This is it.
The moment experts feared and predicted. We avoided it for months, but it eventually came.
Minnesota is about to enter, as Dr. Michael Osterholm of the University of Minnesota put it a few days ago, “COVID hell.”
State and hospital officials say we’re as prepared as we have ever been — but that it very well might not be enough.
And just so we’re clear: This is not like the spring. It’s worse.
Cast blame if you will for how we got here, but this much is certain: We got here from people giving the virus to each other.
And we can slow it down by staying away from each other.
With the cold season upon us and Thanksgiving coming up, experts and public officials are imploring Minnesotans to do exactly that: Mask up, and stay away from each other to every extent possible.
The messages, being echoed around the nation, even include faint signals of bipartisan harmony not heard since the earliest days of the coronavirus pandemic, with members of both parties in Minnesota, rural and urban, urging everyone that this is the real deal.
While few are using the phrase in Minnesota, many acknowledge that what they’re asking for is akin to a voluntary stay-at-home reality. Like the spring “shutdown,” but without the official orders and forced closures of businesses.
Like many of his peers, Gov. Tim Walz is averse to imposing a lockdown on a workforce he won’t be able to compensate among a population whose widespread compliance would be questionable.
But make no mistake: Sheltering in place, to the extent possible, is what the medical experts believe is needed to diffuse the surging wave of disease.
“Absolutely,” said Dr. Marilyn Peitso, a pediatric hospitalist in St. Cloud and president of the Minnesota Medical Association. “The voluntary restriction of your activities is what we need.”
“I think that’s right,” said Osterholm, director of the U’s Center for Infectious Disease Research and Policy who was named Monday to President-elect Joe Biden’s coronavirus advisory group. “Be only with people who can be bubbled with you.”
Experts wince at saying this — and political leaders fear being this blunt — because the implications are crushing, but if they speak frankly, they’ll tell you that, whatever the rules might allow, no one should be socializing, eating, drinking or otherwise gathering indoors in any sort of a public space.
Peer-reviewed research published Tuesday in the scientific journal Nature concluded that restaurants, bars, gyms, cafes and other indoor spaces were the site of about 80 percent of new infections in the early months of pandemic.
“It’s not just bars and restaurants,” Osterholm said. “It’s funerals and weddings — all the things that we want to do. … We’re in bad shape.”
WHERE WE ARE
Minnesota itself isn’t ground zero for the global hot spot right now — but our neighbors are. The top five states for the highest seven-day average of new cases, in order: North Dakota, South Dakota, Iowa, Wyoming, Wisconsin.
By some measurements, North Dakota has the highest rate of infections of any developed place on the planet. Hospitals are essentially full, and on Tuesday, Gov. Doug Burgum took the extraordinary step of allowing asymptomatic COVID-positive health care workers to keep working in COVID-19 wards, underscoring that the limiting factor for the health system isn’t beds, but healthy staff.
Minnesota isn’t there yet, but guidelines from the Centers for Disease Control and Prevention offer the option as part of “crisis capacity strategies,” when things get really bad. (The federal plan includes a “last resort” measure that would allow such workers to care for non-COVID patients.)
According to a New York Times analysis of various ways to measure who’s being hit hardest by the virus, Minnesota is surrounded by COVID notoriety. South Dakota is the state with the highest hospitalization rate. The Times labeled Wisconsin “the state that unraveled the fastest,” based on its steep surge in cases, hospitalizations and deaths. And to our south, Sioux City, Iowa, is “the metro area that may have faced the most prolonged suffering,” based on its sustained infection rate.
WHAT OUR NUMBERS SAY
Minnesota is breaking its own records daily.
The state is experiencing exponential growth, that hard-to-wrap-your-head-around phenomenon that allows a small investment to become millions of dollars over a lifetime, a colony of locusts to become a plague in a few years, and an outbreak of a novel contagion to bring a society to its knees in a matter of weeks or months.
So by the time you read this, those records might have been eclipsed. And of course, the cruel inevitability of this disease, for which treatment options are limited, is that a rise in cases is always — always — followed by a rise in hospitalizations, which is always followed by a rise in deaths.
