The fall has come, and as Old Man Winter rears its head, COVID-19 is not dissipating. In fact, it’s seemingly spreading faster than ever, creating major challenges at nursing homes, filling up hospital beds and closing schools.
Nicollet County has not been an exception, and Public Health staff is responding aggressively.
On Nov. 17, the county pursued its most enterprising step yet, hosting a COVID-19 testing event at the St. Peter Community Center. Public Health staff, led by Director Cassandra Sassenberg, along with Jody Fischenich and Bree Allen, organized an efficient and pandemic-safe makeshift test site in the gym, allowing for social distancing, as nurses administered nasal swab tests to interested participants.
The team was hoping to administer at least 600 tests and finished with 686. They won’t know the results until a few days after.
“Locally, the last couple weeks, the cases have really surged,” Sassenberg said. “Not just the number of cases, but the amount of time people are spending with each other is really increasing. People are spending more time indoors with family and friends.”
As of Nov. 17, Nicollet County had reported 1,245 positive cases, including 22 deaths. Among those deaths, eight were in the 90-99 age range, six from 80-89, four in 70-79, two in 60-69 and two in 50-59.
Sassenberg noted that when they find positive tests and work on contact tracing, it’s not uncommon now to quarantine up to 20 individuals or even more. This is an increase from the earlier months of the pandemic, and it indicates people are experiencing pandemic fatigue and are venturing out more. However, as cases continue to rocket upward (more than 6,000 new confirmed daily in Minnesota), and hospitals and nursing homes become overwhelmed, it’s bad timing for residents to break safe habits.
“We know our local hospitals are busier,” Sassenberg said. “And it’s not just been older residents; there has been a wider spread of age.”
The good news, though, Sassenberg said, is that community members continue to respond loudly to preventative actions, such as the testing event in St. Peter. She said people were “really eager to participate” and also helped with outreach, spreading the word to others.
Sassenberg also pointed out the positive relationships Public Health has had with community partners. A number of school districts have recently switched their learning models to help reduce potential spread, including St. Peter, which switched to distance learning only, likely until at least early January.
“Our communication and partnerships within this community have been strengths for us,” Sassenberg said. “Regular communication with long-term care, hospitals, schools. We haven’t ran into partners who haven’t engaged.”
The purpose of a testing event in a community like St. Peter is to get as many people informed on their own status as possible. Public health workers everywhere are consistently finding positive tests in asymptomatic individuals.
People without symptoms wouldn’t be aware they have the virus, and therefore may be more likely to interact with a larger subset of people. The virus then spreads, and eventually people more vulnerable end up with the disease.
If more people know their positive or negative status, then the county can do more contact tracing, get more people quarantined, and those individuals who are positive can take immediate precautions to avoid spreading the virus. This is especially important as major holidays approach.
“Particularly, if we’re catching people who are asymptomatic or have mild symptoms, we can help them identify who else they might’ve spread it to, and we can encourage them to stay home,” Sassenberg said. “More people not interacting with so many others, especially during the holiday season, can really lessen the spread.”
Fischenich, who serves as the disease prevention and control coordinator for Nicollet County, explained how the Nov. 17 event was set up. Participants entered and were asked if they had registered online; if not, they were sent to do a computer station to do so; if they had, they were put in the testing line. In the testing line, there is one more check, so organizers can mark that the person showed up for the test and give them a label to go with their test. Then the participant heads to one of the nurses to have a nasal swab sample taken. At each table, one nurse takes the swabs, while another handles all of the used and contaminated materials.
“The model has been used throughout the state,” Fischenich said.
A bit after 11:30 a.m., the team started welcoming in the first participants, who had arrived before the noon scheduled start time. The first in line was Pat Stoll. She wasn’t experiencing any COVID-19 symptoms but wanted to be sure of her status.
“I tested several times while I was working, but now I’m retired, so I just thought I’d check again,” she said.
Asked what concerns her during this pandemic, Stoll had a simple response.
“Getting it,” she said. “Being around my family, which I haven’t been recently. That’s been hard.”
She noted that getting a negative result back “certainly” offers her reassurance and a sense of calm as the virus continues to spread. Stoll felt the testing event in St. Peter offered a level of convenience, as did Kayla Donahue Lee, who also joined the line to get tested.
