REGIONAL- As key indicators of coronavirus activity continue to rise across Minnesota, health officials directed their attention on Tuesday to recent developments that may help to slow the concerning increase.
“Compared to last year at this time our case rates are 84 percent higher,” said health commissioner Jan Malcolm, noting that all but two of the state’s counties have substantial or high transmission according to the Centers for Disease Control. “The seven-day average of new cases is 22.8 per 100,000, up from 17.7 in the prior week.”
There were 9,710 new COVID cases last week, Malcolm said, compared to 8,870 cases the prior week.
Cases are also on the rise in St. Louis County, according to Public Health Director Amy Westbrook.
“Our rates are a little bit better than the state,” Westbrook said. “Still, the increase is concerning, because we are seeing our rates where we were in early May, even late April. That’s concerning, because we’re going into the school year, we’re going into events like the state fair.”
The greatest increases are in northern and central St. Louis County, Westbrook said. Evidence of that can be seen in the biweekly case rate used for school decision-making, which in north St. Louis County more than doubled from about 8 to 19.2 in two weeks. This is the highest of any region of the county. Because of the process used to confirm and calculate the biweekly case rate, the number reflects the level of case activity two weeks prior.
“We want to do all we can to call attention to our increasing rates, the importance of vaccination and masking, and all the other public health interventions that we rely on for decreasing community transmission,” Westbrook said.
Westbrook also emphasized the need for those with symptoms to get tested, not only for their personal health, but to assist public health officials in assessing the ongoing extent of infections to help plan for mitigation efforts.
Vaccinations rise
Malcolm reported that the pace in vaccinations also continued to rise last week, and noted an encouraging trend among school-age recipients. Fifty percent of those between 12-15 years old have now received at least one dose of the Pfizer vaccine, the only one approved for use in that age group. Daily vaccinations among all Minnesotans have nearly doubled in recent weeks, Malcolm said.
“Today we’re averaging almost 5,000 a day,” she said.
As of Tuesday, nearly 3.3 million Minnesotans had received at least one dose of COVID vaccine, including 71.2 percent of those 16 and older. At 69 percent, St. Louis County lags slightly behind the state as a whole for the 16-plus age group.
“The number of people who show up for vaccination (at county-sponsored clinics) is fewer than before, but we’re still moving along and getting people vaccinated, which is a good thing,” Westbrook said. With respect to the gains, she said, “We’re talking about inches now rather than meters or miles.”
State officials and Westbrook were of one accord that the official approval of the Pfizer vaccine by the FDA could lead many of those who are unvaccinated to now get the shots. The final approval, which applies to vaccines for those 16 and older, also paves the way for employers to implement vaccination requirements more easily for employees.
“Now that it’s fully authorized, it’s very similar to any other vaccine that’s out there,” Westbrook said. “It’s been tested to be safe, and it’s been tested to be effective. Especially given the situation we’re in with the Delta variant circulating, there is a lot of reason to consider mandating vaccines, especially through employers.”
A Monday press release from Gov. Tim Walz also touted the success of the state’s $100 gift card incentive in raising vaccination rates. About 80,000 people who received their first dose of vaccine applied for the reward, which ended last Sunday.
Of particular note, Walz said, was that a high percentage of applicants were from counties that had some of the lowest overall vaccination rates in the state.
Nursing homes
In the realm of employer mandates, two North Country nursing homes are awaiting guidance from the Centers for Medicaid and Medicare Services about President Joe Biden’s recent declaration that all nursing home staff nationwide will be required to be vaccinated. Facilities will stand to lose federal funding if they are not in compliance.
Boundary Waters Care Center, in Ely, and Cook Care Center, affiliated with Cook Hospital, are the area facilities that would be affected by the new rule. Both facilities were above the state average for vaccinated staff in the most recent CMMS report. Boundary Waters Care Center showed 69.6 percent of staff as fully vaccinated and Cook Care Center was in the top quartile statewide at 75.9 percent.
