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    Closures across the state

    Updated: March 30
    Is there any definitive statement regarding an extension of the shutdown mandate? — Annette

    Gov. Tim Walz has ordered Minnesotans to stay at home for two weeks, at least, as part of the state's ongoing efforts to control the spread of the coronavirus and COVID-19 disease. People will be allowed to exercise outdoors and visit the grocery store, for example, with proper social distancing. But many businesses, like restaurants and gyms, are to stay closed except for pick-up services.

    What did Gov. Walz specifically mandate for Minnesota dentists? — Tracy
    On March 19, Walz issued an order that "all non-essential or elective surgeries and procedures, including non-emergent or elective dental care, that utilize PPE or ventilators must be postponed indefinitely" for the duration of the peacetime emergency declared earlier in the month or until it is rescinded.
    Before that order, dentists were following the advice of the Minnesota Dental Association and the American Dental Association and were temporarily limiting practices as the number of COVID-19 cases continues to increase.
    Are businesses supposed to close until April 10 or May 1? — Jennifer
    According to the executive orders issued March 25, all businesses that were originally told to close until March 27 are now asked to extend that until 5 p.m. on May 1. 
    April 10 is the current end date for the governor's "stay at home" order. That order begins Friday, March 27 at 11:59 p.m.
    Are people exempt from the stay-at home order if they work at a restaurant that does take out only? — Itzel
    Yes, the same rules apply for restaurants and bars as before the "stay at home" order, dine-in services are closed but delivery and takeout services can continue.
    Do companies need to do anything to declare them essential? Do essential employees need to carry a letter authorizing workforce travel? — Carol
    The Minnesota Department of Employment and Economic Development have a full list of businesses considered critical here. And those with further questions on whether or not they fall into a category can reach out to state economic development officials at criticalsectors@state.mn.us
    Essential employees will not need any kind of special documentation to prove where they work or where they are going during the order, Gov. Walz said.
    How can Minnesotans with expiring drivers license renew there licenses now the the counties have closed there license centers? — Mike
    Authorities said they would close vehicle services offices through April 10 to comply with Walz’s order. The state will extend expiration dates for licenses and permits set to expire in this period. Vehicle registration can be renewed online or by mail.
     
    Read more about the "stay at home" order in our "What you need to know" guide here.

    Social distancing

    Updated: March 27

    Is it OK for me to take a daily walk outside (on nice days) by myself during this COVID-19 event? — Chris

    Yes. Stress and anxiety run rampant during crises like this and exercise can help mitigate those feelings and boost your immune system.

    However, the same general guidance for preventing coronavirus’ spread applies for nature, too: No large groups, try to maintain approximately six feet between yourself and others, wash your hands often and well, and stay home if you’re sick or have been potentially exposed to COVID-19.

    State parks and trails will remain open for now, the Department of Natural Resources said, but they are monitoring the situation and will respond with updates if needed.

    Since there's an increased demand on services like Instacart, is it better to go to the grocery store or to order online for delivery? — Elizabeth

    While the CDC is suggesting people use delivery options, going to the grocery store will likely be essential for many. You can take precautions to make the visit safer.

     

    Those steps include avoiding peak hours (usually midday and you can also search for your local store on Google to check for the busiest times), washing your hands before and after the visit, avoiding touching your face while at the store and — if you have disinfectant wipes or if the store provides them — wipe off cart and basket handles before and after you use them.

    I worry about the items I bring home. Should I be dowsing everything in bleach spray? — Nancy
     

    Currently, there is no evidence of food or food packaging being associated with transmission of COVID-19.

    Daniel Kuritzkes, an infectious disease expert at Brigham and Women’s Hospital, told NPR that the food itself “is probably not a major risk factor.” That’s because most infections from the new coronavirus appear to start with the respiratory system, not the digestive system.

    Infection comes from getting the virus on your hands and then touching your own eyes, nose and mouth. Making washing your hands before and after handling your food important, as well as keeping clean surfaces and utensils.

     

    If we go to drive-thru pick up at a restaurant, isn't that a vulnerable act for the public? — Pam

     

    As mentioned above, the CDC recommends drive-through, pick-up or delivery options over dine-in, and a few small actions after getting your meal can help reduce any risks.

