A Public Health Update on Covid-19 in Beltrami County

Jul 29, 2020

Cynthia Borgen is Director of Beltrami County Public Health. She spoke with Northern Community Radio’s Dan  Houg and Maggie Montgomery right after 4th of July weekend when Covid-19 cases started rising in Beltrami County, and gave them an update this morning (July 29th) on the Wednesday Morning Show.

Maggie Montgomery: Right before the 4th, there were about 30 cases of Covid-19 in Beltrami County. But when I looked it up yesterday, the count was up to 157.

Cynthia Borgen: Yes. Those cases that we saw after the Fourth of July weekend really created a significant cluster in the community. And we ended up with many cases in the 20 to 29-year-old age group that were tied back to several different events. People had socialized together. They played in recreational sports leagues. We really were surprised by the spread that had happened just from those social interactions.

Maggie Montgomery: So a lot of that was tied to those cases that we talked about three weeks ago?

Cynthia Borgen: Initially they were, yes. And then then we saw it start to spread to broader age groups. People socialize with a certain group, but then they go to work and they go visit family, and they do the rest of the things that people do in their lives. Now we're seeing that the cases that we are continuing to get are really spread along a much broader age group.

Dan Houg: Is Beltrami County doing contact tracing? How are we geared up for that?

Cynthia Borgen: We are reaching out to every individual as soon as we get a positive case count. And we do have a connection, you know, directly with Sanford Health here in Bemidji so that we can support each other in trying to get information out to these folks as quickly as possible. The key is to help people recognize that once they have tested positive, if we can identify who their contacts are, and help those contacts both go get tested and also stay in quarantine, that that can really help to reduce the spread.

Dan Houg: Earlier this morning, we talked to Senator Tina Smith and she's sponsoring a bill in the US Senate to, in part, help increase the speed of Covid testing. What's the time to get results back now? And what would you like to see it at realistically?

Cynthia Borgen: Well, we really have kind of caught up now, but over the last three weeks, there really was a lag for testing in pretty much every lab across the country. There are some organizations…you know Sanford has their own in-house testing and even that was delayed. But then many other testing places where people go to get tested might be using a national lab that was, you know, they were really backed up. So sometimes people waited a full week to get their results. And that just that really makes it difficult to do useful contact tracing.

So now we're starting to see that many facilities have added capacity to increase the number of tests that they're running each day. Now we're getting caught up to where it's just a two- to three-day timeframe until we get the results. And that helps us a lot in being able to do that contact tracing and to help to reduce that spread.

Maggie Montgomery: Besides contact tracing, do you check up on people if they get sick? Do you kind of keep tabs on them at all?

Cynthia Borgen: So, again, in partnership with Sanford, Sanford will do that support for individuals who need it. We tend to provide more of a connection with folks who don't need any additional medical support, just to make sure that they have what they need. One of the roles that public health plays in this event is called Providing Essential Services. So one of our public health roles is to make sure that people have what they need to successfully isolate or quarantine. So we help to make sure that they have what they need. We've provided people with their medications. Most people can take care of things using their family and friend networks. But there have been a few times when we've needed to provide, just some minimal groceries. We do provide shelter for folks that are homeless or that are unable to isolate or quarantine safely in their current home situation. So we've been providing some of that the whole time that we've been responding. We did our first isolation support for shelter way back in March or April.

Maggie Montgomery: I did have a question to ask you about our homeless population. What is being done to keep them safe?

Cynthia Borgen: There has been some guidance that has come out in trying to help think through the numbers and the set-up at the shelters that we have. The Northwest MN Foundation has really taken a lead in connecting the people who work directly with the homeless and then the rest of us help to support their work. We've been talking at least weekly for the last six months to identify what are the issues that we're seeing and what can we do.

You know, one thing that we really hadn't thought about when everything closed down was, well, now we have no more public toilets and public restrooms for folks. And so we did set up a porta potty in a parking lot by a homeless shelter just to help, you know, identify what is it that people need. Right now there's some folks that are working on how do we just provide a way for folks to charge their phone. We've always had the problem with how can we help homeless people with their hygiene, both in their own personal hygiene, but in getting their clothes washed. You can imagine how uncomfortable it is to know that you haven't been able to keep up with your own personal hygiene and to not have a place to go anymore with the way that Covid has shut a lot of things down. So there's still a lot of things that we're working on with Covid that we hope will help to address some of the concerns that we've had long term with that population.

Dan Houg: With the spike in cases at 157 now, how many of those are translating to an actual illness now rather than just a positive test, do you know?

Cynthia Borgen: You know, many of them do have at least a small number of symptoms. The time that we really get the asymptomatic individuals are when they're identified, you know, as contact with someone and then go in for testing. Sometimes they go in for testing and they really haven't had those symptoms. But the symptoms may come later. So it's a real challenge. As you can tell, it's a continuum from no symptoms to maybe a few minor symptoms that you might not even notice if you weren't watching for them, to the individuals that we've had in the hospital. And some of the hospitalized individuals are really surprising in that they're not people who've had a lot of issues prior to contracting Covid. So it is a disease that we're really surprised at how it can impact people very significantly when they really don't have a lot of other conditions.

