Coronavirus in one state (158)

Today is the first anniversary of Minnesota Governor Tim Walz’s self-parodying fiasco of a speech on the public health emergency allegedly created by Covid-19 (video below). I lived in blissful ignorance of Governor Walz before the speech. Now my motto is Tear down this Walz. The guy is a glorified used car salesman of the Joe Isuzu variety. I bought the car from him on March 25, 2020, but it didn’t make it off the lot.

In our American Experiment article “False alarm,” Kevin Roche and I paid special attention to the speech and related shutdown ordered by Governor Walz. I wrote the first draft of the article, by the way, in late May last year.

Governor Walz announced his sweeping executive order in the March 25 speech, four days after Minnesota recorded its first death attributed to the virus. While the future course of the epidemic was uncertain, it was already apparent that the greatest risk was among the elderly. But Walz chose to set forth an apocalyptic vision of doom.

“To battle COVID,” he vowed, “we’re going to make sure that we reduce the impact, especially deaths of our neighbors.” Walz touted his reliance on “the best data possible” as projected by a tailor-made model produced by experts at the University of Minnesota and the Minnesota Department of Health. “We’re using the best scientific data,” Walz assured Minnesotans, and then issued a warning based on the model. “If we just let this thing run its course and did nothing,” Walz asserted, “upwards of 74,000 Minnesotans could be killed by this.” And Walz emphasized that all age groups are at risk: “Here in Minnesota, our cases range from six months to 94 years.”

Walz didn’t tell us that”the best scientific data” he relied on projected 50,000 deaths. “Buying time” over two weeks or longer was projected to save 24,000 Minnesota lives by freeing up intensive care units and hospital capacity. Walz omitted this refinement, perhaps in the interest of plausibility.

We all heard about “flattening the curve.” It’s become a laughable cliché. According to Walz, however, it was already too late to flatten the curve in Minnesota. The best we could do was “move the infection rate out, slow it down, and buy time” to build up the availability of intensive care units and hospital capacity.

According to Walz, only 235 intensive care units were available in the state. “Buying time” became a recurring theme of the shutdown. Walz said he needed two weeks. A year later we are still “buying time,” and we will be paying for it for a long time to come.

Faithful readers will recall that Governor Walz’s minions illegally expelled me from the the Minnesota Department of Health press briefings this past April 27. I had a bad attitude to the party line.

When I figured out what they had done and why, I sought out Theresa Bevilacqua of Dorsey and Whitney to sue the Commissioner of Health and her communications director on my behalf in federal court. To settle my case they agreed to answer three written questions a week from me. I have provided their responses in this series verbatim in the hopes of providing a more rounded understanding of the ongoing catastrophe created by the Walz regime.

The department has contributed in its own special way to our observation of this anniversary with its responses this week to my questions submitted on March 7 and 14. Here are the department’s responses to my questions of March 7.

1. Question: In my questions submitted February 21 I asked you what criteria or benchmarks would suggest to the Department of Health that the “emergency” under which Governor Walz continues one-man rule is over. You reformulated my question and referred me to Governor Walz’s letters to Legislative Leaders dated January 7 and 21 earlier this year. Let me try one more time. This isn’t a trick question. Have you formulated any criteria or benchmarks that would aid Minnesotans seeking to understand if and when the public health “emergency” presented by Covid-19 has ended? If so, what are they? If not, please let me know that.

Answer: As a matter of epidemiology, there’s no clear-cut criterion that determines a pandemic to be over. Most scientists agree that it’s likely the virus will continue to be with us at some level indefinitely, like influenza. However, some of the criteria public health practitioners use to gauge whether a virus represents a public health emergency include the 7-day cumulative incidence rate of new cases/100,000 population, the 7-day rolling average for the test positivity rate, the 7-day rolling average for # of deaths and hospitalizations/capita, and level of herd immunity within a given population (as measured through vaccination rate).

While neither MDH nor CDC have yet put hard numbers on these criteria – but are working to do so – we can say that if we can get to 80% vaccination rate and keep some of the other indicators at acceptably low levels for a consistent period of time, the pandemic will no longer present a public health emergency. We look for evidence that sustained transmission is no longer occurring.