     

    NPR interviewed Drew Harris, a population health researcher from Thomas Jefferson University in Philadelphia, who suggests taking the food out of the containers they were delivered in, throwing those containers out, then washing your hands thoroughly before eating. 

     

    “We don’t want to get too crazy about this, but taking reasonable precautions should be sufficient,” he said.

    How do I safely handle delivered newspaper and mail? — Judith

    The U.S. Postal Service is monitoring the situation and is following the guidance of health officials. According to the CDC, the World Health Organization and the Surgeon General there is currently no evidence that COVID-19 is being spread through the mail.

    Note that it is still a good idea to wash your hands before and after touching any objects or surfaces that were likely touched by many other people.

    Why aren’t day cares closing? Parents are feeling safe sending their kids, because they haven’t closed. Are they? — Tonya

    Gov. Tim Walz has ordered schools to close for in-person sessions until early May to slow the spread of the virus, but state officials urged child care centers to remain open to help essential workers go about their regular jobs.

    Some early childhood educators made the decision to close their centers anyway. Still, many remain open, which is a decision that’s been tough for some day care staff and parents worried about the risk of infection or spreading COVID-19.

    The National Association for the Education of Young Children released a statement Sunday, saying only a select few centers should remain open as long as schools are closed. The organization emphasized the importance of child care centers and asked states and federal governments for funding to support them.

    Whether to keep day cares open or order them to close is a lose-lose situation: Close child care centers and you leave families that can’t telecommute unable to find care for their young ones. Stay open and risk spreading the disease further. Read the full report by MPR News reporter Riham Feshir.

    I am 65 years old. Can I visit my grandchildren at their house or mine? — Patricia

    The official guidance from health care professionals is that older adults avoid contact with children during the COVID-19 outbreak.

    A new study found that 13 percent of children with confirmed cases of COVID-19 didn't show symptoms and public health officials say your risk of severe illness from this infection goes up significantly after age 50.

    "We want to minimize the risk of that child passing on disease to their grandparents, who are at increased risk," Sean Morrison, a geriatrician with Mount Sinai Health System in New York told NPR

    Morrison went on to suggest alternatives such as video chats, phone calls and care packages.

    Where should I go to donate blood? I'm not sick but I wonder if I need to be socially isolated for a period of time before I can donate? — Karen

    A spike in blood drive cancellations means many organizations have an urgent need for blood and platelet donations. Donation centers like The American Red Cross and Memorial Blood Centers have guidelines on their websites for people who wish to donate.

    You should not donate blood if you are sick or think you may have been in contact with someone who is sick. You should also call ahead to make an appointment rather than going directly to a center — this makes it possible to maintain social distancing between donors.

    Public health

    Updated: March 25

    What does it take for schools, besides universities, to take the step to cancel in-person classes and go online? — Amy

    Hundreds of schools across the nation have closed in response to COVID-19. Many closures are triggered by a known infection or exposure of a student or staff member.

    Gov. Tim Walz announced that he was ordering K-12 public schools across the state to close and extended the closure through early May in an effort to slow the spread of COVID-19.

    Closing schools is a big decision with far reaching consequences as many parents need to make arrangements for child care and many families rely on the free or reduced-prices of school lunches. But it’s also a practice proven to slow the spread of diseases.

    "Closing the schools before anyone in the schools is sick is a very difficult thing to do," Yale University sociologist and physician Nicholas Christakis told NPR, "even though it's probably extremely beneficial and much wiser."

    Walz's office said his emergency executive order “requires schools to provide care for elementary-age children of health care professionals, first responders, and other emergency workers" so those individuals can stay on the job. It also "makes provisions for the continuity of mental health services and requires schools to continue providing meals to students in need."

    Kids don't seem to be getting the disease. Can they transmit the virus if they've been exposed to it? — Laura

    While children do appear to be less susceptible to the disease and often exhibit milder symptoms when infected, the potential is there for infection and there’s no evidence they can’t spread COVID-19.

    While they might not end up feeling as sick, the guidance for prevention and care are much the same for kids as infected or exposed adults — contact your doctor for guidance, stay home and limit contact with others. It can be an emotional time and the Centers for Disease Control and Prevention has some guidance to help children get through emergencies and on how to care for them at home.

