Facing a nationwide shortage of laboratory tests for COVID-19, the Minnesota Department of Health Tuesday, March 17, announced it would limit testing to those considered highest priority.

Among those prioritized for tests are those already hospitalized with severe illness, health care workers and those in congregate living settings, such as long-term care facilities.

Kris Ehresmann, the department’s infectious disease director, said during a conference call with media Tuesday that focusing on those individuals would have the greatest impact in mitigating the spread of the new coronavirus, which causes the respiratory illness COVID-19.

“Obviously it would be wonderful if we could continue to test with a very open hand,” Ehresmann said. “But one of the positive things about not being able to test everyone is that because we can only focus on highest-risk individuals, that will limit the use of the health care system by those individuals with mild illness — easing the burden on the health care system.”

Gov. Tim Walz sent a letter to Vice President Mike Pence last week calling for an immediate increase in the number of COVID-19 laboratory tests available to Minnesota health care providers. Ehresmann said while “it would be lovely if we could know everybody who has COVID-19,” the reality of the shortage means that isn’t possible. She emphasized that for patients with mild to moderate symptoms who do not require hospitalization, a positive test makes no difference in care, treatment or recommendations for isolation.

“If you have upper respiratory symptoms and are able to manage them at home,” said Ehresmann, “it doesn't change the treatment recommendations or our recommendations about staying home when you are sick. We want people who are ill to stay home from seven days after the onset of illness, or 72 hours after resolution of fever and respiratory symptoms, whatever is longer.

“... Having a positive test of COVID-19 for someone with mild symptoms is not a magic bullet. It doesn't change our recommendations for staying home when you're sick, and isolating yourself for the period recommended.”

Should symptoms become severe, Ehresmann said, patients should call their provider. Health officials also stressed that household and intimate partner contacts of all who have a fever and upper respiratory symptoms should severely limit their public activities as well, and for two weeks.

New figures released Tuesday showed six more people tested positive for the coronavirus in the state, raising the total to 60 cases.

No new counties were included in the new cases, all of whom are recovering at home, and all of whom are believed to have contracted the illness from people they met on international travel or out of state.

Two of the cases were located in Hennepin County, two in Olmsted County, and one case each in Dakota and Ramsey counties. They ranged in age from 37 to 71.

Focusing the testing on a smaller number of people is a change in operation after testing was occurring more widely in the state.

“When we shifted to allow greater flexibility in testing, we saw a huge influx of specimens to the point we are not able to keep up,” Ehresmann said. “So now we are prioritizing.”

What this change in testing guidance means, however, is the gulf between the official reported numbers of cases and the actual number of COVID-19 cases in the state is expected to widen.

“Absolutely we anticipate that the situation could get worse and we want to get prepared so we can test hospitalized individuals,” Ehresmann said. “What happens next really depends to a large extent on behavior of Minnesotans.”

Crow Wing County

In Crow Wing County, Cuyuna Regional Medical Center in Crosby and Essentia Health-St. Joseph’s Medical Center in Brainerd are running COVID-19 tests and this number changes daily, according to a joint statement from the county’s two major health care providers.

“The facilities are following the daily updates from the Minnesota Department of Health and CDC (Centers for Disease Control and Prevention) testing guidelines and only testing patients if they meet the criteria of requiring hospitalization. Health care workers and those in group living settings such as long-term care are also being given priority,” the release stated.

Ehresmann said the health department has not limited the distribution of tests based on geography and the laboratory is receiving samples from all across Minnesota.

Essentia Health is offering free e-visits for patients with concerns relating to COVID-19. Those who are 18 or older and live in Minnesota, Wisconsin or North Dakota can use the online service and they don’t have to be Essentia patients. Start an e-visit at essentiahealth.org/services/e-visit .

Although a positive COVID-19 test would not change treatment or isolation recommendations, the fear of the unknown and concern for loved ones has some symptomatic area residents feeling anxious.

Pequot Lakes man Zane Smith, 32, said he’s been denied testing for failing to meet criteria — even though he recently traveled in the Pacific Northwest as part of his job and flew from the Seattle-Tacoma International Airport to Minneapolis-St. Paul and then Brainerd. As of Tuesday afternoon, the Washington State Department of Health reported 569 confirmed cases in King County, which includes Seattle. Among those are 43 deaths.

Smith said he first began experiencing flu-like symptoms Friday, nearly two weeks after returning to Pequot Lakes. It began as a sore throat before evolving to include a headache, stuffy nose and fever — all unusual for someone who is rarely sick, Smith said.

He said although being ill hasn’t been pleasant, he’s less concerned about his own welfare and more worried about that of his parents, both of whom are in their 70s and have underlying conditions. His stepmother is now experiencing the same symptoms, according to Smith, and his family quarantined themselves. He’s also concerned for all the friends he was in contact with between returning home and when he started feeling sick.

“I’m worried about infecting my father. I’m worried about them getting worse,” Smith said. “I’m worrying about me not being able to go to work. … I’m kind of on vacation when I come back home, so the first thing I do is I drive around and see all my friends, so it’d be really nice if I knew if I got them sick.”

What to do if you’re sick

• Patients with undiagnosed fever and/or acute respiratory symptoms (cough, shortness of breath), even those not able to be tested, should self-quarantine for seven days after illness onset, or 72 hours after resolution of fever (without taking fever-reducing medications) and improvement of respiratory symptoms, whichever is longer. Patients should seek care if their symptoms become severe. They should call ahead to health providers when possible.

• Patients with symptoms who are not able to be tested should isolate themselves from household and intimate contacts as much as possible. Household and intimate contacts of these individuals should limit their activities in public for 14 days after incorporating precautions in the home, and monitor for symptoms.

More information about the symptoms of COVID-19 can be found on MDH’s Coronavirus Disease (COVID-19) website, as well as additional information about how to protect yourself and your community.
MDH has set up a COVID-19 public hotline that is open 7 a.m. to 7 p.m. The hotline number is (651) 201-3920.

The Minnesota Department of Public Safety has a hotline to field questions about the issues associated with community mitigation, including school and business impacts. That line is open 7 a.m. to 7 p.m. daily, and the hotline numbers are 651-297-1304 in the Twin Cities and 800-657-3504 for greater Minnesota.

Health officials have opened a school and child care hotline at 651-297-1304 or 800-657-3504.

Forum News Service contributed to this report.

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CHELSEY PERKINS may be reached at 218-855-5874 or chelsey.perkins@brainerddispatch.com . Follow on Twitter at twitter.com/DispatchChelsey .