2. Question: A Power Line reader writes: “I am an employee in a division of the state of Minnesota. The MDH guidelines provide that if you travel out of state you are then to quarantine for the next 14 day even if you have been vaccinated. How does this make any sense when states such as Wisconsin and Iowa have equal or lower infection rates? Also how does this work in border cities such as Duluth and Moorhead where interstate travel is routine? Some employees even live in the other state.” (Reference: https://www.health.state.mn.us/diseases/coronavirus/prevention.html.)

Answer: If you live out-of-state and work in Minnesota, we recognize this is not travel and would not apply. Travel for work means more like traveling for a conference or meeting in another state. As always, we recommend people work from home if able.

CDC encourages people to quarantine after travel in case you were exposed while travelling or at your destination. Travel increases your chances of getting and spreading COVID-19. The quarantine is a mitigation measure to lower chances of spreading COVID-19 to others if you were exposed.

We also are concerned because of the potential for exposure to variants and spread of highly infectious variants, or those that may respond less well to immunity from vaccine or from prior infection.

For now, fully vaccinated people should continue to:
· Take precautions in public like wearing a well-fitted mask and physical distancing
· Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
· Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
· Avoid medium- and large-sized in-person gatherings
· Get tested if experiencing COVID-19 symptoms
· Follow guidance issued by individual employers
· Follow CDC and health department travel requirements and recommendations

More information here.

3. Question: For many months the CDC reported a lower total number of deaths with Covid-19 in Minnesota than the state was reporting at the same time. This was understandable because the CDC relies on death certificates sent by the state to the CDC and there would be a lag in that reporting. In the fall for some reason the CDC actually began reporting more total deaths that Minnesota had reported as of the same time period and recently that gap has grown to over 200 deaths. Do you know why the CDC is reporting more deaths than the state is? Does the CDC do an independent analysis of cause of death?

Answer: As your characterization of the data is not consistent with our understanding of the data or the facts, if you would like to continue with this question, please resubmit it as a future question and include the CDC and Minnesota data to which you are referring.

Here are the department’s responses to my questions submitted on March 14. I submitted them all together without numbering. I have added numbers to them below.

Your submission included a total of four questions rather than three. Although a response to the fourth question is not required, we are providing one as a courtesy while reserving our right to limit our responses to only the first three questions that are posed in a given week.

1. Question: We are trying to understand the release of 138 new deaths on a day last week. These deaths were said to be related to cases from a time frame around last October. The exact sequence of events is puzzling. Did none of the death certificates related to these individuals mention coronavirus as either an underlying or contributing cause?

Answer: We receive reports of deaths from a variety of sources (death certificates, hospitals, medical examiners, LTC facilities, etc.) but they are not counted in Minnesota’s official tallies until we have the necessary information to determine whether they meet our agreed upon case definition. Death certificates come through every day with COVID listed as a primary or underlying cause of death, but we collect information from a variety of sources, including laboratory and clinical information. For the most part, these deaths were reported in a timely manner, but we lacked all of the necessary information to make a final determination.

2. Question: If not, then how does merely matching a positive test result indicate that coronavirus have anything to do with the death?

Answer: We use a case definition to determine which cases are counted as COVID deaths. A big part of that determination rests on lab results, but we also use supplementary clinical and death certificate information. In order to determine if a death should be counted, we need a death certificate and/or a discharge summary from people who die in the hospital, labs, and clinical information on symptoms. Since this information comes from so many different sources, it can sometimes delay that final case determination even if a death was reported promptly.

3. Question: If the death certificates did mention coronavirus, then why wouldn’t the deaths have been initially categorized as Covid-19 deaths?

Answer: As mentioned above, we use an agreed upon case definition to consistently categorize and count deaths. If we are missing key pieces of information, like a lab result, that determination is delayed while we wait for it to come in.

4. Question: For those people who have requested the 2020 death certificates would these people not show up as coronavirus deaths?

Answer: If a death certificate was filed in Minnesota, they [sic] will show up in the lists provided by the Office of Vital Records.

In a March 23 post Kevin Roche revisits the question of masks. Kevin and I will be “circling back” on the data regarding deaths for the evasive crew at the department in next week’s questions.

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