    Should we cut back on non-essential outings? — Aimee

    Health officials suggest avoiding large crowds and confined spaces with many people — advice many large events have acted on in the form of cancelations and postponements. Groups with the greatest risk for serious infection should especially consider limiting non-essential travel and outings.

    Gov. Walz has ordered Minnesotans to stay at home for two weeks, at least, as part of the state's ongoing efforts to control the spread of the coronavirus and COVID-19 disease.

    The order isn’t a complete lockdown and it allows essential activities and services to continue, Walz said. People will be allowed to exercise outdoors and visit the grocery store, for example, with proper social distancing.

    If you feel sick you should stay at home. If you think you’ve come into contact with someone who is sick with COVID-19, you’ll also want to stay at home for two weeks and watch for symptoms (see self-quarantine.) 

    When you do go out for essential trips, try to keep a distance of a few feet (six feet when possible) from others. Wash your hands frequently, especially after touching things like handrails or door handles.

    Practices like limiting large gatherings, working from home, and closing schools — often referred to as social distancing — might not seem as essential to a healthy person, but it’s an important step in limiting the spread of a person-to-person virus like COVID-19. NPR has a great Q&A related to social distancing you can check out here.

    How do I know if I'm in a vulnerable population? — Hilary

    You'll want to contact your health care provider for specific guidance but the Centers for Disease Control and Prevention says those with weakened immune systems and older adults -- ages 50 and older -- are at greater risk of becoming very sick from the virus.

    It's especially important for people who think they may fall into this group to take preventative actions and limit close contact with others -- especially if there is a reported outbreak in the area. Find their full guide here.

    Getting prepared


    Updated: March 19

    What supplies should people stock up on to mitigate coronavirus? — David

    Cheryl Petersen-Kroeber, director of preparedness and response with the Minnesota Department of Health, said people should make sure to have enough food, prescription drugs and cleaning supplies in their house in case they need to stay home for a couple of weeks. She also suggests checking out Ready.gov for tools people can use for emergency situations.

    Stocking up is important, not because there are currently fears of any supply shortages, but because if there is an outbreak you'll want to avoid crowded places, and if you are infected you'll need to stay home.

    Are insurance companies going to allow customers to stock up on prescriptions? — Mary

    This will largely depend on your insurance provider and the prescriptions you need. For daily medications, health officials suggest stocking up for several weeks, if you are currently unable to do this reach out to your insurance provider for approval and your doctor for guidance.

    As of March 13, HealthPartners said it is authorizing -- and covering -- early refills of prescriptions. Blue Cross Blue Shield of Minnesota is waiving early refill limits on 30-day prescription medications and encouraging members to order 90-day refills by mail. The company also says that members will not face additional charges for non-preferred medications. 


    Medica has not relaxed its policy for the early refill of prescriptions. But members may request early refills, through a process typically used when travel is involved. Medica says it may adjust its policy as the coronavirus situation evolves.

    Has the WHO banned use of ibuprofen due to Covid-19 — Elizabeth and Richard

    Health officials also suggest stocking up on nonprescription medicines like pain relievers, cold and flu medicine and stomach remedies which can be bought over the counter.

    There have been conflicting reports on whether ibuprofen can aggravate COVID-19. But most infectious disease experts say there's no good scientific evidence at this point to support that claim, reports NPR.


    What can I do to prepare for this? How much should I be freaking out? — Anna

    State health officials have stressed that while they are directing Minnesotans to prepare, there is no reason to panic. In fact, stress can dampen your immune system so remaining calm is key. As mentioned above, stocking up can help you feel more prepared if an outbreak does occur.

    It's also a good idea to talk to your employer about the possibility of working from home, if it is an option in your profession. Make plans with family and loved ones for in case someone gets sick or if school closures make child care an issue.

    Another important piece of being prepared is prevention, so make sure you're washing your hands, covering when you cough and staying home when you feel sick.

    What if someone in my house gets sick but I am not sick. Do I need to be quarantined until I am sure I haven't been infected? — Stefanie

    The CDC does suggest that if someone in your household is sick that you also stay home. If possible, use a separate bedroom and bathroom than the infected family member and avoid sharing food and drinks. Continue preventative measures like covering coughs and washing hands. Keep frequently touched surfaces clean using soap and water or a common household detergent.

