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Minnesota hospitals rush to get ready as COVID cases rise to 262

Hospitals have accelerated response plans for COVID-19 and the creation of spillover locations for infected patients with moderate levels of illness, as the pandemic has now reached 262 confirmed cases in Minnesota.

The current rate of increase suggests that all hospitals will have patients admitted for COVID-19 within a week and will see a large surge in early April, said Dr. John Hick, medical director of Hennepin Healthcare and also the Metro Health & Medical Preparedness Coalition that is mapping out a joint metro-hospital response to the pandemic.

“We’re trying to get ready for a really broad range of contingencies,” said Hick, stressing that community adherence to state social distancing measures will dictate the amount of any patient surge.

The Minnesota Department of Health on Tuesday morning reported 262 confirmed cases, an increase of 27 from the day before. But state officials have stressed that this is based on limited testing and is likely an undercount of cases in Minnesota. Fifteen patients are currently hospitalized.

The total includes 88 patients who have recovered and no longer require isolation.

Current state guidance is for anyone with fever and respiratory symptoms, regardless of a COVID-19 diagnosis, to remain in isolation for 7 days after symptom onset, or 3 days after a fever has gone away without medication — whichever is longer. Close household contacts are asked to quarantine themselves for 14 days as well.

While as many as 80% of COVID-19 cases produce only mild symptoms, the illness caused by a novel coronavirus is more severe for people who are elderly or have other chronic conditions.

Residents in four Minnesota long-term care facilities are being tested for COVID-19 after some tested positive and others reported symptoms, sparking concerns that the coronavirus has been circulating within medically vulnerable populations.

“We have said from the beginning that we know that congregate living settings especially among our elderly are going to be very important to react to very quickly,” said state Health Commissioner Jan Malcolm. “We are taking a very proactive approach to working with those facilities.”

Hick said he is feeling better now than even a few days ago about supplies of masks to protect health care workers treating patients, thanks in part to donations of an industrial-grade masks and to hospital policies to reuse masks when safe to do so.

Because COVID-19 can produce severe breathing problems, Hick said the state is bracing for a large number of patients needing intensive care and hospital ventilators. The statewide supply of 1,180 includes some equipment such as surgical anesthesia machines that have been repurposed to serve as ventilators as needed, he said.

The ebb of the flu season has allowed hospitals to reduce their current usage of ventilators and intensive care beds in preparation, though. A week ago, only 5% of the state’s ICU beds were open. Now, that number is at 15%, Hick said.

The state is bracing for an increased demand for ventilators. The statewide supply of 1,180 includes some equipment such as surgical anesthesia machines that have been repurposed to serve as ventilators as needed.

Minnesota health officials not notifying on negative COVID-19 test results

The Minnesota Department of Health is not directly notifying residents whose COVID-19 tests come back negative, leaving some people to continue wondering if they have the virus, days after the state cleared its testing backlog.

Two people who were tested more than a week ago for the virus that causes COVID-19 at facilities in St. Louis Park said they have yet to hear back from anyone about whether their specimens contained the virus. The delay has deepened their sense of isolation in strict quarantine and left them unable to tell acquaintances and bosses whether they’re affected.

“I’ve been waiting since the 14th for these test results. And I’m pissed off,” said Travis Krulikosky of Minneapolis, who has been out of work and under quarantine at home while the results are pending. “I turn on the TV and I see all the tests are done, but I still don’t have my results.”

State officials declared Sunday that the significant backlog of unprocessed COVID-19 tests from earlier in the month was cleared after Mayo Clinic pitched in to help process untested specimens.

But on Monday, the state Health Department said it was only contacting people whose COVID-19 tests were positive. People whose tests are negative for the virus are supposed to get those results from the health care provider who took the specimen.

“Given the number of tests and the number of positive results, the focus needs to be on notifying positive results first, so we can perform the subsequent investigations,” Minnesota Department of Health spokeswoman Julie Bartkey said in an e-mail. “It’s simply a matter of capacity.”

And on Tuesday, HealthPartners acknowledged that some of its earliest test specimens are still being “processed.” That has left some patients feeling stranded.

