As announced by officials from the Minnesota Department of Health during an afternoon media call Monday, Aug. 10, the new guidance was undertaken with the recognition that while isolation is necessary for infection control safety, the safety of residents was also affected by prolonged isolation, including the loss of visitors to monitor on the care given to residents.
“We will be dealing with COVID-19 for a long time, and it is important to find a way to allow residents to interact with their loved ones safely,” Commissioner Jan Malcolm said in a statement. “Residents have been isolated for months, and that presents significant risks for their emotional and social well-being. This guidance helps facilities keep their COVID-19 guard up while taking cautious steps toward ensuring residents have more social connections and interaction.”
"Our goal is not just to prevent COVID-19 infections," Malcolm said during the call. "It's to enhance the well-being of residents while finding a balance between safety and visitation restrictions."
The new guidance begins Aug. 29. It allows visitors and trips outside the facility among residents at centers with no new cases among staff, residents or servicing professionals in the past 28 days. Malcolm said that less than 10% of facilities have had cases in the past 28 days, meaning 90% of facilities are eligible to re-open themselves to visitors in September.
The guidance builds on the incremental opening measures taken in the last two months. Previous easing of isolation included the addition of outdoor visitation, window visits and visiting privileges for designated "essential caregivers," a program that officials conceded did not elicit much participation.
"The majority of long-term care facilities are doing quite well," Malcolm said. "Only a quarter have ever had an outbreak."
Health officials also pointed at increased testing capacity, procedures to request personal protective equipment, and 1,100 personnel now signed up for crisis staffing support.
Like schools, facilities seeking to reopen are also advised to consider the case rate in their county and neighboring counties, using extra caution if COVID-19 incidence exceeds 10 cases per 10,000 residents over a 14-day period. A facility may choose to stay isolated if it has experienced no cases but the county case rate is high. Other risk factors to be assessed include, facility size and the extent to which staff work at other facilities.
Currently, more than 40 of Minnesota's 87 counties have a case rate surpassing the recommended safety threshold.
Visitors will need to undergo screening measures, observe masking, maintain a 6-foot distance as much as possible and take the shortest path to a resident. While holding hands and kissing is not allowed, safe hugs with heads turned is allowed.
One of the factors that drove the change was the discovery that maltreatment reports are down 20% since March, a drop not expected during a pandemic.
"We are anticipating a positive impact on people in long-term care to being reunited with families in their facilities," said Minnesota Deputy Ombudsman for Long-Term Care Aisha Elmquist. "We're absolutely concerned about the spike COVID-19, but we also know loneliness and isolation are serious health risks ... Walling off residents from family and friends is not sustainable, but neither is a wide open system."
Speaking in favor of the new guidance was Melanie Van Wyhe of Stillwater, whose 82-year-old mother suffers from Alzheimer's disease and has declined during isolation.
"I never thought I would hear my beautiful mother ask me if she were in prison and had done something wrong," Van Whye said. She spoke of watching her mother grow more detached in late June, and eventually appear not to recognize her, anymore, saying "I'll see you in heaven."
Though her mother's facility had never had a single case of COVID-19, it was waiting for a vaccine to allow visitors.
The Minnesota Department of Health reported another 625 cases of COVID-19 on Monday. The new cases join 1,730 reported over the weekend, to bring the laboratory-confirmed case count to 61,516.
Health officials reported three more deaths from the illness, two in Ramsey County and one in Anoka County, one of whom lived in long-term care.
Health systems and the MDH reported an additional 12,787 tests on Monday. Sunday's test reporting surpassed the state's 20,000 daily tests capacity for the first time, with 20,017 tests for the day.
Hospitalizations for the illness are at 320, with 159 of those in ICU settings.
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Minnesota Department of Health COVID-19 hotline: 651-201-3920.
Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.
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