“I am a health care worker, and I have to get tested twice a week. Typically, I get tested in Mankato, but today I have a patient here, and since I live here, I’m testing here,” Donahue Lee said. “I think these events are great. I think they are needed in the community. So far, there has been a lack of resources to get people tested, so I think it’s great the community is providing this at no cost.”
As a member of the medical community herself, Donahue Lee expressed firm belief that testing can make a difference in preventing spread.
“It absolutely can, as long as your following the guidelines,” she said. “If you’re testing positive, you might be asymptomatic, and staying home is going to help prevent the spread to people who are going to be symptomatic and possible have bigger issues.”
Before the testing event at the Community Center, Nicollet County led a testing event at Gustavus Adolphus College for the students and staff there. The team was able to process 1,365 tests on a six-hour day Nov. 13. The impetus for the testing was a recent increase in cases at the college, but the results returned were actually quite hopeful.
According to the Minnesota Department of Health, about 7.5% to 11.5% of tests usually come back positive from college testing events across the state. But Gustavus’ positivity rate was only 1.5%, or about 20 positive cases in all.
“We were expecting maybe 10%,” Nicollet County’s Fischenich said. “That was pretty exciting. Gustavus has taken a lot of steps with contact tracing and quarantining, and that work has paid off.”
The reason Public Health staff is encouraged by those results is that it indicates strict actions and procedures can help limit the spread. But it won’t mean anything if health workers don’t continue to send the message of continued caution to those on the Gustavus campus and beyond.
“The low numbers means the actions we’re taking are working, but it’s a matter of still communicating the messages,” Fischenich said. “We’re looking at ways to keep going with that partnership with Gustavus. We have tests leftover and we’re talking about strategically the best time to test again.”
The two testing events in St. Peter were well timed, according to organizers, with major holidays coming up, and with them, potential gatherings. If more people know they are positive and more contact tracing can be done, it might help prevent interactions that could lead to more unwanted statistics.
“Many people who have tested positive are people who thought they were being very careful,” Sassenberg said. “You really can’t be as sure as you think you can.”
A months-long pandemic has not made things easy for a program like Meals On Wheels; at the same time more seniors need meals delivered to their doorstep, less volunteers are available to make those deliveries.
So back in the spring, the city of St. Peter and Minnesota River Valley Transit partnered to keep the program going. Every day, Monday-Friday, an MRVT bus, funded by federal CARES Act dollars, makes a route to a couple dozen residences in town, and a volunteer, often from the city's Recreation and Leisure Services Department, takes the meals to front doors.
"We found out just as everyone was trying to figure out what’s going to happen now that they’re we’re dealing with COVID, and we asked ‘What can we do to help out?’," Recreation and Leisure Services Director Joey Schugel said. "The role of our department in a lot of ways has changed; it’s not necessarily to hold these large events; yes, we still have programs and offerings, but we also had the ability to help out in other ways.
"We were worried about food distribution, so we were navigating how to do that and potentially sending out resources and finding ways to help. Then we found out Meals on Wheels was going to lose a lot of volunteers … We decided city transit would do the transportation part, and we’d provide staff to be the runner, bring people their meals, all that. It’s hard for the bus drivers to do that part."
The city contracts MRVT for its transit services, and with the company operating at much less than full capacity during the pandemic, it was eager to jump in and help.
"It’s important that people get meals," MRVT Compliance Manager Wayne Albers said. "People who depend on Meals On Wheels need these meals. We have the capacity to get these meals to them, and it’s a priority."
For Meals on Wheels, the city stepping in has been crucial. Howard Anderson took over the program in St. Peter in June, and when he found out the city was going to handle routes, it was quite a relief.
"Right away, the concern was the delivery routes — who I was going to get to volunteer?," Anderson said. "It’s been very helpful, because then I don’t have to find volunteers to drive. There are a lot of older drivers, and they’re very worried about the pandemic."
In the early months, meal deliverers were restricted from doing anything but dropping off the meals, but they're now allowed to step inside the house (with masks on), greet the recipients and answer questions if needed.
"That’s important, because they’re alone," Anderson said. "They don’t see faces, and when they see meals coming with a happy face and people saying, ‘Hey, how are you?,’ that really helps them to overcome hurdles."
As Minnesota enters the winter, and Recreation and Leisure loses its seasonal staff, the city is seeking more volunteers to ride the MRVT bus and drop off the meals. The route takes about an hour in the morning, with just some walking and minimal lifting. For St. Peter High School National Honor Society junior Lilly Ruffin, it was the perfect opportunity to do some volunteer work.
