State health officials requested $25 million Wednesday to prepare for the novel coronavirus amid growing signs of the virus' spread from China to the U.S. — and in all likelihood to Minnesota.
Increasing precautions include the self-quarantine of two University of Minnesota students who landed Tuesday at the Minneapolis-St. Paul International Airport after being in close contact with a third traveler who had been diagnosed with COVID-19, the illness the coronavirus causes.
State Health Commissioner Jan Malcolm said in a budget request that funding is necessary so the state can track the circulation of the virus, educate the public on how to reduce their exposure, and test what will likely be an increasing number of sick patients to determine if the virus caused their illnesses.
"What has dramatically happened in the last number of days is we are seeing community spread in an increasing number of states, which obviously gives us a great deal of concern," Malcolm said.
The decision for the two travelers to be self-quarantined for 14 days was made after officials with the U.S. Centers for Disease Control and Prevention evaluated them on the plane. A statement from the University of Minnesota identified the two as students.
The sick traveler they'd been with in Europe was "not allowed to board the plane," but the other two were allowed to fly home because they had no symptoms of COVID-19, said Richard Danila, assistant state epidemiologist for the Minnesota Department of Health.
Isolating the travelers for two weeks will determine if they too are infected before they interact with any more people, Danila said. Other travelers on the flight will be notified if either of the two Minnesotans is diagnosed with COVID-19.
"If you do have a known contact to a known case, whether that be in Japan or South Korea or Europe or Washington state, the recommendation is voluntary quarantine for 14 days following the last exposure," he said.
The CDC has reported 80 cases of COVID-19 and nine deaths in 13 states, though the actual count is higher due to state-reported cases that haven't yet been added to the official national tally.
Globally, there have been more than 90,000 cases and 3,000 deaths. Officials with the World Health Organization said Tuesday that the death rate from infection could be as high as 3.4%, but that the virus does not appear to spread as quickly as others — which makes containment measures to reduce its spread all the more important.
In Washington, congressional leaders said they have reached a deal to provide nearly $8 billion in emergency funding to address the outbreak.
However, Minnesota officials said it was unclear how much would come to this state, and that they had to prepare regardless of the promise of federal money.
No COVID-19 cases have been reported in Minnesota, but state health officials believe it is only a matter of time — especially now that the state has the capacity to test suspect cases on its own and no longer has to send lab samples to the CDC in Atlanta.
After sending five samples to the CDC in the initial weeks of the outbreak, the state conducted testing on its own of 16 samples from suspect cases from Monday through Wednesday morning.
Part of the funding request is based on the possibility that the state's public health lab could be testing up to 300 samples per week if the virus circulates widely in Minnesota.
The department's request drew bipartisan support from the Legislature.
"We want to have the money available so when the outbreak occurs that we have systems in place and money in place … to make sure the state is prepared," said Sen. Jerry Relph, R-St. Cloud.
Danila and state health officials could not provide details regarding the returning students. They were not close contacts, such as spouses or relatives, with the infected person, but they did travel together.
Danila also didn't identify the country in which they had been traveling, but it was presumably Italy based on his description of it having sustained community transmission of the virus.
Research has found that symptoms might take 14 days to emerge in people who have been infected by this coronavirus — hence the length of the self-quarantine to determine if the travelers arriving at MSP might be infected.
Students called back from study abroad at the University of St. Thomas' Bernardi Campus in Rome have also been asked to isolate themselves and stay off the university's Minneapolis and St. Paul campuses for two weeks.
St. Thomas initially placed no restrictions on the returning students when it decided Friday to close the Rome campus due to rising case counts and travel restrictions in Italy, but then changed its mind, said Madonna McDermott of the university's Center for Well-Being. "We're just taking extra precautions with our students and our community."
The University of Minnesota also has suspended study abroad programs in Italy, China and South Korea.
The U.S. government took historic steps at first to try to prevent the coronavirus from emerging — including its first mandatory quarantines since a smallpox scare in the 1960s. Hundreds of Americans evacuated on special flights out of China were quarantined for 14 days in January and February on U.S. military bases until it was clear they were healthy.
Danila said mandatory quarantines at such facilities were not considered in the case of the two returnees from Europe.
Now that the virus is circulating in so many countries, he said health officials are pivoting from an all-out containment effort to keep the virus out of the U.S. to mitigation strategies to identify the virus when it does show up and protect surrounding communities.
The state health department's budget request included more than $10 million in new funds to pay the salaries of 100 agency employees who would be redirected to the coronavirus response. Currently, those staff are paid from federal dollars earmarked for specific projects.
Nearly $2 million would go to testing and more than $9 million would support local public health agencies.
The state also wants $4.3 million to purchase supplies from the strategic national stockpile, a repository for pharmaceuticals and medical supplies that are needed during public health emergencies.
During the 2009 H1N1 flu outbreak, Minnesota purchased over 2 million surgical masks from that resource.
"This … has to be a plan that is going to take us through until the Legislature convenes next January," said Rep. Tina Liebling, DFL-Rochester.
The request didn't include funding to help hospitals, clinics and long-term care facilities. Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association, told lawmakers that the industry is planning for a surge in patients that could tax its resources and bed supply.
"State resources are going to be needed," he said, "because we don't know how much will be forthcoming … from the federal government."
