ROCHESTER, Minn. — The latest updating of modeling created to inform Gov. Tim Walz's decision-making around COVID-19 believes that even under the best circumstances, the state will reach 750 deaths a day at the first peak of the coronavirus pandemic this summer.
Other news from the third version of the state's predictive model as presented to reporters on Wednesday, May 13, include the finding that the state could see 1,400 deaths by the end of May, and that the state could reach, if not surpass its the limits of available ventilators.
Health officials added on Wednesday that Minnesotans have done more mixing than they had assumed would happen under the previous version of the model, that deaths have occurred in hospitals less than expected, and that the state is on track to losing 8,000 more lives than expected.
The model now states that Minnesota could lose 29,000 persons to coronavirus during a 12 month period without an extension of the stay at home order.
"By peaking at levels just below 750 under different scenarios," said state health economist Stefan Gildemeister, "the model produces mortality that is pretty dramatic in the context of any other history that we have for mortality related to a single factor, whether it's traffic deaths, cancer or military conflicts."
Gildemeister said the updated model introduced changes to reflect what has been learned about the virus in the month since its last updating in April. Those changes included the fact of asymptomatic spread (presumably bad for infection control), and the fact of many deaths occurring outside of the hospital system (presumably beneficial in relieving pressure on the hospital system).
When health officials depicted what would have happened had the state done nothing, ICU demand would have peaked around 5,000 persons a day, they reported, a number two times the state's maximum available ICU beds.
Under this scenario, the state stood to lose 57,000 lives.
When health officials framed the outcomes around a scenario depicting what would happen should the state lift the stay at home order Monday, May 18, as planned, ICU demand peaks at around 3,400 persons a day.
That is a number well over the state's 2,600 ICU beds. In that model, the state stands to lose 29,000 lives.
Extending the stay at home order until the end of May, however, with the very best possible testing, pulls ICU use under the state's capacity, and drops the death count by over 6,000 to 22,500 for a 12 month period.
Health officials were candid with the finding that merely pushing the peak out a few months does little to lower deaths without adopting better interventions to contain or treat the illness.
"Going back to version one, what we have been saying all along is the greatest effect of our mitigation strategy is to push out the curve to the right, with some impact on reducing full mortality over the course of a year as well," said Gildemeister. "That continues to be the case."
"The question is, what are we doing with that extra time, and that is where testing scenarios and treatment scenarios come into play. So just buying time without using it will not dramatically change the outcome of the disease. Once mitigation drops, there are a considerable number of individuals who are susceptible to the disease. Once the pathogen starts circulating, the outcome based on people's individual ability to be hospitalized and find an ICU remains unchanged."
With this, the state's third modeling update, interest continues to intensify in how the abstract health data tool can predict the effects of different interventions.
The reports thus far have prioritized transparency and engaging the public in the work of public health, but the presentations themselves, with their clipped references to parameter values, caliber parameters, refined scenarios and outputs, arguably have done little to clear up the public's desire to know how much mitigation is enough.
Gildemeister referred to the possible mitigating effects of the arrival of remdesivir, for example, a treatment widely considered to hold nominal effects on hospitalization and no effects on mortality. It underscored what health officials have long stressed, that there is much they still do not know about the virus, including a host of treatment outcome questions, length of stay in the hospital and even the best course of treatment.
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Minnesota Department of Health COVID-19 hotline: 651-201-3920.
COVID-19 discrimination hotline: 833-454-0148
Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.