Krulikosky said his case was probably bronchitis, not COVID-19. He was initially told he’d have his results within two days, which he told his employer. Now it has been more than a week and he still doesn’t know what to tell his human resources department.

Rachel Jackson, 43, of Golden Valley, said she was tested for COVID-19 on March 13, after returning from a trip to southern Texas and experiencing coughing and a fever. Her negative test results from strep and influenza arrived within a day, but her COVID-19 test has never come back.

Jackson said she understands public health officials need to prioritize their resources in dealing with the outbreak, and her situation doesn’t put her in a high-priority group. That doesn’t make it easier to deal with the limitations of a self-quarantine at a personal level.

“From a levelheaded, rational, nonemotional perspective, I don’t need to know right now. But there is still that underlying anxiety,” Jackson said. “I’ve been isolated. I haven’t touched another human for 11 days — and I’m an extrovert and a hugger. I just want one hug, you know? It’s just one of those things that is really difficult.”

Jackson and Krulikosky were both tested at facilities run by HealthPartners. A third case reported to the Star Tribune involved a physician tested at a different Twin Cities health system on March 16. Her results remained unknown as well.

HealthPartners said Tuesday that the large volume of patients who presented with COVID-19-like symptoms early in the United States’ response to the outbreak created challenges in processing COVID-19 tests at labs across the country.

“While we have overcome many of these challenges, some of the tests that we obtained early-on are still being processed,” HealthPartners spokesman David Martinson said in an e-mail. “Aside from those that were in this early wave of testing, people can expect to receive results in 3 to 4 days.”

Although the state Health Department has a laboratory where COVID-19 tests are being processed, the nasal swabs and other test specimens are collected at local health care providers. In some cases, those tests are processed locally, and in others they are forwarded to the state. All positive tests are reported to the state.

The Health Department “has indicated that we will only test specimens from certain groups at our lab to ensure that we can maintain the needed public health testing for the long term,” state infectious disease director Kris Ehresmann said in an e-mail via a spokeswoman. “Testing is available elsewhere and providers can use those labs for testing.”

“Given the number of tests and the number of positive results, the focus needs to be on notifying positive results first, so we can perform the subsequent investigations.” Julie Bartkey, Minnesota Department of Health spokeswoman

Jae C. Hong 

A man is seen through the Olympic rings in front of the New National Stadium in Tokyo, Tuesday, March 24, 2020. IOC President Thomas Bach has agreed "100%" to a proposal of postponing the Tokyo Olympics for about one year until 2021 because of the coronavirus outbreak, Japanese Prime Minister Shinzo Abe said Tuesday. (AP Photo/Jae C. Hong)


Crime-and-courts
alert top story
Sheriff: Winona man in custody after leading police on high-speed chase

Lemke 

A Winona man is in police custody after fleeing a police officer in a motor vehicle Monday night.

Winona County sheriff’s deputies say the chase occurred on Hwy. 61 after they had been called to locate a vehicle that had left the scene of an ATV crash.

Upon making contact with the suspected vehicle, deputies found it to be going over 100 miles per hour and pursued it for about four miles before getting the vehicle to stop in a farmer’s field near County Road 23.

Dennis George Lemke, 44, of Winona was charged with fleeing a peace officer in a motor vehicle and possession of drug paraphernalia. Lemke was also referred for suspicion of misdemeanor DWI, but charges are pending the result of a blood test.

According to the deputy’s report, Lemke was uncooperative and was tased several times. He was subsequently medically cleared by responding EMTs.

Police found in Lemke’s vehicle what they believed to be marijuana drug paraphernalia and a broken methamphetamine pipe.

No injuries were reported from the pursuit.


Washington
AP
Trump looks at easing curbs

WASHINGTON — With lives and the economy hanging in the balance, President Donald Trump said Tuesday he is hoping the United States will be reopened by Easter as he weighs how to relax nationwide social-distancing guidelines to put some workers back on the job during the coronavirus outbreak.

