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Here's why Minnesota extended the Stay at Home order

The Minnesota model is estimating at least 6,000 deaths over a 12-month period.
Tim Walz modeling

Minnesota's stay-at-home order has been extended until May 4, with Gov. Tim Walz and Minnesota Department of Health Commissioner Jan Malcolm supporting the extension by revealing some of the key findings of a state-specific coronavirus model. 

Malcolm said that Minnesota has flattened the curve, at least temporarily, with the number of confirmed cases now doubling approximately every eight days, which is a significantly slower pace than before the original Stay at Home order went into effect March 27. 

"It can all go sideways very quickly if we don't continue," Gov. Walz said, urging Minnesotans to hang tough and continue to focus on staying home outside of leaving for essential needs or to go outside for fresh air while always practicing social distancing.

Even with Minnesotans following the order and practicing social distancing, the Minnesota-specific model developed by the Department of Health and University of Minnesota still forecasts a low end of 6,000 deaths in 12 months from the start of the outbreak. 

The danger of taking the foot off the gas, so to speak, is that the COVID-19 outbreak could spike as it has in other places around the country, including New York, Michigan and Louisiana. 

The graph below shows the number of days since reaching 100 cases and how many cases there are per 100,000 people.

New York and Minnesota had approximately the same number of cases per 100,000 people nine days after reaching 100 confirmed cases, but New York has since exploded – nearly 500 of every 100,000 people infected – while Minnesota has slowly increased, essentially pushing out when the peak of the outbreak could come. 

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"It took 10 days for us to remain flat and New York to go to crisis situation. We cannot rest easy. This thing can explode overnight if you don't take the proper precautions," said Walz. 

New model predicts peak need from mid-May to mid-July

"That pink rectangle that you see in the middle, using the modeling that we have, with a 95 percent confidence interval, this is the spread that falls in," said Walz, referencing the graphic below.

"We can say with 95 percent confidence that we are going to need a minimum of 3,000 beds starting in the middle of May. And that could be 3,000 beds as far out as the middle of July, depending on what we do social distancing-wise, and it could go higher." 

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The image above shows the projected peak need for ICU beds from mid-May to mid-July. It shows that Minnesota will have a need of 3,000 to 5,000 ICU beds during the extent of the surge. 

Right now, the current ICU bed capacity is 1,147. But within 24 hours, an additional 1,098 ICU beds can be made available, and within 72 hours another 525 could be readied for a maximum capacity of 2,770. 

That is the maximum capacity for all ICU patients. Keep in mind that as of today 844 ICU beds are in use, and that counts against the total that can be made available. 

Just as critical is the ventilator inventory, of which the state currently has 2,458, although 1,048 are already in use (for patients with various issues, not just COVID-19). Another 888 have been ordered, but as you can see in the chart below, those might not be delivered until during or after the peak of the outbreak. 

If you need a ventilator and don't get one, there's a very slim chance you're going to survive it," Walz said of critically ill COVID-19 patients. "If you do need a ventilator and you do get one, your chance of survival increases 10 times."

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If the extension of the stay-at-home order is as successful as the first, it's possible that the onset of the peak could be pushed a little further, also bringing the peak down slight, perhaps to the point where Minnesota's hospitals could handle the number of ICU patients and patients who will need a ventilator, not to mention stockpiling surgical masks, N95 respirator masks, gowns and gloves for healthcare workers.

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How many Minnesotans could die?

The new model represents what could happen over the course of a year in Minnesota, which includes a potential rebound in the fall.

According to Malcolm, with proper social distancing and following the rules of the stay-at-home order, the estimated death toll is 6,000 on the low end and a middle range around 20,000. 

Malcolm did not say what the high-end toll is with proper social distancing. But had Minnesota done nothing – no social distancing measures, no stay-at-home orders – the model predicted around 50,000 deaths in Minnesota over the course of a year, which fell inside of a wide range of 34,000 to 68,000. 

"We really want to counsel people that we're not predicting a certain number of deaths will happen or won't happen with these scenarios," warned Malcolm. "What the model confirms – the Minnesota model and the other models – is that the biggest levers are building up ICU capacity and isolating the most vulnerable."

One model that has received a lot of attention is from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine. It's a model that Gov. Walz referred to as "overly optimistic," while Malcolm called it "particularly optimistic." 

The University of Washington model only goes through August 4 and is currently forecasting 456 deaths in Minnesota. It does not, however, forecast what could happen in any additional waves of the outbreak, which Walz said will "more than likely" come in the fall. 

Walz and health officials suggested that they'll provide an in-depth look at the variables going into the Minnesota-specific model on Friday. 

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