APPLE VALLEY CHAMBER NOTE - NOTES FROM LARGE COMPANIES:
You will learn a great deal by reading these notes from this morning. This meeting we were not part of but the notes we received are fascinating. MN Business Partnership is the very large companies and the detail here is VERY INSIGHTFUL as to what the Governor’s Commissioners are really trending towards and what they feel is important.
NOTES FROM CONFERENCE CALL
Walz CoS Chris Schmitter
– First piece is getting more test and more equipment like PPE and ventilators. That is the top priority. Right behind is the economic recovery piece – how do we start to build out of this reality? Personal and recreational pieces of work also.
DEED Commish, IT, MDH and others, looking at how do we get people back to work and what if we see another spike? Massive testing is a critical piece of re-opening society as well. Want your help and guidance on how to return to normal life. We are looking at forming coalitions with other states and will continue to work on this – can we find some real benefit for MN from this or not? Each state in a very different position, and the Gov is already talking daily to various other Governors.
Jan Malcolm MDH
– what has changed in the model that we are looking at? Globally close to 2m cases. In MN we have 1695 cases, we keep a close eye on how many days it takes for the case count to double, and it’s around 7-8 days which is modest growth. We have 177 people in the hospital today, 79 deaths total in MN. Great majority are quite elderly. Youngest person so far who has died was in their 50’s. We have only been testing high priority cases. Update on the model – there has really been very little time passed since March 6
which was our first lab-confirmed case. Our “1.0” version of our model really only had MN info in it which was very little, and we have been updating it heavily with data from around the country and Europe, along with more MN data. Starting on March 23 the model was able to incorporate our own mortality and illness statistics. The rate of infectiousness is around 1 infected person can spread to around 4 more people, and also now we know asymptomatic people can carry and spread it with no symptoms. The length of stay in the hospitals is lower than what had been projected before, and length of time in ICUs is also shorter. The CDC has continued to publish new data about specific comorbidities, and we have added MN data to that. Re-running version 2 of the model, which we did last week, the net effect was to push the peak a little earlier by about 1 week, and projected infections and hospitalizations declined. We now also have explicit “confidence intervals” in the model?
Our model suggests peak will come in early July, but this has a range of couple of weeks on either side of it. Challenge is to build up enough hospital capacity and ICU ability to meet this.
We are looking at converting hospital space to ICU space and then create new hospital spaces. Lots of info on the MDH website if you want to look into it further.
Steve Grove DEED
– thankful for the advice you have given over the last couple of weeks. Let’s talk about workers going back to work – message right now is SAH, but can you begin to safely have people go back to work and ensure you don’t have a backslide in illness? We are pulling together recommendations about how businesses can do it. We don’t want to extend the pandemic any longer than necessary. 82% of the workforce is still working in the critical workforce. 18% of noncritical workers who aren’t currently working in plants, etc, how can they go back safely? How would you structure that decision – one thing is looking at an office setting, another looking at customer facing businesses and how they interface with clients, then industrial settings. For any re-opening, we want to look at how having businesses having a plan in place with clear instructions to their employees, along with health screenings (thermometers, health checks, 5 key questions to ask employees when they show up for work). We have a Social Distancing Work Group and then an Economic Security Work Group. Businesses are teaching us how they are or have handled interactions and work environments. Charlie has asked that you submit ideas to him and he’ll pass them along. Critical sector businesses currently operating are the test ground for how to do this right, and we are looking at those best practices. Quick update on UI – we are at 440,000 applications so far. This week we will hit the milestone of hitting double the applications we had last year. Last week we were the first state in the nation to be able to get out the $600 per person from the feds on UI.
Charlie asked – what about timing? When might you announce the protocols for businesses to go back? Grove – we don’t have the capacity right now to test like we need to. I can’t comment on timing right now because I really don’t know. No state has loosened restrictions yet.
Myron Frans MMB
– three things announced yesterday – 1) budget projection plan we announced yesterday, and we are trying to figure out how to budget 2) We will issue projection in early May. 10% pay cut for Gov, COS and Commissioners for the balance of this year 3) We are implementing statewide hiring freeze for Exec Branch to have more control over the jobs we fill over the next several months. On the budget projections – we are looking at revenues dropping, though we are also getting a lot of federal money, so we are looking at the interplay between these and also the timing of when dollars come in. We are also reviewing spending. We have a large budget surplus, but on the other hand we know we are in an economic downturn. It’s hard because we don’t know how long these restrictions are going to last, and assume you are trying to do the same exercise I am in budget planning with a lot of uncertainty in the mix.
