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Minnesota Department of Health model update projects higher COVID-19 deaths

The latest model was presented to the public on Wednesday morning.
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The latest model for the COVID-19 pandemic in Minnesota is projecting a higher number of deaths than previously estimated.

The update was provided by the Minnesota Department of Health on Wednesday, and reveals a series of new scenarios for the state's response to the virus, with the death count revised up because people aren't social distancing as well as assumed.

The previous version of the model, released on Apr. 10, put an estimated death count between 9,900 and 36,000 during a cumulative 12-month period. But the latest update estimates a death count range between 16,000 and 44,000, based on the Stay at Home order continuing a further 6 weeks.

The model also projects between 1,400 and 2,000 COVID-19 deaths by the end of May. As of this morning, there have been 638, with daily confirmed deaths tending to range between 15 and 30 in recent weeks with little sign yet of it trending upward.

To reach 1,400 deaths, the state would have to see 40 deaths per day on average between now and the end of the month. To reach 1,700, there would need to be an average 56 deaths a day.

When this was put to him by BMTN that this figure seems high given the death rate so far, Gildemeister said that his hope is that these are "pessimistic estimates," but that the outcome is still "plausible" based on the current rate of spread.

Officials did not however that the model is based on current rates, and doesn't factor in the enhanced measures the MDH is in the process of rolling out in long-term care facilities, though this might be factored in to future models.

"The purpose of the model is showing general directions," Gildemeister said. "The general direction that we're seeing here is that there's increased mortality by the end of May. Secondly, there's a range of uncertainty around this point from about 1,000 to 2,000 cases. These are plausible outcomes."

Over the past 7 days, Minnesota has averaged 21.85 deaths a day. If that were to continue to the end of May, Minnesota's death total would reach 1,053.

The latest model also says Minnesota is between 11 and 13 weeks away from peak epidemic, a shorter timeframe than the version 2.0 of the model. 

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Part of the reason for the change is because mitigation measures, through social distancing guidelines and the Stay at Home order, have not been as effective in preventing the spread as was assumed in previous models.

MDH state health economist Stefan Gildemeister said there has been "more mixing going on in the population than we had assumed," causing the disease to "spread farther." 

"The real pathway to significant flattening of the curve is long standing mitigation," said Gildemeister, suggesting it requires some form of mitigation into September if Minnesota were to follow the CDC's guidelines for seeing 14 days of decreased hospitalizations after the peak before opening things up again.

The social distancing guidelines were initially estimated to have reduced contacts between people by 50 percent, but the actual result is an estimated 38 percent drop, while the Stay at Home order was assumed to reduce contact by 80 percent, but it's been around 60 percent.

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It also notes that the new model takes into account the increasing number of asymptomatic patients and deaths that are occurring outside of hospital settings.

As ever with models, Gildemeister notes that there is still much unknown in the predictions as Minnesota is still in the early stages of the pandemic.

Nonetheless, the MDH says that its modeling has so far followed the actual rise in deaths and hospitalizations relatively accurately though Apr. 25. 

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The number of deaths by the end of May is projected to reduce slightly in the event the state is able to offer 20,000 COVID-19 tests a day with a 95 percent sensitivity.

But again, the model is also projecting 2,444 to 3,400 maximum ventilator/ICU at the peak of late June/early July with an extended Stay at Home order in place.

The current number of ventilators in use in Minnesota is 512 – which includes both COVID and non-COVID patients.

Based on various scenarios presented, the number of deaths with a Stay at Home order is expected to be half what it would be with zero mitigation in place.

Gildemeister also said that the introduction of effective antivirals such as Remdesivir on a widespread scale could help reduce peak hospitalizations and ventilator use if it arrives before the peak, though it would be less effective afterwards.

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You can find the CDC/White House guidelines referenced in scenarios 7 and 8 here.

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