Big Books & Bold Ideas with Kerri Miller

How is Minnesota handling a surge in COVID-19 cases?

person holds package, person stands in background
A new COVID-19 testing site open at the Minneapolis Convention Center on Monday November 9, 2020 as cases in Minnesota reach record levels. The saliva tests will be free of charge to all Minnesotans.
Kathryn Styer Martinez | MPR News

Active cases of COVID-19 passed the 40,000 mark in Minnesota on Friday.

The Health Department on Monday reported another 7,444 newly confirmed or probable cases of the disease. That number is staggering on its own, but it’s especially concerning given that about two weeks earlier the daily case number had never passed 3,000.

Cases are rising in nearly every part of the state, and health experts are concerned that pattern will continue as social gatherings, even small ones, continue to happen.

Last week, Gov. Tim Walz imposed new restrictions on bars and restaurants requiring them to close in-person dining by 10 p.m. He also placed a limit on the amount of people who attend public gatherings such as weddings. 

What happens if the number of cases doesn’t decrease? How will hospitals handle the influx of cases? Will we have a vaccine sooner than we thought?

Monday at 9 a.m., MPR News host Kerri Miller checked in with Jan Malcolm and Kris Ehresmann from the Minnesota Department of Health about how the state is handling the recent surge in cases and how the state is preparing for the upcoming holiday season.  

Hospitals are reaching a ‘breaking point’

Many Minnesotans wonder if we will see a shutdown similar to what we saw in March and April of this year to help slow the spread. Ehresmann thinks it’s a good idea. 

“We've got to do something to change the trajectory of where we're at. Our health care systems are at the breaking point. And so we're going to have to think carefully about next steps and what we need to do,” she said. 

As the number of cases increase, so could the number of hospitalizations. In the next couple of weeks, hospitalizations may see an increase by a factor of two or three according to Malcolm. If this happens, hospitals may not have enough staff to treat patients because many hospital workers are contracting the virus out in the community, quarantining due to exposure or taking care of sick family members.

Since the pandemic began, hospitals and state health departments have been communicating about their surgical and intensive care bed capacity and movement of patients around the state to different hospitals.

“The public has to know it’s going to happen that more and more people may not be able to be hospitalized close to home, they may need to be hospitalized where there's a bed,” said Malcolm. 

Health officials are seeing a trend in hospital consolidation lasting for quite a long time according to Malcolm. 

“The theory and the principles have always been that that would lead to greater efficiency and greater ability to concentrate volumes of highly specialized care in a way that would be good for quality,” she said.

Since the pandemic, health officials have learned that looking at hospital capacities and other factors are extremely important. 

COVID is spreading more quickly

This past summer, cases remained at a stable place, but this fall they grew faster than health officials could have predicted according to Ehresmann. They used to think that 3,000 to 4,000 cases a day were concerning. Now, at over 7,000 cases in a single day, they are becoming even more concerned.

Malcolm broke down the numbers to show just how quickly cases are growing. 

“It took us 29 weeks from our first laboratory confirmed cases till the first 100,000 marks. The next 100,000 took us six weeks, when we hit 200,000 on Nov. 10. We're now projecting we'll hit the next 100,000 so 300,000 cases cumulatively before Thanksgiving,” she said.

Monday afternoon, Malcolm and Ehresmann joined Gov. Walz in a press conference urging Minnesotans not to gather in groups outside of their immediate households.

Despite the recommendations, many people will still get together in large groups this holiday season. Ehresmann encourages these people to get tested before and after these gatherings.

“If you got tested, and you tested negative, and you were able to quarantine — so literally keep yourself out of circulation — after having tested, and you did that for 14 days, you would be in a much better place,” she said.

Gatherings — large and small — are pushing the spread

In the last few months, the single largest group of cases has been young Minnesotans. However, this is occurring nationwide.

“This is not just a Minnesota phenomenon,” said Malcolm. 

Many of these young people are asymptomatic and spreading the virus without knowing they are doing so. This is dangerous, because young people tend to socialize and continue to be mobile more than any other group.

A study conducted by the Minnesota Department of Health found that people who were at a bar or restaurant at or after 9 p.m. were twice as likely to be part of an outbreak. Ehresmann said that there are many factors that may reduce one’s inhibitions during a night out such as more interactions or alcohol consumption. 

“It's important to keep in mind that that doesn't mean that visiting at a different time is completely risk free. But we certainly know that later means more risk,” said Ehresmann.

Some places of worship in Minnesota have returned to in-person services, yet health officials still encourage folks to stay home and attend virtual versions instead.

“We really urge people not to be gathering in large numbers, or really, even in small numbers outside your immediate household in this next period of time,” said Malcolm.

Timing for a vaccine is still unclear

Recently, biotechnology company Moderna said their vaccine is nearly 100 percent effective in its first analysis. Malcolm and Ehresmann found this news to be extremely encouraging, yet remain a bit skeptical. 

“The one caveat I'll mention is that obviously, these were published in press releases, and so not peer reviewed journals. But nonetheless, the data are incredibly encouraging, and we're very heartened by that,” said Ehresmann.

Pharmaceutical company Pfizer has also created a vaccine that is 90 percent effective, however it needs to be kept 80 below zero which makes storage and handling of the vaccine challenging. 

“Pfizer has put together some very elaborate transportation mechanisms that will be shipped with the vaccine … And that's why we've wanted to let the public know that even as we prepare for this, it's going to be a complex process because of some of the storage and handling requirements,” said Ehresmann.

Once the vaccine is ready to be distributed, the state will receive a framework from the National Academy of Sciences about the vaccine distribution process.

“We also have a Minnesota group of clinicians, ethicists, others helping, and as soon as we get that federal framework, we will take that and tailor it to the degree it needs to be to Minnesota,” said Malcolm.

Ehresmann said they are looking for FDA approval for vaccine distribution sometime in mid-December to January. There will be three phases of vaccination.

The first phase will be a limited supply for health care and essential workers. Once more vaccines become available, the second phase will be distributed to high risk individuals. At the third phase, everyone will have the opportunity to get vaccinated.

The Health Department is working with public health systems to help identify who will receive the vaccine at what point in the process.

We don’t know everything about the virus

Health officials say COVID-19 patients can still spread the virus two weeks after testing positive, regardless of whether they show symptoms. 

However, there are patients who continuously test positive for a long time, yet are not infectious to other people at that point.

If you are in a situation like this, Ehresmann recommends wearing a mask around high risk people just to be safe. 

On a previous visit to the show, she also pointed out that the long-term impacts of the virus are not fully known.

“What we're hearing and what we're seeing is that individuals who have had COVID and may have had what wasn't perceived as a severe case, are continuing to have lingering effects,” Ehresmann said. “There's also been research that's been done that looked at individuals who, again, had mild cases or perhaps asymptomatic cases that suggest that they may have had cardiac damage. So what we're learning is that the initial symptoms and the initial presentation of this disease does not necessarily constitute the full effect that it has on a person's body.”


  • 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.

To listen to the full conversation you can use the audio player above.

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