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Attempts to track outbreaks of COVID-19 among Twin Cities protesters through mass testing are being complicated by a supply shortage at some clinics and concerns among protesters about the information they'd have to disclose if they tested positive.

M Health Fairview is not testing anyone who is asymptomatic for now, despite an advisory from the Minnesota Department of Health to test anyone involved in mass demonstrations over the past week — whether they appear to be sick or not.

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"While M Health Fairview is working quickly to increase our COVID-19 testing capacity to include asymptomatic individuals who were involved in recent mass public events, national shortages of lab testing supplies require us to prioritize testing for those admitted to our care facilities and symptomatic individuals at this time," said Dr. Mark Welton, M Health Fairview's chief medical officer.

State health officials worry about a surge of COVID-19 cases involving protesters, first responders and others at recent mass events — right as cases appear to be trending downward in Minnesota.

The state reported 339 lab-confirmed cases of COVID-19 and 11 deaths on Monday — down from daily highs of roughly 840 confirmed cases on May 23 and 35 deaths on May 28. Hospitalizations for COVID-19 reached their lowest levels since mid-May.

The trends were favorable enough that state Health Commissioner Jan Malcolm said on Monday that Minnesota could see the resumption of youth baseball, basketball and soccer games by the end of June — though new sports guidance now prohibits those games due to the risks of spreading the coronavirus that causes COVID-19.

Malcolm said health officials aren't confident enough yet to project a normal start to the school year in the fall.

"We just don't know what the state of the epidemic is going to be," she said.

One reason for concern is the protests following the death of George Floyd in police custody — with thousands of people packing together and singing and shouting in ways that could have increased viral transmission.

Many of the protesters were black, and state health data have shown that black people suffer higher rates of severe COVID-19 due in part to their higher instances of chronic diseases that exacerbate their infections. Black people make up less than 7% of the state population but more than 20% of the patients hospitalized for COVID-19.

"There seem to be converging concerns here," Malcolm said.

Hennepin Healthcare is scheduling tests for people involved in protests, regardless of whether they have symptoms. HealthPartners is testing asymptomatic protesters as well and has updated its online Virtuwell site to permit these patients. Priority will still go to patients with symptoms if supplies run short, though, the health system said in a written statement.

As many as 80% of COVID-19 infections cause mild or no symptoms, raising concerns that protesters could have been spreading the virus without knowing it.

Some people are worried if they test positive that they will have to disclose who they were with during protests as part of state contact tracing to identify others who may be at risk for infection.

VJ Smith of MAD DADS said he can understand such concerns but ultimately recommends that people who participated in protests get tested, especially if they live with elderly parents or others who are vulnerable.

"It's about who you are around and the people that you care about," he said.

The state is providing free testing on Tuesdays and Wednesdays for the next three weeks through local community organizations that people trust. The sites are Holy Trinity Church, Sabathani Community Center and New Salem Baptist Church in Minneapolis; and at Jimmy Lee Recreation Center in St. Paul.

"There's a lot of public health education to be done about why this is so important to help protect not only individuals themselves but their loved ones and the larger communities," Malcolm said.

Contact tracing has been used to track infectious diseases for years — long before COVID-19 — and can involve the asking of sensitive questions, even about sexual partners or illicit activities, but is used exclusively to identify the spread of a virus and other people at risk, said Kris Ehresmann, state infectious disease director.

"There is no part of our work that is beyond that," she said.

If people are uncomfortable disclosing their contacts at the time they became infected, Ehresmann said health officials still want to talk to them and encourage them to tell contacts on their own about their infection risks.

The state has identified 28,224 cases of COVID-19 through diagnostic testing so far. The state death toll of 1,197 people includes 955 residents of long-term care facilities and mostly people who are older or have chronic health conditions.

However, the state on Monday reported its second COVID-19 death of a Minnesotan 29 or younger with no apparent underlying health conditions.

As of Monday morning, 452 people with COVID-19 were admitted to Minnesota hospitals, including 198 who needed intensive care.

That is the lowest number of COVID-19 patients hospitalized since May 12, though Malcolm warned against complacency and encouraged people to continue following guidelines such as wearing masks and staying 6 feet apart in public.

The state on Wednesday will scale back statewide restrictions designed to reduce the spread of the virus — allowing group gatherings of 10 people indoors and 25 outdoors, as well as limited indoor restaurant and bar service and fitness club usage.

New guidance also permits competitions in youth and adult sports in which social distancing can be maintained — such as tennis and running. Practices that maintain social distancing can take place in other sports, but no games that require close contact yet.

"While we're encouraged to see the number of individuals hospitalized and in ICU drop," Ehresmann said, "we also are concerned because we have seen deaths in healthy younger adults, and that is very sobering."

Jeremy Olson • 612-673-7744