STATUS OF MINNESOTA HOSPITALS
Since the pandemic began, the state’s hospitals have ramped up capacity. Minnesota has about 9,500 beds and nearly 1,900 intensive care beds, as well as access to about 3,500 ventilators, according to state data.
However, that apparent capacity belies the reality of the current surge: Doctors and nurses are falling ill, caring for ill family members, and being forced to isolate after close exposures to COVID-positive people. As the surge rises, the real capacity of hospitals will likely shrink — as will the quality of the care, Peitso and other hospital officials have warned.
“We are in a lot better position than we were in March,” said Peitso. “That being said, if the rise in cases continues to increase exponentially, we will surely get to a point where we have exceeded our ability to care for people.”
The numbers — dwindling beds and shrinking staffs as they become infected or care for family members who are sick — are only part of the impact on the health care system, she said. “We have been doing this now for nine months, and to see the impact it’s having now, it’s fatiguing. There doesn’t seem to be an end in sight.”
To some degree, the state’s last stand in what it can offer against the virus is testing because it confirms to someone: You, particularly, must isolate.
To this end, Minnesota has taken a series of steps in the past two weeks to rapidly scale up testing and its ease of access. Numerous free mass-testing facilities are dotted around the state, and now everyone can have a saliva test kit sent to their home.
The state is also throwing manpower at the surge, reassigning unprecedented numbers of the state workforce of 35,000 to coronavirus-related tasks. On average each week, some 1,265 state employees are working on COVID-19 response, according to figures supplied by the Minnesota Management and Budget department.
Earlier in the week, the agency told workers it was creating a pool of an additional 300 to 500 state workers to take on an array of tasks, including about 150 contact tracers.
However, the contact-tracing escalation comes as the outbreak is so out of control that at least one health department has given up.
Itasca County’s public health department suspended its contact-tracing efforts Tuesday, with department manager Kelly Chandler saying, “If you are in a group setting, just assume that someone has COVID.”
WHERE WE’RE HEADED
Forget the numbers for a moment.
When you add up what experts and officials are saying, the picture of daily life in Minnesota for the near future will look bleak.
In-person weddings, many previously postponed, should be postponed again. Same for funerals. At least, anything remotely resembling what we usually do for such occasions.
Many schools that are open will close in-person classes.
College students living on campus will have to stay there through Thanksgiving, either because they’ve been exposed, or because they could have been, and they shouldn’t risk taking the virus home.
Speaking of Thanksgiving, families accustomed to large gatherings will have to give that up. Walz on Tuesday ordered private social gatherings to no more than 10 people from no more than three households. But every expert interviewed for this report said that the safest course is no one outside your household.
It won’t end with Thanksgiving. The December holidays — Christmas, Hanukkah and New Year’s Eve — they won’t be what any of us wanted, either.
“We’re not going to be out of this by Christmas,” Peitso said. “It’s time to have these conversations about the entire winter season.”
PLEA FOR UNITY
The uniquely American political divide over the virus remains, but even some Minnesota Republicans, previously critics of nearly all state restrictions and lackluster boosters of masks, have changed their tone.
For the first time since Walz declared a state of emergency, Republicans who control the state Senate did not vote to rescind Walz’s emergency powers when they convened for a brief special session Thursday.
In the House, at least one Republican acknowledged that members of his caucus have not been leading with urging public health measures that are nearly universally accepted as effective.
“We can do a better job,” state Rep. Dave Baker, R-Willmar, said Thursday during a media call. “Masking should not be looked at as taking a knee to the governor, not at all. It’s part of the process to get us to a vaccine. If you need a Republican to help encourage that, I’m there.”
Peitso said a unified message is the only way ground can be gained against the surge.
“The time is now, Minnesota,” she said. “The time for Minnesotans to step up and renew their commitment to hand washing, masking, social distancing, limiting the size of gatherings, staying in your bubble, is now. And if we all do it, it will slow the spread. Everybody has to be in this together. Health care can’t do this alone.”