Maggie Montgomery: Has this been going on long enough for you to hear about after effects and long recoveries? We've been hearing a lot about that in the news, that people get Covid and then they have a hard time recovering completely.

Cynthia Borgen: We've heard of that anecdotally here. But we've also, you know, as you see in the news, the national and international news, that it does appear that for a lot of people, especially those who have a more serious illness, it really takes a significant amount of time to fully recover. And for some, we've seen that some of the injury that they received through the illness has potential to be lifelong issues with their lungs, with their liver, with other symptoms that really could cause a lot of ongoing concerns.

Of course, anyone who's was in the hospital, especially if they end up being intubated, just that lack of motion, the just laying still for a long time really is not what the body is designed for. And there can be a lot of aftereffects to that sort of thing. We don't know if these things are really long term. We only have six months of data to look at and it's pretty sketchy right now. We're still hopeful that most people will be able to fully recover. But it is a concern that it does seem to take a long time for some folks to get back to normal after they've had Covid.

Dan Houg: Do you have any expectations of a vaccine? I know it's kind of up and down in the news, but anything you're getting from within the public health world?

Cynthia Borgen: We really haven’t spent a lot of time looking at that. I think we're kind of waiting. There certainly are many vaccines that are in the works right now. And a couple of them are starting to do kind of the broader trials where they'll be testing the vaccine on 30,000 people to get a sense as to how well it works. But, you know, that's something that's not really in our wheelhouse. We're watching just like everyone else but don't really have a lot of insider information on that one.

Maggie Montgomery: When I was on the Minnesota Department of Health website yesterday, they identified three facilities in Beltrami County with “exposure” to Covid-19. What does that mean when they say that there has been “exposure” in these places? And if that happens, what do they do to try to keep the residents safe?

Cynthia Borgen: The Minnesota Department of Health does have projects in place where once they identify a case, whether it's with a resident of a facility or with staff, they contact that facility and talk through kind of what their current infection control plan is and try to identify if there are any lapses that maybe they could shore up as they go along. So the information that's released on the website doesn't indicate whether it is a staff person or a resident of those facilities.

But they do get support along the way. Even in March and April, MDH had inspectors going out to each of the facilities and going through kind of a survey. They're used to having MDH license those facilities on an annual basis to help to assure that all of their policies and environment are in compliance with what the federal and state regulations are. They went out early on and talked about their infection control plans, and identified places where they need to improve things.

We were really fortunate…it took us many months before we saw any cases in any of our facilities. And even now we see a case, maybe two, happen in facilities, but we are not seeing that kind of spread that some of those earlier long term care facilities saw. So I think that that's a testament to the great work that our long term care facilities have done in helping to assure that that if there is a case that it's not spreading to the rest of the residents.

Maggie Montgomery: That is reassuring because so many of our deaths early on occurred in those places.

Cynthia Borgen: And they will continue to do that. I mean, we have to remember about who resides in those long term care facilities. And the reason that many folks are in those facilities is because their health is at risk. And so it doesn't take a very serious disease to cause a lot of problems there. But we really are happy to see that we're not seeing that significant spread because, again, those folks are at very high risk.

Maggie Montgomery: When we talked last time, you said that your office has been in regular contact with the Native American community and tribal health offices. How is it going for them?

Cynthia Borgen: Well, just like us, they are very busy. We connect weekly with both Red Lake and Leech Lake tribes and kind of talk through what we're seeing, what they're seeing. You know, we recognize that that they have an interest in all of their band members as well as the full community. And many of their band members live in Bemidji and the Beltrami County area. So we do try to coordinate kind of who's connecting with who and who needs support. Can we help by providing some housing support for individuals at a local hotel? Are they seeing any clusters? So it's been a challenge.

We've just recently changed the way that the Minnesota Department of Health is tracking. They changed from one platform that they were using to track cases to another one. And any time you change that kind of software, it causes some delays and some challenges. So we're just getting that worked through.

And during that time, it seems that some agencies have more trouble than others in getting that going. So those partnerships are continuing. We continue to talk weekly and help to support each other and both of those tribes are doing the same kind of follow up that we're doing where they contact their members and identify who the contacts might be, and then try to get folks into quarantine and get them tested.

Dan Houg: Any final words of what we should be doing to stay safe right now?

Cynthia Borgen: Well, we have our new mask mandate that the governor has released and we've seen some really promising outcomes in other states and other communities where they have been doing that required masking. So I would encourage everyone to follow that mandate, wear your mask, and hopefully that will help us to reduce these numbers that we're seeing in our community.

Cynthia Borgen is director of the Beltrami County Public Health.