– on testing, which is the key to re-opening businesses, how are we doing in terms of testing equipment? How soon would we have enough? Malcolm – it is ONE key to re-opening, not the only thing. The global supply issues are severe. There are a lot of people worried about the strategy to expand to massive testing because of the huge shortage of supply. We have to work around it as best we can. As Asia and Europe level out, we hope the supply chain will stabilize but that has yet to materialize. Some countries with good control are having resurgences, so it’s too early to see how this all works. We are seeing a proliferation of different kinds of tests for different reasons. There are some rapid tests being developed. Would be helpful to be able to do more surveillance testing, as opposed to individual testing to see right now if one person has it or not. Also tests to see if a person has enough antibodies and therefore is immune. There will be multi-layers of this, with different kinds of tests for different purposes.
Michael with Star Tribune
– back to the models. The IHME model for U of Washington, what is your reaction? In yesterday’s update it projects a peak of April 28
for Minnesota and overall fatality of 656 by August 4
. This diverges wildly from MN model, can you give us some reconciliation of this? IHME model has been super accurate on fatalities. How can this be so wildly off? Malcolm – yes, this is a good question. The assumptions in the IHME model are what many researchers consider to be very optimistic, they assume social distancing as stringent as what was in Wujan, and it’s all built around mortality, while ours is built around the disease itself – transmission, number end up in the hospital, etc. The IHME does yield more optimistic results, but only goes out 4 months. IHME could be right about first wave of deaths but very wrong about what happens after 4 months. We are looking at much longer terms, and at what’s really true in MN. Most hospitals in MN are working with their own models and those show results much more like our’s, and they are concerned about the over-optimism of IHME. We think it is prudent to prepare for a more conservative scenario.
– Target has appreciated the public/private partnership you are trying to have with us. For Grove – we would like to provide guidance to MN on social distancing and protocols. For Malcolm – have we gotten a hold on where PPE is needed in MN? Malcolm – we do get a lot of data from health systems around the state so we have a better sense of this information. We know that PPE is very short already, medical grade and surgical, N95s, non-latex gloves – these are all very hard to come by and the supply isn’t adequate. We are short of PPE in long term care facilities. The Strategic National Stockpile which we have relied on is very depleted, and the priority has been whatever supplies do exist there are not coming to Minnesota. We have a big effort on procurement. We have been very focused on conservation in as much reserve as we can in the event of growth in cases but we are on the early end of that curve. We are trying to move it to where the need is most acute. This is an item of great nervousness for all of us.
Mall of America
– we have thousands of employees and customers here. What kinds of things are you working on to screen employees? Allow employers to track temperature of employees (opt-in, not mandatory), we are working on this with Target. Temp screening is just one piece, and there are other screening pieces that are as important. We want to use technology as best we can to help with this. MN IT and Target working together. With asymptomatic cases where there is no temperature, what can be done to screen? Malcolm – we know we can’t rely solely on temperature, but also asking questions about recent activities and other symptoms. Not everyone who gets COVID even ever has a fever – sometimes not present. Absence of fever doesn’t mean absence of COVID.
– for Grove – other parts of country have gone to requiring facial coverings for workers and customers, are we considering that in MN? Grove – as we look at health guidelines for workplaces, masks definitely play a big role. There are lots of supply issues, but masks are important. I don’t know if I would say “require them” at this point, but it is best practices.
– observations on state’s data: total of 146 people in ICU, and yet using the 72 hour data, there appear to be 1926 ICU beds and many available ventilators. With lots of unemployed people in MN. At what point will the government say there is enough economic pain in the state given all the empty beds and unused equipment? Malcolm – the economic effects are very important to health and we know that, you are right in terms of today’s numbers, there is capacity except not on the PPE front. Our model does project top ICU demand will be 2600-4800 ICU beds needed, which means they must be equipped with vents and staff, so by that measure we have a long way to go. With every passing week, the models we all see (including the hospitals own scenarios predict more need will arise than the state model shows) will change. The CDC is pulling together a dashboard of some 50 models that exist so people can have access to multiple looks at this data. The model will never be the only data the Gov relies on.
– for Malcolm – given that people are contagious a few days prior to temperature fever hitting, so if we do temp checks is that a false indicator, false sense of security if people have no fever? Malcolm – yes. Also, these tests can have a real error rate, so we can’t rely on any single thing as proof positive. Need various tools. We all have to be mindful of not looking for any one test or one panacea.