ROCHESTER, Minn. — Citing hospital-acquired infections and limited hospital capacity, state officials on Wednesday, May 27 defended the controversial policy of allowing hospitals to discharge patients recovering from COVID-19 and possibly infectious into nursing homes.

"I think it's important to remember these are folks that went to the hospital, they recovered, but they're still in that mode, and they're going back to their home, and this is where they live," said Gov. Tim Walz during an afternoon press conference. "The rest of us, we may self-isolate, but where are we going to put (these) people?"

"This was federal guidance," Walz said. "This was what everyone was doing. This was not a mistake. It wasn't like no one thought about this. There was complexity in how you deal with this."

With roughly 80% of the deaths in the state coming in long-term care settings, critics have suggested the homes are not built to allow safe distancing.

Others have argued that placing infected patients in congregate settings may relieve strain on resources in the short term, but holds the potential of sending more and presumably sicker patients back into hospitals.

Currently, California and New York have forbidden hospitals from discharging patients with active cases of COVID-19 into nursing homes.

"That's certainly a question a lot of people are asking," said state commissioner of health Jan Malcolm. "It has been an affirmative part of our plan all along (however), to get people out of a hospital as soon as they no longer need hospital-level care, both for their own protection — hospital-acquired infections are a real concern — as well to free up acute care capacity."

"If you are going to die in an American hospital," Walz said, "the number one thing that will kill you is hospital-acquired infections. That kills 90,000 people a year."

It's not clear however what role hospital-acquired infections, a longtime consideration in geriatric care, plays in the radically-transformed public health equation during the COVID-19 pandemic.

The question is not helped by popular suspicions that high-earning nonprofit hospital systems have long sought to reduce costs through the early discharge of patients.

Malcolm said each facility with a positive case has a nurse case manager from the state department of public health, an expert who works with that site to minimize the risk of spread. Both Walz and Malcolm said, however, that the state is preparing to revisit the policy.

"I think it's a fair question," Walz said, "but there's complexity around it, both for the humanity of people, and the sense of containing spread. We're tracking it very closely."

"We think it's a good idea to take stock of what we've learned," Malcolm said. "We're going to be having conversations with stakeholders across the spectrum... I think we're making careful decisions, but it's a fair question, and something we're going to be revisiting and have conversations about."

Outdoor dining, campgrounds to open

In other news Wednesday, calling it "a cautious, strategic turn of the dial," Walz signed an executive order that outlines the second phase of his Stay Safe MN Plan.

The order allows outdoor dining at half capacity and with 6 foot distancing in bars and restaurants beginning June 1. It also allows salons and barbershops to work at 25% capacity with mitigation plans. Campgrounds and organized youth sports without competitive games are allowed as well.

Walz repeated his assertion that while the rules may seem uneven to some, they are developed around three principles: "how close you are to someone, how long you are around and yelling. That's the lens we're looking through."

Malcolm said the governor's 5-part battle plan to address COVID-19 in long-term care has now tested all staff and patients in 40 long-term care centers, with dozens more scheduled in coming weeks.

Malcolm said the measure has discovered staff in facilities who were working with asymptomatic COVID-19, "which is what we feared," she added, as it requires their removal into quarantine, increasing staffing challenges addressed by the plan.

Deaths from COVID-19 shot back up Wednesday, with the Department of Health reporting another 33 lives lost to the illness, tying a previous one-day high.

One death was recorded each in Nobles, Nicollet and Washington counties. Three deaths were recorded among residents of Anoka County. Five residents of Ramsey County died from the virus, as did six from Dakota County and 16 from Hennepin County.

The Nobles County case, site of an outbreak at the JBS pork plant in Worthington, was a person in their 30s with no known underlying health conditions. Four of the deaths occurred among Minnesotans in their 60s, six were in their 70s, 11 were in their 80s, nine were in their 90s and two were 100 or older.

An outbreak has continued to worsen in Todd County. Part of lake country in central Minnesota, the region is home to Long Prairie, Staples, and hosts a population of just 24,000. It recorded 76 cases on Wednesday. By comparison, at 63, fewer cases were identified on Wednesday in Ramsey County, population, 550,000.

In the past 10 days, the total positive caseload in Todd County has now jumped nearly 500% percent, from 60 cases to 296.

The state recorded 510 new cases on the results of 6,634 tests Wednesday, a continuation of Gov. Tim Walz's stated goal to surpass 5,000 tests daily, but far short of its capacity to test 10,000 Minnesotans a day.

ICU admissions rose by two on Wednesday, as well, reaching a new high at 260 beds. An additional 338 Minnesotans were hospitalized for the virus outside of ICU settings.

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Minnesota Department of Health COVID-19 hotline: 651-201-3920.

COVID-19 discrimination hotline: 833-454-0148

Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.