Earlier this week, Nobles County elected officials received a correspondence from Minnesota Commissioner of Health Jan Malcolm. I would like to share some of its contents with county residents.
The first thing the commissioner pointed out is that Nobles County currently has a COVID positivity rate of greater than 5%. She explained that the rate "reflects the number of COVID-19 tests that were positive over the total number of tests performed in your county during the most recent 14-day period prior to a one-week lag period to assure data completeness." A positivity rate above 5%, she added, means spread of the virus in Nobles County "has reached a concerning level." This higher risk, of course, means an increased risk for everyone.
The commissioner also noted that this increased risk is particularly serious at long-term care facilities. In her correspondence, Malcom pointed out the following:
* Data shows that one in four long-term care residents who develop COVID-19 will be hospitalized, and one in five will die from the disease. In addition, community and workplace-related exposure and infection of staff can lead to staffing shortages, jeopardizing care for all residents.
* Although LTC facilities have made great efforts to keep their residents and staff safe, the work that has taken place in these settings cannot completely protect facilities and residents from the high rate of viral transmission in the communities surrounding them. All too often, the virus enters a facility from staff who have been exposed through their interactions in the community, often through contact with someone who is infected but may have mild or no symptoms and be unaware that they have COVID. As the number of cases in the community continues to increase, it is increasingly likely that these hard-won safeguards of our most vulnerable Minnesotans will be overwhelmed. The consequences of this can be grave.
* If a county’s 14-day percent positivity rate is greater than 10%, skilled nursing facilities and assisted living settings will no longer be able to allow visitors beyond Essential Caregivers and compassionate care. This will increase isolation for LTC residents, which presents risks for their physical and mental well-being.
The commissioner also noted what state and local public health (LPH) departments are doing to help facilities in our community. These include:
* The Minnesota Department of Health (MDH) provides guidance on implementing infection control best practices, health care worker monitoring, drafting crisis-staffing plans and implementing testing requirements. MDH has distributed all best practices to LTC facilities and is available seven days a week to help facilities in crisis.
* All facilities with a COVID-19 outbreak are assigned a COVID-19 case manager to help navigate guidance and connect them to resources.
* Local public health departments provide outreach, consultation and support for LTC partners.
* Skilled nursing facilities must test their staff (one or two times per week) based on state and federal guidance. MDH, often in partnership with local public health, provides a range of supports to help facilities accomplish this. Work is also ongoing to obtain comprehensive data on testing in LTC facilities, and these will be reviewed and assistance provided if gaps are identified.
* MDH is reaching out to all assisted living facilities in the county and strongly encourages them to start testing their staff regularly, offering them swabbing teams to do this if they need it.
* State assistance is always available to provide testing support to LTC facilities, including sending a mobile swabbing team, providing an ordering physician, making all arrangements for labs and testing supplies.
Finally, here's how the commissioner said we can limit spreading of the virus in our communities. We should all encourage compliance with masking requirements and gathering restrictions. We need to increase communication with and partnerships with businesses, including restaurants/bars, to reinforce the harmful impact of spread on our vulnerable LTC residents. We need to make the risk and spread of the virus as clear as we can to everyone, especially when it comes to our elders. Those with the highest risk for the disease —the elderly and those with health conditions — should stay home as much as possible, and those who interact with them should use prevention measures carefully.
As mayor, I agree with the health commissioner that limiting community spread is critical for successfully preventing COVID-19 infections and deaths in LTC facilities. We all must do our part.