    You can find more on how to care for someone with COVID-19 in the home here.

    Symptoms and spread

    Updated: March 16
    What are the symptoms? — Duane

    Mild cases of COVID-19 — and the majority of cases are mild — cause symptoms similar to a cold or flu. They include a fever, dry cough and shortness of breath with some patients also reporting a sore throat and headaches.

    But in about 20 percent of patients, infections can become more serious. It can attack the lungs, causing an immune system response that can destroy lung tissue and cause inflammation that can then trigger other problems.

    "The lack of oxygen leads to more inflammation, more problems in the body. Organs need oxygen to function, right? So when you don't have oxygen there, then your liver dies and your kidney dies," Dr. Carlos del Rio, a professor of medicine and global health at Emory University told NPR.

    For a look at how the symptoms differ between COVID-19, flu and colds, check out this guide.

    How long is the virus viable on inert surfaces, like books or handrails? — Kirsten
    What cleaning products do you recommend for best stopping the spread of the virus? — Linda

    A recent study found that the virus can live on surfaces for about two or three days -- with that time varying depending on the type of surface. But household cleaners and just some simple soap and water have been proven to wipe out COVID-19 on household objects and surfaces.

    When cleaning, focus on areas that get touched often, such as counters, faucets, handrails and door knobs.

    You can find the CDC's official cleaning recommendations here.

    If you’ve gotten the coronavirus, when are you no longer contagious? — Mike

    There is not an exact time frame for how long an infected person is contagious, however, according to the CDC it appears people are most contagious when they are experiencing the most symptoms and the National Foundation of Infectious Diseases reports that there has been evidence that people can spread COVID-19 before they start exhibiting symptoms.

    Decisions on how long someone should be quarantined or isolated are being made on a case-by-case basis. Here's the official statement from the CDC:


    "How long someone is actively sick can vary so the decision on when to release someone from isolation is made on a case-by-case basis in consultation with doctors, infection prevention and control experts, and public health officials and involves considering specifics of each situation including disease severity, illness signs and symptoms, and results of laboratory testing for that patient.

    Current CDC guidance for when it is OK to release someone from isolation is made on a case by case basis and includes meeting all of the following requirements:
    The patient is free from fever without the use of fever-reducing medications.
    The patient is no longer showing symptoms, including cough.
    The patient has tested negative on at least two consecutive respiratory specimens collected at least 24 hours apart."


    Keep in mind, "someone who has completed quarantine or has been released from isolation does not pose a risk of infection to other people," the CDC reports. " For COVID-19, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar coronaviruses.

    It is also very important to remember there is a difference between quarantine and isolation.

    Just because a person is in quarantine that does not mean they have COVID-19. Quarantine is used in reference to people who appear to be healthy but who may have been exposed to someone who is known to have COVID-19.

    Isolation is used for people who do have potential coronavirus symptoms and have decided to or have been told to stay home and away from the public.

    If a person had the disease and recovers, are they immune from the disease? — Tom

    While it's something health professionals are looking into, it is not yet clear if someone can be reinfected with the virus after recovering.

    If we get symptoms, what specifically should we do? Go to our doctor, or urgent care, or ER? Or call our doctor? — Ah-li

    If you are exhibiting symptoms, the CDC is advising you first call your doctor's office. This allows them to take precautions against it potentially spreading within the health care system. It also gives your health care professional time to cooperate with the state public health department and CDC to determine whether a test is required.

    Does the coronavirus affect animals/pets? — Barbara

    While different coronaviruses appear across many animal species, including cats and dogs, there is no evidence that this specific strain is transferable to or from your pets -- though they can test positive for it. Health officials do suggest washing your hands before and after being around your animals and, if you become sick, to include them in any quarantine plans.

    Travel safety

    Updated: March 19

    Is domestic flight travel still advisable for March? — Cheryl
    Is it safe to travel to California this summer? — Diane K.
    [I’m going on a trip to another country.] What precautions should I take? What are the risks? — Jeanne




    While there are not restrictions on domestic travel, yet, public health officials are encouraging people to social distance, which involves avoiding places that are potentially crowded as well as confined spaces -- airports and airplanes are often both.


