Cynthia Borgen is Director of Beltrami County Public Health. In the past several weeks COVID-19 numbers have been risng rapidly in Beltrami County as they have across the entire region. She spoke with Maggie Montgomery and Dan Houg from 91.7 KAXE/90.5 KBXE on Wednesday November 11th to give an update and some advice for the holidays.
Maggie Montgomery:
We've been hearing some really high numbers and some scary predictions for the coming winter with the coronavirus, both in Minnesota and nationally. Tell us what you're seeing for COVID-19 in the Beltrami County area.
Cynthia Borgen:
Well, we have seen a significant increase in the numbers over the last couple weeks. This week has been very high. We've had days when we received up to 86 positive cases in a single day, which is an anomaly - it averages out probably to 30 or 40 cases a day - but even that is a lot for us to see in Beltrami County,
Maggie Montgomery:
We've had 13 people die in the County.
Cynthia Borgen:
We have. The majority of them have been elderly, but we…right now we are seeing a real increase in the number of people in the hospital. So over this last couple of weeks, those numbers in the hospital have been coming up on 30. That's a real issue for Sanford. They have been moving things around and shifting things and increasing their bed capacity. And as soon as they increase it, it fills up.
We're really fortunate that this didn't happen to us right away in the spring so that they were able to really complete the planning they needed and come up with the systems and the facility changes they needed to be able to continue to increase their capacity. But they are really… they're staying full.
Dan Houg:
Do you know if they're cutting back on elective surgeries at this point? I know they did earlier at the beginning of all this. And then they kind of opened it back up. Where are we at with electives?
Cynthia Borgen:
You know, I really can't speak to that. I know they have recently made changes again in their visitor policies, but I really couldn't speak to whether or not they're making any changes in procedures that they're offering right now.
Maggie Montgomery:
We talked to some folks at Sanford Health a couple of weeks back, and it seemed like their capacity - their total capacity [for COVID patients] - was somewhere in the thirties. Are they trying to expand that?
Cynthia Borgen:
There are several things at play. One is COVID. And so when we see COVID, they need to have separate negative pressure rooms to treat the COVID patients so that that's not spreading throughout the hospital. Then there also are the other patients who need care including intensive care. And so they are reconfiguring a lot of different spaces, providing as many rooms and wards as they can, that are negative pressure. You know, again, they would have much more of the detail on it, but they're certainly adapting to meet the demand. But we're just starting on flu season. We just really need to do what we can to help keep ourselves healthy so that we don't overwhelm their system
Dan Houg:
Talk about flu vaccines for this year. Are they available now, and who should get them?
Cynthia Borgen:
So everybody, everybody over six months old should be getting a flu vaccine this year. That is one way to help reduce your risk for disease and possibly hospitalization. Flu vaccine is available. It's available at Public Health. It's available with your primary provider. It's available at a large number of pharmacies around the community. So it is something that everyone should take advantage of.
Maggie Montgomery:
How is Beltrami County comparing to the state as a whole? Is the story here similar to that in neighboring counties and the state of Minnesota statewide?
Cynthia Borgen:
It is. One thing that they look at is the positivity rate for testing. And it's considered concerning when your positivity rate is over 5%; if 5% of the people tested come back positive. Well, for the last month, we have been over 10%. And that is similar with our surrounding counties
Maggie Montgomery:
How many cases – active cases - are you following right now?
Cynthia Borgen:
Right now we are at a high of 271 active cases.
Maggie Montgomery:
How do you have to follow…how can you follow them?
Cynthia Borgen:
Well, it's…that's a challenge. It's a challenge for us locally. It's a challenge for us regionally. And it is a challenge at the state. Everyone is having a difficult time. The state is currently hiring 500 additional contact tracers. We have relied on the state to do the official contact tracing for us, but we have made contact calls with individuals in the county. And we've not been able to keep up with that lately.
We are building our volunteer force to help us to reach out to additional folks. One benefit we have here is that a lot of the people here are tested at Sanford and when they test positive, they receive a call from their provider. And then that provider is able to, you know, share the information they need about how to isolate themselves, how to think through who they may have had close contact with, and then give those people advice to quarantine and just making sure that they have the information and the resources they need to take care of themselves while they are ill.
Maggie Montgomery:
And as you're making these calls, what are you hearing about how the virus is spreading in this area?
