ST. PAUL -- The Minnesota Health Department released new figures on Tuesday, March 17, showing six more people have tested positive for the coronavirus in the state, raising the total to 60 cases.

No new counties were included in the new cases, all of whom are recovering at home, and all of whom are believed to have contracted the illness from people they met on international travel or out of state.

Two of the cases were located in Hennepin County, two in Olmsted County, and one case each in Dakota and Ramsey counties. They ranged in age from 37 to 71. The news came accompanied by the starkest expression yet that the state and even private testing entities are running out of necessary materials to utilize test kits.

That development emerged as health officials expanded on a new policy for the state health lab to limit testing for COVID-19, changes framed on Monday, March 16, as a prioritizing of testing, and on Tuesday as a firm limitation of the lab work to certain groups only. Citing shortages of materials, the state now says until further notice it will restrict the use of state testing to those who work in health care, people who are hospitalized or residents of congregate settings.

Infectious Disease Division Director Kris Ehresmann said the new policy supported the larger goal going forward of protecting the health care system for those most in need.

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"Obviously it would be wonderful if we could continue to test with a very open hand," Ehresmann said in a conference call with the media. "But one of the positive things about not being able to test everyone is that because we can only focus on highest-risk individuals, that will limit the use of the health care system by those individuals with mild illness -- easing the burden on the health care system."

Ehresmann said the state needs to prioritize the identification of positive cases under the care of hospitals in order to prevent the spread of the illness within the system.

"Additionally," she said, "hospitalized patients who test positive are eligible to participate in a number of drug trials for antivirals."

The new limitations were echoed in a statement and press conference from the Minnesota Hospital Association on Tuesday. "I’m concerned that national messaging from the White House task force today regarding test availability in all states -- does not accurately reflect these critical shortages in Minnesota," said Rahul Koranne, president and CEO of MHA on Tuesday in a call with reporters. "We currently do not have adequate supplies and testing capabilities in Minnesota,"

The limiting of testing provided yet another round of public-health whiplash. Over the past five days Minnesota residents have seen schools spared from closure and then closed, recommendations against 250 person gatherings tightened to gatherings of 50 and then reissued once again as the shuttering of most gathering spots outright.

The new restrictions have also placed public health authorities in the position of telling Minnesotans that if they feel as though they have a mild case of the flu, knowing whether that illness is COVID-19 is of little importance, given they would receive the same advice with or without a diagnosis. It also reflects the fact that in terms of self-isolation, all illnesses resembling COVID-19 are to be treated as if they are COVID-19.

"If you have upper respiratory symptoms and are able to manage them at home," said Ehresmann, "it doesn't change the treatment recommendations or our recommendations about staying home when you are sick. We want people who are ill to stay home from seven days after the onset of illness, or 72 hours after resolution of fever and respiratory symptoms, whatever is longer.

"Having a positive test of COVID-19 for someone with mild symptoms is not a magic bullet. It doesn't change our recommendations for staying home when you're sick, and isolating yourself for the period recommended."

Should symptoms become severe, Ehresmann said, patients should call their provider. Health officials also stressed that household and intimate partner contacts of all who have a fever and upper respiratory symptoms should severely limit their public activities as well, and for two weeks.

Also on Tuesday, Mayo Clinic announced in a statement that effective March 23, it will "defer all elective care that can be deferred for eight or more weeks. This will include both elective surgeries, procedures and office visits.

"Semi-urgent, urgent and emergency care will continue in clinic and hospital settings."

The new directive, effectively turning the nation's largest privately held hospital and the state's largest private employer into a facility for urgent and coronavirus care only, will apply to all Mayo Clinic locations nationwide, including Mayo Clinic Health System.

"This decision is being made to ensure the safest possible environment for our patients and staff and to free up resources to assist in Mayo Clinic’s response to the COVID-19 pandemic. Staff working in impacted areas will be redeployed where needed most."

The virus that causes COVID-19 is spread primarily by respiratory droplets when an infected person coughs or sneezes, similar to how influenza spreads. It can also spread when people touch contaminated surfaces and then touch their eyes, nose or mouth.

More information about the symptoms of COVID-19 can be found on MDH’s Coronavirus Disease (COVID-19) website, as well as additional information about how to protect yourself and your community.

MDH has set up a COVID-19 public hotline that is open 7 a.m. to 7 p.m. The hotline number is (651) 201-3920.

The Minnesota Department of Public Safety has a hotline to field questions about the issues associated with community mitigation, including school and business impacts. That line is open 7 a.m. to 7 p.m. daily, and the hotline numbers are (651) 297-1304 in the Twin Cities and (800) 657-3504 for greater Minnesota.

Health officials have opened a school and childcare hotline at (651) 297-1304 or (800) 657-3504.

Additional reporting provided by Forum News Service reporter Sarah Mearhoff.

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