Coronavirus in one state (151)

In the settlement of my lawsuit against them last year, the authorities at the Minnesota Department of Health agreed to respond to three questions a week from me in the same fashion that they respond to questions submitted by other reporters. My lawsuit stood at the intersection of politics, public policy, and First Amendment/free press that on which this series has centered. MDH’s handling of my questions is located at the same spot. As the song goes, I went down to the crossroads…

I submitted last week’s questions to MDH on January 18. I received the answers last night at 6:23 p.m. along with this preface: “Our apologies for the lateness of this reply. We’ve included an additional revised response to a previous week’s question…” I have not yet received any response to this week’s questions submitted early this past Monday morning, or to my old question about the number of cases they have traced to tribal casinos. They’re laboring on them.

Here are the three questions submitted in the early morning hours of January 18 along with MDH’s responses:

1. Question: The current executive order requires the wearing of masks for youth sports despite significant evidence of harm to the athletes from doing so. No such requirement is imposed on professional athletes. Please explain the disparate treatment.

Answer: We know from past experience that sports teams, games and practices are environments where viruses can spread easily. So being able to control as much of that environment as possible is necessary to control the spread of COVID-19. Professional sports teams are employers, the athletes their employees. As workplaces then, pro sports teams are able to exert considerable control over the workplace environment and the athletes in order to reduce the spread of the virus. Youth sports are not workplaces for the athletes so our ability to reduce transmission and protect athletes is limited to what we can accomplish through executive orders and working with youth sports organizations on appropriate measures. Professional sports organizations can and most often do require the athletes they employ to be tested frequently, in some cases daily. If there is a positive, the employer is immediately able to isolate the employee and the exposed staff and quarantine household members, etc. Masks are required just about everywhere other than on the playing field on game day. The professional sports organizations have developed protocols that go beyond most public health guidance. The sports teams can even restrict who comes into contact with the athletes. Public health does not have the same level of control over youth sports or student athletes. Requiring players to wear masks is one of the ways we can allow youth sports to function while still limiting spread of the disease.

The assertion in your question that there is “significant evidence of harm to athletes” who are masked is not correct. In fact, there is little evidence of any harm. We are attuned to the scientific literature, and work with our youth sports partners to communicate to us if they’re hearing of any issues. While some youth may experience shortness of breath, dizziness, or headaches until they acclimate to wearing a mask, these symptoms are not considered harmful. Masks can be safely worn, with the proper coaching and training, by young athletes. The State of Minnesota is working with the MN youth sports associations, and they are in support of the mask requirement. Our guidelines are in alignment with the American Academy of Pediatrics (AAP) COVID-19 Interim Guidance: Return to Sports which recommends that athletes wear cloth face coverings during group training and competition as well as when they are on the sidelines. Several other states have recently opened up youth sports while requiring that players wear masks during play.

2. Question: In a late summer press briefing you said you were working on a case control study on the effectiveness of masks whose results you would release. You never released any results. What were the results of that study or of any other studies that MDH has conducted or sponsored on the effectiveness of masks?

Answer: We began with a small pilot study that was very limited and inconclusive. We didn’t have the resources to look at mask efficacy or use through a case/control study. Moreover, there is already a considerable body of literature on the effectiveness of masks, so we determined that pursuing such research was not a responsible use of resources when it is not MDH’s mission to conduct primary research.

3. Question: MDH has not released any new model runs predicting case trends. If you have any new model runs predicting case trends, please provide the results.

Answer: There is nothing new to report since we last answered this question in December.

In the spirit that permeates its handling of my questions, the department has appended a very special “BONUS CATCH-UP QUESTION/ANSWER THIS WEEK.” As the revolutionary dictator of San Marcos orders the assembled multitude in Bananas, silence! Here it is:

Question: The share of fatalities attributed to COVID-19 that includes decedents with one of the seven significant underlying conditions. This is a question that Kris Ehresmann has answered many times during the press briefings. I am asking for the current data you have compiled as in the tweet per Tom Hauser.

Answer: We have not compiled this data since we provided it for Mr. Hauser. [They farcically attach the tweet from Tom Hauser that I included with my question (below).] We have not investigated underlying health conditions for all deaths. If the patient was hospitalized, and was part of our in-depth medical record review as part of COVID-NET, we might know about their underlying health conditions. Otherwise, we might only know what was listed on the death certificate as a significant contributing cause of death. If someone had diabetes, which is known to be a risk factor for COVID-19-associated mortality, but it was not listed as a cause of death on the death certificate, we would not know that person had an underlying health condition. For media that have asked for an analysis of causes of death and underlying conditions, we have directed them to the Office of Vital Records and instructed them on how to obtain the deaths data files in order to conduct their own analyses.

This is the form in which the department last answered the question. They have had the data available on demand. I included a screenshot with my question. They returned the favor.

Since part 150 the department held press briefings on January 21 and January 26. Although I continue to listen in, there is little of general interest in them. All the relevant numbers have continued to decline as the most recent wave of the epidemic has receded in the Upper Midwest. The department congratulates itself on its performance in the vaccination of Minnesotans, although it ranks near the bottom of states in this regard. That is the subject of one of the questions submitted this past Monday that remains unanswered as of this date. Silence!

NOTE: I post my questions and MDH answers verbatim without comment. We report, you decide. Kevin Roche comments on the questions and answers reported in part 150 of this series here. Kevin’s commentary is brutal but just.

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