Cynthia Borgen:
Well, there's a couple things that we see a lot. One is the spread within households and there, the challenge is, you know, you need to live with your family. By the time someone is aware that they have been exposed to COVID, they already typically have exposed members of their family members of their household. And we've been seeing some delays in testing lately, which makes that even more difficult.
Maggie Montgomery:
We got notified that schools in Grand Rapids are going to be going to all distance learning on the 23rd. There are schools in, I believe, Duluth that are going to be going to distance learning next Wednesday. And I don't think it's as much because the virus is spreading in schools, but it's spreading in the community so that there aren't enough teachers not being isolated or quarantined to cover the classrooms. How will this increase impact the schools in the Bemidji areas?
Cynthia Borgen:
Well, we've been working with them on a daily basis and providing them information. We've been tracking cases by age and what you said is totally accurate. We are seeing that same thing here. We have not seen any spread that's happening within the schools and the numbers of our school age youth have remained fairly low. But like you said, we have seen more cases among staff, and maintaining that staff capability is something that we talk about, like I said, on a daily basis.
Staffing in schools is only one of our concerns. We also have concerns about staffing in our healthcare facilities, in our long-term care facilities - that has been a challenge for us - in other congregate settings. We've also had challenges with staffing some of our group homes, correction facilities… When you have this rate of spread within the community, it creates a challenge for so many different facilities and organizations and work sites.
Maggie Montgomery:
Oh yeah. And I just read too, in North Dakota, they're asking even COVID 19-positive healthcare workers to actually come to work if they're able. In places with unmitigated spread the situation with getting personnel is really tough.
Cynthia Borgen:
Well, and it is. And many of our plans have always been to reach out to other areas where they're not experiencing such a surge. With COVID every place is surging, and often at the same time. So we really have stretched the limits of trying to reach out for traveling staff. Or with our long-term care facilities, often they're part of a large number of facilities throughout the region or the state, and they can pull in staff from other facilities and other communities. That's not an option for us right now. So we're really, you know, looking at, we've got a great group of retired healthcare workers who've been working with us as volunteers, and we're trying to jump through the hoops of the systems that CMS and the state and others have in place, to help get them qualified to be working in some of these facilities. But that's been a challenge for us.
Maggie Montgomery:
Yesterday Governor Walz announced a 10:00 PM curfew for bars and restaurants and some limits on gatherings. Do you think this is going to have an impact?
Cynthia Borgen:
Well, I certainly hope so. One of the issues is, we have been pleading for the last two months for people to take that personal responsibility. Wear your mask, avoid crowds, social distance. And as we've seen, it hasn't been enough. There have been enough people who don't adhere to those recommendations.
And when we look at where the cases are occurring, we have seen many, many clusters that are happening in bars and restaurants. And when you look at human behavior, we see that a lot of those happen later at night. As things get crowded, people are having a good time, but they're not thinking about the risks that are in play right now.
So that's when the governor has decided to step in, trying to make the changes as precise as possible so that we don't, once again, really create a lot of hardship for these businesses a second or third time. But that's where we're seeing cases happen. We're seeing cases happen with our young adults and we're seeing them happen in bars and restaurant, hospitality industry. That's why the governor made those choices to close it down at 10 o'clock.
Dan Houg:
Talk about the saliva test kits, the home saliva test kits that are available to residents of Beltrami County, Itasca County, a Red Lake Nation, quite a large area.
Cynthia Borgen:
Yup. And also, in order to use those, people do need to have their internet connection and to be able to participate in a Zoom call, which is a quick and easy free app that people can pull down on a smartphone.
So to participate in the saliva, you can go on to the Minnesota Department of Health website and look for testing. And then you can find the website where you request a saliva test and you need to provide an email address as well as a physical mailing address. They've been doing a good job of getting those mailed out quickly.
The test usually comes the next day. Then you schedule a Zoom call, which again, has been able to be scheduled very quickly. You work with the provider to make sure that you collect the specimen appropriately with, you know, how/when you've last eaten or drank something and making sure you get sufficient saliva and the tube.
And then that gets packaged up and it gets sent back in. It does need to be brought to a UPS drop box, and there's several of those in the Bemidji area. Then typically it takes another day for that to get down to the Oakdale test lab. And within 24 to 48 hours, you get an email with your results. Right now that has been working a little bit faster than some of the PCR tests that have been happening in some of our clinics and other facilities, just because the demand is so high.