"After my counselor sent out the opportunity, I asked my mom about it, and she said she did it as a kid, and she always loved to do it, and I’ve always loved to help people, so I decided that this would be an awesome thing to do," Ruffin said. "I’m really enjoying it, just helping out whoever I can, meeting new people and getting to know them."
Ruffin has had nothing but positive experiences on the route.
"(The meal recipients) are really nice and very appreciative that someone my age is volunteering to do something like this," she said. "It’s been a really cool opportunity."
The state of Minnesota is leading the nation in census outreach at a crucial time for the state’s reapportionment. And local communities contributed positively to the effort.
Data released by the United States Census showed that 75.1% of Minnesotans voluntarily responded to the census by phone, mail or online more than any other state. Minnesota’s voluntary response rate grew by 1% compared to the 2010 census and is seven points ahead of the 67% national average. Self-response in Minnesota also ran nearly three points ahead of Washington and Wisconsin, which held second and third place in voluntary response rates at 72.4% and 72.2% respectively.
High voluntary response rates were seen locally as well. In Le Sueur County, 74% of residents voluntarily responded, just below the state average, while Nicollet County saw an 81.6% response rate, well above state averages.
Local response rates are also well above the national averages. In Le Sueur County, Heidelberg led with an 88.2% response rate followed by Cleveland at 83.8%, Montgomery at 79.9%, Le Center at 79%, Le Sueur at 76.7% and Waterville at 71.7%. In Nicollet County, Cortland had an 89.2% response rate, North Mankato had 84%, New Um 79.4% and St. Peter 78%.
These high voluntary response rates are good news for the state of Minnesota, which has representation in Congress riding on the line this year. Minnesota could lose one representative in the U.S. House after the nationwide count is complete. The state is one of several in the Midwest, including Michigan and Illinois, that is projected to lose representation in 2020 because of major population growth in southern and western states, like Texas, Florida, Arizona and Colorado, which are poised to gain representatives.
A complete count isn’t just important for representation. Census data is used when federal and state governments distribute aid and grants to state and local governments and for federal programs like Medicaid and SNAP. It’s used in the private sector as well. Businesses use census data when moving into markets and expanding their operations.
“The Census Bureau has told us that they believe that for every person that is not counted, an undercount of a person, that can cost us $15,000 over the next decade,” said St. Peter City Administrator Todd Prafke.
Undercounts are most likely to occur with hard-to-reach populations, such as renters. A report from the U.S. Census Office estimates 8.5% of renters were undercounted in the 2010 census.
This has resulted in demographic groups that are more likely to live in rental units, including black and Latino populations, to be undercounted as well. Children ages 4 and younger were also undercounted in the last census by 1.7%
One hard-to-reach group specific to areas like Minnesota is snowbirds — people who reside in the state but head down south during the colder months of the year.
“In St. Peter, one of the things that’s important to us is making sure snowbirds are counted here,” said Prafke. “Lots of people look at this and think maybe it’s the Latino community being undercounted, maybe it’s teenagers, maybe it’s college kids, but what we found was two primary demographics: snowbirds and children under 5 years old. Families may not have counted those very young children, because they didn’t think they needed to, they weren’t in school yet.”
St. Peter is one of many communities that formed complete count committees to make the community aware of the census. The committee was staffed with volunteers who could reach out to groups within the community and promote the census on posters, social media and the city website.
But for other communities, COVID-19 interrupted those plans. The pandemic hit at the same time communities were beginning to assemble complete count committees and some, like Le Sueur County, declined to form committees. County Administrator Darrell Pettis said the county was too busy responding to the pandemic to put resources into promoting the census.
The city of Le Center had formed a complete count committee, but City Administrator Chris Collins said that the Census Office stopped responding to requests for training for the committee.
The pandemic has also put added pressure on the Census Bureau as deadlines shifted throughout the year. The count was originally supposed to stop at the end of July, but the pandemic shut down the bureau’s efforts to count in the spring. The Census Bureau moved their deadline to the end of October, but that was reversed by the Supreme Court. The court sided with the Trump administration on Oct. 13 to immediately halt the census count on Oct. 15.
The White House argued for an immediate end to the count so that the numbers could be reported by Dec. 31 — the congressionally mandated deadline for completing data to apportion House seats. However, activists have raised worries that the early deadline will undermine the accuracy of the census and undercount black and Latino populations, as well as Native Americans on reservations.