And congressional and White House officials said Tuesday a deal appears to be at hand to provide sweeping aid to businesses and workers facing ruin from the coronavirus pandemic.

Both Senate Majority Leader Mitch McConnell and the top Democrat, Sen. Chuck Schumer, said agreement appeared close on the nearly $2 trillion package. “I don’t see any issue that can’t be overcome within the next few hours,” Schumer said. “Last night I thought we were on the five-yard line. Now we’re on the two.”

As many public health officials call for stricter — not looser — restrictions on public interactions, Trump said he was already looking toward easing the advisories that have sidelined workers, shuttered schools and led to a widespread economic slowdown.

“I would love to have the country opened up and just raring to go by Easter,” he said during a Fox News virtual town hall. Easter is just over two weeks away — April 12.

Health experts have made clear that unless Americans continue to dramatically limit social interaction — staying home from work and isolating themselves — the number of infections will overwhelm the health care system, as it has in parts of Italy, leading to many more deaths. While the worst outbreaks are concentrated in certain parts of the country, such as New York, experts warn that the highly infectious disease is certain to spread.

The U.S. is now more than a week into an unprecedented 15-day effort to encourage all Americans to drastically scale back their public activities. The guidelines, issued by the Centers for Disease Control and Prevention, are voluntary, but many state and local leaders have issued mandatory restrictions in line with, or even tighter than, those issued by the CDC.

“I gave it two weeks,” Trump said during the town hall from the Rose Garden. He argued that tens of thousands of Americans die each year from the seasonal flu and in automobile accidents and “we don’t turn the country off.”

On Monday, the U.S. saw its biggest jump yet in the death toll from the virus, with more than 600 American deaths now attributed to COVID-19. Trump’s comments come after dire warnings by officials in hard-hit areas. New York. Gov. Andrew Cuomo sounded his most dire warning yet about the coronavirus pandemic Tuesday, saying the infection rate in New York is doubling about every three days and the state could be as close as two weeks away from a crisis that sees 40,000 people in intensive care.

Such a surge would overwhelm hospitals, which now have just 3,000 intensive care unit beds statewide.

Meanwhile, the International Olympic Committee postponed the 2020 Tokyo Olympics until the summer of 2021 at the latest, acting on the recommendation of Japan’s prime minister. That could be a heavy economic blow to Japan and could upset athletes’ training regimens, perhaps costing some of them a shot at a medal.

When the 15-day period ends next Monday, he said, “We’ll assess at that time and we’ll give it some more time if we need a little more time, but we need to open this country up.” He added, “We have to go back to work, much sooner than people thought.”

Trump’s Easter target was not immediately embraced by Dr. Deborah Birx, the coordinator for the White House task force, who indicated any move would have to be guided by data still being collected. She suggested that public health professionals could recommend a general easing, while pushing for local restrictions to remain in the hardest-hit areas.

Trump acknowledged that some want the guidance to continue, but claimed without providing evidence that keeping the guidance in place would lead to deaths from suicide and depression.

“I’m sure that we have doctors that would say, ‘Let’s keep it closed for two years,’” Trump said. “No, we got to get it open.”

He added, “This cure is worse than the problem.”

On Capitol Hill, negotiators labored in the shadow of what McConnell called “the most serous threat to Americans’ health in over a century and quite likely the greatest risk to America’s jobs and prosperity that we’ve seen since the Great Depression.”

Treasury Secretary Steven Mnuchin and congressional leaders engaged in final negotiations after a tumultuous but productive day on Monday. While the two sides have resolved many issues in the sweeping package, some sticking points remained. Also, the complex task of writing legislation can take time, aides warned. A Senate vote could come later in the day or on Wednesday.

At issue is an unprecedented economic rescue package that would give direct payments to most Americans, expanded unemployment benefits, and a $367 billion program for small businesses to keep making payroll while workers are forced to stay home. A point of contention has been $500 billion for guaranteed loans to larger industries.

A one-time payment of $1,200 per person, or $3,000 for a family of four, would go directly to the public.

Hospitals could get up to $200 billion for the expected influx of sick patients, Mnuchin said.