A cohesive COVID-19 response that Gov. Tim Walz has described as the envy of the nation showed signs of cracking Thursday as organizations threatened to defy the governor's remaining state lockdown restrictions.
Even as the state's one-day death toll reached a single-day high, backlash continued to the governor's decision Wednesday to allow only outdoor bar and restaurant services to reopen June 1, to delay campground reopenings until after Memorial Day weekend, and to limit indoor and outdoor religious services to 10 people.
"Arbitrarily forcing restaurants to remain closed through the Memorial Day weekend is a crushing blow," said Mikael Asp, owner of La Grolla restaurant in St. Paul, who wanted the governor to OK indoor restaurant service at 50% capacity.
State health officials said they expected discontent but discouraged rebellion — especially given that the governor's strategy and the lifting of a 51-day statewide stay-at-home order on Monday put Minnesota on a faster return-to-normal trajectory than recommended by President Donald Trump's COVID-19 task force.
COVID-19 continues to spread across Minnesota, which according to a new national COVID Exit Strategy web page is one of 20 states in which cases are increasing. The 32 deaths associated with COVID-19 reported Thursday for a new high included 28 long-term care residents. The state's toll now stands at 809. Total lab-confirmed case count reached 18,200.
The number of Minnesotans hospitalized for COVID-19 stands at 566 — with 229 in intensive care.
While as many as 80% of infections cause mild to moderate symptoms, health officials noted that 2.5 million Minnesotans are at elevated risk for severe cases because of obesity, smoking, or diseases of the heart, lung, kidneys or immune system. "What may seem to be OK for a certain segment of the population could have devastating consequences for others. So [people need] to be willing to consider that need higher than our own," said Kris Ehresmann, state infectious disease director, adding that she was concerned that the reopening of churches would prompt the elderly and vulnerable to attend.
Modeling by the University of Minnesota and state health researchers found the stay-home policy reduced face-to-face contact and virus transmission by 55%. That bought preparation time for hospitals, which added ICU beds and ventilators.
Walz said the improved hospital readiness helped persuade him to scale back restrictions — first exempting manufacturers and then retailers from the stay-at-home order in mid-April before lifting it completely this week.
Many business leaders and the Minnesota Chamber of Commerce supported those incremental steps but were hoping for more freedom by June.
The state also is facing lawsuits on multiple fronts, including from churches that want to reopen, an owner of six bars in Stearns County and a small-business group.
Conservative advocates also filed a recall petition against Walz with the Minnesota Secretary of State on Thursday.
"Governor Walz continues to ignore the creative, thoughtful and safe reopening plans that small business owners have developed," Rep. Dave Baker, R-Willmar, said Thursday at a news conference unrelated to the recall.
Continued health risks
Complicating matters is the fact that Walz's strategy has caused concerns on the opposite end of the safety argument.
The Minnesota Nurses Association believes a return to normal too soon will result in a surge in COVID-19 cases that exhausts hospital supplies and threatens nurse safety.
Car traffic levels have started to creep up but were still 19% below average in the metro area Tuesday, according to the Minnesota Department of Transportation.
The state now receives an "F" grade, as most states do, from Unacast, which uses mobile devices to assess how much people are moving around and away from home.
The risks of ignoring state health guidance were evident when a group in Minnesota tried to set up a graduation event in violation of Walz's order.
One infected person involved in setup exposed two others, who didn't know their risk status when they participated, Ehresmann said.
Guidelines might seem irregular in restricting one type of location but not another, but they account for differences in the amount and predictability of movement between people — which can dictate risk levels for virus transmission, Ehresmann said.
A graduation ceremony is not as predictable as some might think, she added. "Even the best-laid plans cannot account for the human reaction of students rushing to hug classmates they have not seen in a long time."
The Minnesota Catholic Conference continued with its recommendation that churches could fill to one-third of their capacities for indoor masses starting Tuesday — in violation of the state order.
The city of Eveleth declared earlier this week that it wouldn't enforce any of the governor's shutdown restrictions, but it was unclear Thursday if any businesses would take advantage.
Margie Koivunen didn't want to jeopardize the liquor license at her bar but said "there's a lot that doesn't make sense. If you go into a big-box store, they're crawling with people. I wouldn't see that many customers in a week."
Restaurant leaders on the North Shore are asking for the governor to recognize the folly of investing in outdoor seating at a time of limited resources.
"To try to use a one-size-fits-all approach just doesn't work," said Jason Vincent, owner of the Boat Club Restaurant and Bar in Duluth, and Vanilla Bean cafes in Two Harbors and Duluth.
Technically, Walz's rollback of restrictions is more aggressive than recommended by the White House guidelines, which ask states to wait until they have seen 14 days of declining cases.
State health officials aren't sure that will happen until the fall.
Other states aren't following that guidance either, and the president himself has questioned it and at one point issued a "liberate Minnesota" tweet in response to its ongoing stay-at-home order.
Walz gained support from former U.S. Sen. Dave Durenberger, who said the absence of consistent federal leadership has forced governors to act on their own — and left them open to criticism and comparisons.
"There's kind of a constant chipping away of confidence and trust," said Durenberger, a Catholic who was disappointed by the decision to proceed with indoor masses that violate state guidance.
Durenberger joined with a group of health care leaders, including Edina resident and former Medicare administrator Andy Slavitt, in calling for state-ordered shutdowns to be relaxed carefully.
"It won't help the economy if we end up having to pull back hard or close again because the virus starts spreading toward the point where it threatens our health care systems and further disrupts our health," they wrote in USA Today.
Slavitt gave an unvarnished assessment of Minnesota's response, which, among other things, he said was too slow to respond to the heightened risks in long-term care facilities. Long-term care residents have made up 663 of Minnesota deaths so far in the pandemic, or about 82%.
However, the pace at which Walz is scaling back restrictions is "not out of the mainstream" compared with other states, Slavitt said. "I think the governor has probably got it close to about right on his opening activities — the pace at which he is opening them."
Five metrics are guiding decisions on whether to scale back restrictions, or even impose new ones if COVID-19 cases surge and strain hospital capacity.
One showed improvements — with the rate of doubling of COVID-19 cases being 14 days in Minnesota.
The state considers a doubling rate of seven days or fewer to be a concern.
A new metric showed a rate of hospital admissions well above the state threshold, though. Hospitals are nearing initial capacity with 1,034 of 1,261 ICU beds occupied by patients with COVID-19 or unrelated medical conditions. Another 1,124 beds could be readied within 72 hours if needed.
Staff writers James Walsh and Katie Galioto contributed to this report.