National and state long-term care advocacy groups have responded to Biden’s mandate with alarm, asserting that the requirement could cause facilities to lose staff at a time when staffing shortages are already widespread and critical.
“Right now on any given day, there are about 10,000 open positions in long-term care settings in Minnesota,” said Gayle Kvenvold in an Aug. 20 statement. Kvenvold is the CEO of LeadingAge Minnesota, an association that represents about 1,000 assisted-living and nursing homes. “The concern that we have about this mandate is that it has the potential to make worse a very severe workforce crisis that we already have in our settings.”
But, at the moment, without specific direction and guidance from CMMS, it’s not easy for nursing home administrators to predict specific workforce and financial impacts of the mandate.
“We recognize the great importance that COVID-19 vaccines play in the overall health and wellness of everyone who lives and works at Boundary Waters Care Center,” said Executive Director Adam Masloski in a written statement provided to the Timberjay. “Whereas we believe vaccination against COVID-19 is a necessary step we all can take to end this pandemic, it is important we thoughtfully consider the needs of our residents, team members, and all others residing in our region. Our team is presently considering how we can best protect those most vulnerable to the devastating outcomes from this relentless virus—older adults, the immunocompromised, and unvaccinated children.”
Maslowki said that BWCC has been in compliance with all federal, state, and local health requirements since the beginning of the pandemic in March 2020. He urged people to get vaccinated “to prevent further spread of COVID-19.”
Westbrook said that the county health department has been working closely with long-term and congregate care facilities to encourage vaccinations among both residents and staff.
“No one wants to see mandates,” Westbrook said. “Everybody wants the vaccine to be taken up voluntarily.”

Schools
When county health specialist Aubrie Hoover took on the task of advising schools in northern St. Louis County about COVID-19 practices last year, the state’s Safe Schools Plan provided a regulatory framework for her consultations. With the end of the state emergency, regulations are gone, replaced by strong recommendations based on CDC, American Academy of Pediatrics, and state health and education department guidance. That’s brought about some changes in her work.
“This year is almost more challenging than last year because they don’t have the mandates or the requirements to fall back on,” Hoover said. “Now every best practice is strongly recommended, strongly encouraged, but ultimately up to the school to decide if they will implement that. So consultations, we’ve been doing a lot more than last year as they’re planning for return to school.”
The upward trend in cases over the past six weeks has caused many districts to rethink the plans they started formulating in July, Hoover said.
“Our rates were lower when we began planning with a lot of the schools (in mid-July),” Hoover said. “For schools that wanted to dial back on masks; we’re saying, ‘Okay, this is local control. If that’s what you’re going to decide, how can we make it safer?’ They have to put a policy in place if they’re going to require masks, and what does that look like for a student who chooses not to wear a mask? What’s the plan?”
The issue is complicated, Hoover said, by the fact that a large portion of the population is experiencing COVID fatigue and have scaled back on their own COVID precautions. This creates a balancing act for school administrators as they decide what COVID precautions and protocols to implement.
“Schools are being very mindful and thoughtful in how they approach this because they want to protect the integrity of in-person learning and their faculty and their students, and they also want to have their students remain in school,” Hoover said.
The state Department of Education is making free COVID testing available to schools, recommending weekly tests for all who are unvaccinated and more frequent testing for students involved in extracurricular activities such as sports. However, Hoover said the response to the program among districts she consults with has been mixed.
“I have some schools that adamantly want that to be one of their mitigation strategies, especially for student athletes,” she said. “Then, I have some schools that just want to provide resources and information to families about where they can go for a COVID test in their area. So, it’s kind of across the board.”
Booster shots
State infectious disease director Kris Ehresmann addressed the recent CDC recommendation for COVID booster shots during Tuesday’s press conference, emphasizing that the federal guidance is clear that people should not receive a booster until eight months have passed since their second vaccination. Boosters have been recommended only for those people who received the Pfizer or Moderna vaccines, Ehresmann said, with additional study necessary before determining a recommendation for the Johnson & Johnson vaccine.