Minnesota tightens criteria for COVID-19 testing

Samples are tested for COVID-19.
Samples are tested for COVID-19 on March 3, 2020, at the Minnesota Department of Health.
Courtesy of Minnesota Department of Health file

Update: 5:40 p.m.

The Minnesota Department of Health said Tuesday the state is tightening its criteria for COVID-19 testing amid a national shortage of testing materials.

As the spread of the novel coronavirus continues — Minnesota announced 60 confirmed cases of the disease Tuesday morning — officials said the move will allow them to focus on highest-priority patients.

Tests will be reserved mostly for health care workers and people with underlying health conditions who are already hospitalized, as well as those who live in what health officials call “congregate living” situations, such as long-term care facilities or nursing homes.

For weeks, the state health department was doing the bulk of the COVID-19 testing, with kits from the Centers for Disease Control and Prevention. Hospitals would take nose and throat swabs from patients, and send samples to the state. But now that’s changed.

“We need to be focusing on testing those individuals for whom the positive test will make a significant difference either in their care or for our health care system,” said Kris Ehresmann, director of the Minnesota Department of Health’s infectious disease division.

For instance: “For a hospitalized patient who is positive for COVID-19, having a positive laboratory test helps inform the facility of the necessary infection prevention activities that must be undertaken, or the type of room the patient needs to remain in,” said Ehresmann.

She added that hospitalized patients who test positive can also participate in a number of drug trials for anti-virals.

It’s also important for health officials to know if a health care worker has contracted COVID-19, and could have infected patients in a health care facility. And because people living in nursing homes and long-term care are medically vulnerable, identifying patients who have the virus in these settings is also important, Ehresmann said.

The health department said Tuesday that all other patients — those who have a fever, cough, shortness of breath and other symptoms associated with a possible COVID-19 infection — should self-quarantine and isolate themselves from others, even family, as much as possible.

Ehresmann said in these cases, having a positive COVID-19 diagnosis “doesn’t make a difference in their care and treatment or in the recommendations for isolation.”

Because there's no treatment for COVID-19, a patient with mild or manageable symptoms would likely be sent home to rest, hydrate and recover — with or without a positive coronavirus diagnosis.

Health officials are advising patients with mild symptoms to operate as though they have been diagnosed with the coronavirus: Self-quarantine for 7 days after the illness starts, or for 72 hours after a fever has stopped without the help of medication, whichever is longer. They recommend patients stay in touch with their doctors, in case their symptoms worsen.

Patients with severe symptoms, or those who are members of populations vulnerable to the most severe impacts of COVID-19 — older adults and those who have significant underlying health conditions — are being told to contact their health care providers before they seek testing.

Ehresmann said this decision was made in response to a global shortage of testing supplies.

“The supply chains are based on needs prior to COVID-19,” she said. “High demand globally is driving these shortages and “it’s not always possible to ramp up in the span of six weeks.”

The health department is asking providers to send samples from patients who don’t meet these criteria to commercial laboratories, as they would for other tests, like blood work. But Ehresmann added those labs may be facing the same testing supply shortages the state is.

For one provider, that’s meant taking down temporary drive-through testing clinics. In a press release, M Health Fairview, a hospital on the University of Minnesota’s Minneapolis campus, said it would take down its clinic immediately in response to the state’s testing recommendations. M Health said it would divert the clinic’s staff to an online portal meant to help patients assess whether they have COVID-19.

Ehresmann said Minnesota has requested more tests and protective equipment for health professionals from the federal government, and is waiting to find out when they might receive it, adjusting its response to the disease accordingly.

“Obviously, this is a continuously moving situation and we are assessing and adapting on a daily, if not hourly, basis," she said.

In a letter to the Trump administration last week, Gov. Tim Walz wrote that the ability to test widely is critical to the state’s response to COVID-19.

“We have been forced to ration the number of tests performed at our public health lab,” Walz wrote. “I call upon you to help ensure we appropriately prevent and mitigate the spread of the COVID-19 pandemic.”

Health officials for weeks have been increasingly raising the alarm over the spread of the novel coronavirus in the United States. The disease is transmitted through respiratory droplets, coughs and sneezes, similar to the way the flu can spread.

Government and medical leaders are urging people to wash their hands frequently and well, refrain from touching their faces, cover their coughs, disinfect surfaces and avoid large crowds, all in an effort to curb the virus’ rapid spread.

The state of Minnesota has temporarily closed schools, while administrators work to determine next steps, and is requiring a temporary closure of all in-person dining at restaurants, bars and coffee shops, as well as theaters, gyms, yoga studios and other spaces in which people congregate in close proximity.