Local: COVID-19 in Minnesota
As the weekend drew to a close, two cases of COVID-19 were identified in Minnesota. With mild symptoms, both individuals are self quarantined.
The first case was identified Friday afternoon: a Ramsey County resident over 65 years of age. Symptoms began February 25, four days after disembarking from a Grand Princess cruise ship on the west coast. Officials from the Minnesota Department of Health (MDH) have determined there were no concerning community exposures, meaning no exposures lasting longer than 10 minutes within six feet of another person. There were 26 other Minnesotans who vacationed on the same cruise but only two were tested. Those asymptomatic were not tested.
With a new set of passengers, including 42 from Minnesota, the Grand Princess set sail again. Twenty-one of these passengers tested positive for COVID-19 and the ship sailed in circles offshore from California until docking Monday. Upon disembarking, passengers will be distributed to military bases for a 14 day mandatory quarantine. International passengers will be returned to their countries via chartered flights.
Now to the second Minnesota case. The second case belongs to a Carver County resident in their 50s and is also travel related (Europe). Symptoms began March 2, and health care was sought March 7. An investigation identifying case contacts determined that the infected person had contact with at least 20 people, who have been alerted and quarantined if the level of contact was high.
As of Sunday night, a total of 80 COVID-19 tests have been performed in Minnesota with 31 tests performed over the weekend. Testing supplies are described to be adequate and testing capacity is expected to be expanded to private laboratories around the state later this week.
Kris Ehresman of MDH urges anyone who is ill to stay home, saying “we want to be clear that just because COVID-19 is circulating people don’t have to seek care if they have symptoms that they normally would not seek health care for.” If fever, cough, shortness of breath occur with a possible COVID-19 exposure, people are urged to call their health provider before showing up if medical care is necessary. Minnesota Health Commissioner Jan Malcolm stated, “every Minnesotan has a role in helping to limit the spread of COVID-19.”
MPR: Minnesota health officials say state's first coronavirus patient had minimal contact with others
MPR: Minnesota health officials report second case of coronavirus
Minnesota Department of Health
National: Shift from containment to mitigation strategies in the United States
The COVID-19 case tally in the United States reached 566 with 22 deaths over the weekend. Cases have been identified in 34 states with the highest number reported in New York, Washington, and California. Many more cases are expected as testing capacity continues to increase.
A shifting disease control strategy from containment to mitigation is occurring across the nation. Quarantining sick individuals and their contacts is no longer enough; new cases are developing without a foreign travel link. People are working from home, schools have shut down, and universities including Princeton and Stanford are moving classes online. Additionally, many professional conferences have been canceled, including the highly popular festival South by Southwest.
Federal public health officials are even considering mandatory measures to control the spread of COVID-19. Currently, there is no systematic plan in place requiring the above mentioned closures and event cancellations. The former commissioner of the Food and Drug Administration, Dr. Scott Gottlieb, said, “we leave these decisions to local officials, but we really should have a comprehensive plan in terms of recommendations to cities and in some support from the federal government for cities that make that step, make that leap, if you will.”
On the topic of locking down a country, Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, believes one is not necessary at this point like in China or Italy, but encourages older adults or those with underlying health conditions, or living in close contact with those populations, to be cognizant of potential risks. He believes voluntary social distancing is the way to go, saying “don’t go to crowded places, think twice before a long plane trip, and for goodness sake don’t go on any cruises.”
New York Times: Stricter methods necessary to stop coronavirus spread
New York Times: Coronavirus shuts down schools
New York Times: South by Southwest cancelled
NPR
International: Italy in Lockdown over COVID-19
Monday morning arrived with more than 107,000 COVID-19 cases and 3,600 deaths across the world.
Second to China, Italy has the highest number of confirmed cases—over 9,000 as of Monday night with 463 deaths. The healthcare system is described as being “one step from collapse.” Saturday night, Italy’s Prime Minister announced a quarantine to 14 provinces and announced school, gym, museum, and other venue closures affecting a quarter of the Italian population. People are not able to enter or leave the Lombardy region, in which Milan is the main city. Cruise ships are unable to dock in Venice. Train stations and roadways have control points checking temperatures. Monday night, the entire country was in lockdown. All public events are banned.
A citizen from the initial closed off region said,“we are the new Wuhan.” But unlike China, Italy is a democracy. Debate exists regarding whether citizens will obey control measures and at what level the government can enforce the new rules. During his news conference the Prime Minister urged citizens to reject a generalized Italian character trait tendency towards “furbizia” by requesting “we must not try to be clever.” The Italian word “furbizia” is used for cleverness or cunning behavior to avoid bureaucracy and inconvenient laws. Those not abiding to the rules risk three months of potential jail time.
So far, the most damaging ripple effects from the lockdown includes deadly prison protests after visitors were banned. Inmates overran 22 prison facilities and kidnapped officers. This resulted in multiple deaths and almost all of the prisons are seriously damaged. The lockdown is scheduled to be enforced until April 3.
Jan Mladonicky
Jan Mladonicky is a veterinary public health resident at the University of Minnesota. She became interested in public health while working on basic science research at Michigan State University. Her focus shifted to Veterinary Public Health during an internship working with health surveillance programs at the Lincoln Park Zoo. While completing her DVM/MPH degree from Colorado State University, Dr. Mladonicky traveled to the rural villages of Uganda for an epidemiology field project, which solidified her career interest in One Health. Since graduation, she has been practicing small animal emergency and urgent care medicine.