Maggie Montgomery:
The state has announced that they're going to be opening about a dozen new testing sites in the next couple of weeks, mostly based at armories and operated by the national guard. And that sounds like something that happened on a temporary basis here before. Do you know if one of those new sites are going to be in this area?
Cynthia Borgen:
Nope. And really, because we have Sanford here with a significant capacity to do testing, they're identifying locations where there is not sufficient testing. And so really between Sanford and between Red Lake and Leech Lake IHS, most people in the community have been able to get tested when they need to. And now with this free saliva collection, I think the determination was that we're covered for getting tested here and they wanted to set up those sites in other areas that don't have the resources we have
Maggie Montgomery:
Is the saliva testing going to be expanded statewide?
Cynthia Borgen:
That's the plan. They wanted to kind of phase it in. They started with just providing a little bit of information and just a handful of free tests for each different County. Then they open it up to 23 counties plus the Red Lake nation. And they hope within the next couple of weeks, they'll be up to capacity. The Vault lab in Oakdale that is conducting the testing on these specimens is brand new. It just opened up in October. So they wanted to gradually work it up to full capacity. We've seen in several other labs that they can quickly be overwhelmed with the number of specimens that they need to test. So they really wanted to do it in a planful way so that they can build up that capacity without causing a backlog right away.
Maggie Montgomery:
Now coming up we have the holidays, and I'm assuming that some families are going to be getting together. Are there ways to maximize our safety in light of the fact that we are in Northern Minnesota and getting together outside and opening the windows isn't always possible?
Cynthia Borgen:
Yep. So that was another part of the guidance that the governor released yesterday, looking at limiting your social gatherings to no more than 10 and no more than three households. So it is going to be rethinking your Thanksgiving, and how do you have several small Thanksgiving gatherings within your family rather than one large gathering?
Michael Osterholm is an epidemiologist at the University of Minnesota who often talks about thinking about this as your “COVID year” - that this just is a year where you just need to accept you’re gonna have to do things differently. And sometimes that makes it a little bit easier to think, okay, this one year we're going to do it differently, and we're going to make it smaller. And we just need to accept that this year has to be different. It has to look different than other holiday years.
Dan Houg:
Do you have any additional information on Pfizer's vaccine trial that was showing up to 90% efficacy? Is that continuing forward? Is it going to be the national vaccine, or will there be multiple vaccines presented?
Cynthia Borgen:
Well, there are 11 vaccines that are currently kind of in the same phase, this phase three, where they're doing a large scale trial. So Pfizer is the first one to have started to release some of their results. Once they have two months of safety data available, they will then apply for an emergency use authorization with the FDA. And there are several other vaccines that are also kind of in that trial period and gathering that data. I think one of the things that we need to recognize with COVID that we maybe don't think about with the flu, but there are several different vaccines for the flu. There are different formulations that kind of attack the disease in different ways. People have heard about, you know, there's the nasal spray that some folks are able to use. There are several different formulations that are administered a little bit differently.
And it'll be the same thing with COVID. We'll get a variety of different vaccines coming out over this next year. One of the challenges is that production. This is a global pandemic and the number of vaccine doses that Pfizer will be able to create will be just a small sector of how many we're going to need globally. And they're working now on identifying kind of…you know, we'll start out with vaccinating healthcare workers, and others who are critical to keeping our world working. And then they will kind of work down the priority list. Dr. Anthony Fauci is thinking that by late spring next year, that most people should have access to a vaccine.
Maggie Montgomery:
Is there anything that we're missing that you would like to tell us?
Cynthia Borgen:
You know, I know that there will be people who are disappointed with the changes that the governor made, but as I said, we've been pleading for months for people to make these changes individually and, and it hasn't happened. We really need to work on our own behaviors and support others and try to keep ourselves healthy so that we don't overwhelm our healthcare system. It's the same message. It's a simple message, but it's hard to keep up with it. You really have to continue to wear your mask. And there's more information coming out daily about the protection that even a cloth mask provides for the wearer as well for the people that you're around. Again, the socially distance piece, just maintaining distance from folks when you're out and about and avoiding crowds, as well as continuing with your hand hygiene and cleaning of surfaces. And if you do all those things for COVID, that might actually help reduce your risk of catching the flu or cold. So there might be some extra benefits to maintaining those, those individual protections this year.
