalities coming since Halloween. Wisconsin ended October with just over 2,000 deaths before seeing the total jump to 3,257 by Friday.

Catch-up data for holiday

On Saturday, Minnesota reported 45 new COVID-19 deaths and 9,040 new cases on more than 109,000 newly completed tests, according to the state Health Department.

It was an unusual release because the state provided data for two days to catch up after not reporting numbers on Thanksgiving. The death total was lower than might have been expected, particularly after the state reported a record 101 deaths on Friday for the 24-hour period ending at 4 p.m. Wednesday. The 45 deaths reported Saturday were for a 48-hour period ending Friday afternoon.

The holiday break may be responsible for the fluctuating numbers. Because funeral home directors and medical examiners are required to file reports within five days of death, it's possible that they pushed to file as many reports as they could before Thanksgiving so they wouldn't have to do so on the holiday weekend, Ehresmann said.

It's difficult to interpret the two-day totals released Saturday for new cases and completed tests, Ehresmann said, due to the holiday week.

'Still control our destiny'

Health officials say case growth trends help predict the rate of hospitalizations and deaths that follow. The recent moderation in Minnesota's case growth is encouraging, doctors say, yet models being followed at Allina Health and HealthPartners suggest that cases won't peak here until December.

"To a large degree, we still control our destiny for how bad this is going to get, and it need not be as bad as some of the models suggest," said Dr. Mark Sannes, an infectious disease physician at HealthPartners, via e-mail.

At Allina, hospitals reported fewer health care workers sidelined by exposure to the virus over the past week, said Dr. Ryan Else, interim acute care chief medical officer at Allina Health. But the health system expects the staffing crunch isn't over, with the number of absent health care workers fluctuating from week to week.

"We're really at an ongoing critical place with COVID," Else said. "There's a lot of current COVID infections in our community."

Across Minnesota, COVID patients still make up 1 in 3 patients in intensive care units and more than 1 in 5 medical-surgical beds in hospitals, said Dr. Rahul Koranne, president of the Minnesota Hospital Association.

With the two-day figures released Saturday, Minnesota has now seen 304,023 positive cases, 16,423 hospitalizations and 3,521 deaths since the pandemic arrived here in March. Residents of long-term care and assisted-living facilities accounted for 23 of the newly announced deaths and 2,378 deaths since the start of the pandemic.

For the week, Minnesota reported a total of 320 COVID-19 deaths, down slightly from 327 last week.

A more encouraging sign is the recent decline in the share of coronavirus tests coming back positive in Minnesota, said Matthew Binnicker, director of clinical virology at Mayo Clinic. That could indicate the state is past the peak of the latest surge, he said, although the numbers in coming weeks will be crucial. "We are certainly not out of the woods yet," he wrote in an e-mail.

The goal is to keep case counts low until vaccines become available.

"The only way we can get immunity from COVID is either through illness or through vaccination," Else said. "So, the fact that we have an initial vaccine being distributed next month with reports of significant doses … coming monthly thereafter is very encouraging. Hopefully, we will have safety in our communities in late spring to early summer."

Christopher Snowbeck • 612-673-4744