State health officials doubled down Monday on the need to restrict group gatherings and close indoor bars and restaurants, despite the launch of COVID-19 vaccinations and the lowest infection and hospitalization numbers in Minnesota since Halloween.
Large gatherings over the holidays could refuel a pandemic that has led to 4,872 deaths in Minnesota and 399,311 infections with the novel coronavirus that causes COVID-19, state Health Commissioner Jan Malcolm said.
"Though we have come down at quite a good healthy pace in our case growth, we're still quite a bit above what not just we, but national public health leaders, consider to be indicators of high risk," she said.
Minnesota is on the downside of a pandemic wave that emerged this fall in the Upper Midwest but has since spread nationally and caused record infections. While California and New York are reporting their highest infection rates, Minnesota on Monday reported a single-day count of 1,998 new infections — the first daily tally below 2,000 since Oct. 27 — and 22 deaths.
Minnesota hospitals on Sunday also reported their lowest COVID-19 activity levels since early November, when 1,040 patients with the infectious disease filled inpatient beds, including 237 who needed intensive care.
Malcolm credited the resolve of Minnesotans to maintain social distancing, wear masks and avoid large gatherings — even during Thanksgiving — but also the effect of a four-week pause that shut down indoor bars, restaurants, fitness centers and entertainment destinations from Nov. 21 through Dec. 18.
"We credit ... the hard work of Minnesotans and the sacrifices of some of our businesses," Malcolm said.
Business leaders countered that the fall wave was declining before Gov. Tim Walz ordered the four-week pause — with Minnesota's daily rate of new infections dropping from 124 per 100,000 people on Nov. 11 to 63 on Dec. 10. Even if it helped, they disputed the need for the governor's latest order, which extended the closure of indoor bars and restaurants through Jan. 11 but allowed the limited reopening of fitness clubs and outdoor events.
Increased public awareness and precautions might have made the difference without restrictions on bars and restaurants that have suffered financially during the pandemic, said Ben Wogsland, a spokesman for the trade group Hospitality Minnesota. Surveys show that mask-wearing has increased over the fall.
"My gut tells me that's largely because of the public — that behavior started to change because people were scared about what they were hearing," Wogsland said.
The Minnesota Department of Health as of Monday had tallied 467 reportable outbreaks involving 7,118 customers infected in clusters at bars and restaurants.
The real impact is far greater when estimating the number of secondary infections that occur when people take the virus from these establishments and spread it at home or among friends or co-workers, said Health Department spokesman Doug Schultz. "We estimate those cases to be many times more than the reported number."
Researchers have proved how large gatherings fuel broader outbreaks by looking at genetic similarities of viral strains involved in infections. Genomic sequencing allowed researchers to find 51 COVID-19 cases among Minnesotans who attended the Sturgis Motorcycle Rally this summer and to link them to 36 infections back home.
Genomic sequencing led by Paraic Kenny at the Kabara Cancer Research Institute in La Crosse, Wis., also found that clusters of infections at local colleges seeded outbreaks in cities and long-term care facilities in 21 surrounding counties. Sampling of viruses from 340 infections in the surrounding communities found that 72% traced back to the college outbreaks.
Wogsland agreed with the threat of exponential spread of the virus in large groups but said the evidence is too weak to single out bars and restaurants for restrictions.
"This industry has been disproportionately targeted for the lockdown," he said.
State health officials countered that restaurants and bars present unique challenges, including that people can't wear masks while eating or drinking. They also found evidence that infections increased later in the evening at bars and restaurants when people become less cautious.
The Minnesota Attorney General's Office has now taken actions against 10 establishments that have provided indoor food and beverage service in defiance of the emergency order.
Minnesota hospitals and clinics had vaccinated 2,900 health care workers through Sunday after receiving their first shipments of a Pfizer vaccine last week. Allina Health and North Memorial started COVID-19 vaccination campaigns on Monday.
The state, by week's end, expects to have received 174,350 doses of the first two COVID-19 vaccines — 79,950 doses from Pfizer and 94,400 doses from Moderna — that will be prioritized for health care workers at greater risk of infection and long-term care facility residents at greater risk of severe illness.
Broad communitywide access to the COVID-19 vaccine isn't expected until late winter or early spring 2021.
The U.S. Advisory Committee on Immunization Practices this weekend recommended that people older than 75 and workers in critical industries should be prioritized after health care workers and long-term care residents have been vaccinated. Workers in this next wave should include teachers, police officers, food producers and public transit workers, according to the ACIP guidance.
Minnesota's vaccine advisory group will meet next week and will plan the week of Jan. 18 to announce specific guidance on how to distribute vaccine equitably to this next priority group. The state hopes, based on projected shipments, to have vaccinated the initial priority group by the end of January.
Jeremy Olson • 612-673-7744