    They also warn against traveling to areas where the virus is prevalent. Travel outside the country has been impacted, with some airlines canceling flights to areas experiencing high outbreaks and some universities suspending study-abroad programs


    President Trump announced travel restrictions for Iran and health officials are urging people not to travel to countries including China, Iran, South Korea and much of Europe. The U.S. government has banned travel from Europe, although the ban makes exceptions, including for U.S. citizens and legal permanent residents.


    The border to Canada has also been partially shut down to travelers.


    The Minnesota State Health Department's official advice for anyone traveling is:




    "Review travel recommendations posted on CDC: Coronavirus Disease 2019 Information for Travel if you are planning to travel, and keep an eye on the news for updates on this evolving situation."


    NPR’s “Life Kit” shared this advice:


    Check your health insurance to see if it includes international travel coverage, the CDC recommends. Also, consider travel health insurance and medical evacuation insurance. The CDC estimates that without insurance, a medical evacuation can cost $100,000 or more.


    If you've planned a cruise or overseas travel, consider the possibility of travel disruptions in the event of an outbreak. "Think about the consequences of being caught on ship or over a border when decisions are being made" that could limit or disrupt your travel without much warning, says Christopher Mores of The George Washington University. If you were quarantined, what would your backup plan be for your work and family responsibilities back home? This is something to consider.



    My husband is in Peru where there is a travel ban for two weeks. Does he need to quarantine himself when he comes home? — Marilyn

    Yes. The CDC recommends anyone traveling back from an area where COVID-19 was prevalent and widespread self-quarantine for 14 days and watch for symptoms.


    Where or how (not social media) can I get the most up to date info on where COVID has been positively identified? — Diane


    The Centers for Disease Control and Prevention have more information about highly impacted areas on their website as well as some tips for traveling safely. The page is updated frequently.

    Masks and prevention

    Updated: March 19

    "Will wearing a face mask prevent me from becoming infected?" — John
    "What mask is recommended and where does one acquire them?" — Linda
     

    Maria Godoy, a senior editor at NPR, wrote a very useful guide to the pros and cons of using face masks to prevent the spread of COVID-19.
     

    In it she notes that many health care professionals are using a mask called an N95 respirator. They are disposable and available for purchase to the public, but Godoy notes that they are also difficult to wear and there is no official recommendation for the public to use them.

    From the article:

    But wearing an N95 respirator is serious business, says Dr. William Schaffner of Vanderbilt University Medical Center. Health care workers who use these respirators are required by law to undergo an annual fit test — a check to make sure the mask forms a tight seal on the wearer's face so that contaminated air can't leak in. Although N95s are disposable, workers must also demonstrate that they know how to put on and wear the model that they are using.

    The much more common models — surgical masks — are more accessible and easier to put on, but there isn't a guaranteed benefit to using them.


    Godoy writes:


    "Surgical masks are just a physical barrier that will protect you against "a visible splash or spray of fluid or large droplets," explains Raina MacIntyre, an infectious disease researcher and professor of global biosecurity at the University of New South Wales in Sydney who has studied the efficacy of face masks. These masks fit loosely on the face around the edges, so they don't completely keep out germs, and small airborne particles can still get through.

    So, health officials are suggesting the use of masks only if you are sick or believe you may be sick.

    As the CDC reports: "The role of facemasks is for patient source control, to prevent contamination of the surrounding area when a person coughs or sneezes.  Patients with confirmed or suspected COVID-19 should wear a facemask until they are isolated in a hospital or at home. The patient does not need to wear a facemask while isolated.

    "Can a mask be reused, or wiped with antibiotic wipe, or use a fresh, new one each outing, or each day?" — P.R.H.


    The NPR article also touches on the potential problems with washing and reusing masks:



    MacIntyre notes that cloth masks — which people wash and reuse — are also common in Asian countries. She says there's no evidence to show they have any benefit, and her research suggests they "may actually be harmful," because infrequent washing and moisture retention can make cloth masks a breeding ground for pathogens.

    Read the full article for more information on the usefulness of masks and how to use them properly.
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