Minneapolis Star Tribune, May 8
Minnesotans need to understand and act on COVID-19 risks
Common health conditions appear to increase likelihood for severe illness.
The near-daily COVID-19 briefings by Minnesota health officials provide a deluge of data points about this viral disease and its spread across the state. But few figures have stood out as sharply as this one:
Of all those who have died from the mysterious viral illness statewide, 99.24% had an underlying health condition.
When there’s no proven treatment for COVID-19 and no vaccine, it’s tempting to succumb to the potentially false reassurance offered by both this eye-grabbing statistic and the vagueness of the “underlying condition” category. Without further scrutiny, it may seem that only those who are elderly or acutely ill are vulnerable.
The reality: Many of those who lead normal lives despite having common, treatable chronic conditions - high blood pressure is a prominent example - appear to be at higher risk for becoming seriously ill or dying after becoming infected with this new strain of coronavirus. As mitigation measures begin to ease, it’s critically important to understand individual susceptibilities. Your risk, or that of a loved one, may be higher than previously realized.
The state has a useful dashboard of COVID-19 information. But it doesn’t list underlying health conditions for those who have become severely ill or passed away - an information gap that should be filled.
The New York State Department of Health does track some of this information for that hard-hit state. Of the 20,828 fatalities listed on Friday, 89.4% had at least one underlying health condition, also known as a “co-morbidity.” Hypertension (high blood pressure) is by far the most common. Rounding out the top five are diabetes, hyperlipidemia (high cholesterol), dementia and coronary artery disease.
A recent study published in the medical journal JAMA raised concerns about other common health conditions. The study analyzed the underlying health conditions in 5,700 patients, with a median age of 63, who were hospitalized in the New York City area between March 1 and April 4 with COVID-19. It included patients who survived, a key difference from the state fatalities-only figures.
The most common co-morbidities were hypertension (56.6%), obesity (41.7%) and diabetes (33.8%). Being older and being male were also common characteristics, researchers found, noting the “pattern” here is similar to data reported in China.
Hypertension’s prevalence in both sets of New York data is worth noting. This is a common condition, affecting an estimated 29% of the general population, according to the U.S. Centers for Disease Control and Prevention. The percentage climbs steadily with age. The condition is also more prevalent among blacks.
So what is it about hypertension that may increase the risk of severe COVID-19 illness? And is the risk less if the condition is controlled with medication? “The short answer is we don’t know,’’ said Dr. Bradley Benson, the University of Minnesota Medical School’s chief academic officer.
There are several theories involving vascular abnormalities or inflammation. While researchers scrutinize this, Benson is telling patients with hypertension to continue taking their medication and “not to hit the panic button.”
“Most people with hypertension do just fine. But you do need to understand that if you get COVID … you do have a higher risk of a bad outcome. This is real.”
Data-driven tools under development may soon help doctors more precisely calculate individuals’ risk of a poor outcome after contracting COVID-19. Until then, Benson advises that patients with hypertension or other common conditions err on the side of caution, for example by continuing social distancing even as state-ordered precautions phase out.
Just because you can let down your guard against COVID doesn’t mean you should.
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The Free Press of Mankato, May 7
State budget: Prudence needed in face of deficit
Why it matters: An updated budget forecast now shows Minnesota running a deficit of almost $2.5 billion by July 2021.
Four billion dollars.
That’s the size of the hole the COVID-19 pandemic, and the economic chaos it has wrought, has ripped into Minnesota’s state budget.
When the Legislature convened for what was expected to be a routine, low-pressure 2020 session, Minnesota had a comfortable surplus and a fat rainy-day reserve. Tuesday’s updated budget projection turns all that around.
It could be worse. Minnesotans should be pleased former Gov. Mark Dayton resisted calls to lessen that reserve fund during his second term. His fiscal prudence puts Minnesota in an enviable position relative to other states in the teeth of this recession.
But the reserve fund itself is not quite enough to make up for the projected deficit, and even if it were, it would not be wise to spend the whole fund. The pandemic is far from over - indeed, we are seeing hospitalizations and deaths increase - and even as Gov. Tim Walz takes tentative steps toward reopening the economy, the state will need financial flexibility to deal with issues as they emerge.
There has been talk in Washington of federal aid to states and cities to help buffer the expense of combating the virus; if Americans have learned anything from this outbreak, it is that states and localities cannot count on this administration to take an active hand in helping them. Federal support would be welcome, but Walz and the Legislature should not bank on it until it happens.
There appears to be little legislative interest in tax increases, certainly not from the Republican side. That leaves undetermined spending cuts in other areas.
The 2020 legislative session is winding down, and the budget problems are not likely to be fully dealt with in the remaining time. Sen. Nick Frentz of North Mankato, a member of the DFL leadership in that chamber, predicts monthly special sessions the rest of the year. The governor and lawmakers have a lot to do. Prudence and cooperation will be required.
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St. Cloud Times, May 8
Hey governor, key legislators, don’t feud over money tied to pandemic
Even a pandemic might not be able to overcome politics, especially politics involving money.
With that in mind, Minnesotans need to pay renewed attention to the state Capitol as legislators and Gov. Tim Walz head toward May 18 - the end of the 2020 regular session.
Political battles between the DFL governor, DFL House and Republican Senate are evolving over the governor’s COVID-19 emergency powers declaration, a potential bonding bill and scheduled pay raises for close to 50,000 state workers.
The common thread? Your money.
In mid-March, the governor declared a 30-day peacetime emergency for COVID-19 with the approval of the Executive Council - the state’s top-ranking elected officials, including the lieutenant governor, secretary of state, state auditor and attorney general.
With that declaration came great freedom and control for Walz over how to spend the public’s money to battle the novel coronavirus - including close to $3 billion in related federal aid.
The governor extended his emergency powers in mid-April, again with the approval of the Executive Council, and they are now set to expire Wednesday. Twin Cities media reports indicate Walz is likely to extend them again, which would continue his legal control over spending all pandemic aid.
That troubles Republicans in the House. Rep. Kurt Daudt, the Republican minority leader, declared May 2 his caucus would not act on a bonding bill, citing the desire to have Walz give up his emergency powers and let the Legislature be involved in more pandemic policy decisions.
That’s key because a bonding bill requires a three-fifths majority vote, which means it cannot clear the House without some Republican support.
Of course, it also must be noted that Daudt wasn’t exactly forthright in defending his position. In a WCCO radio interview May 4, he stridently claimed this was about only the emergency powers and he has fully supported Walz’s decisions, including the stay-at-home mandate.
He must have forgotten the statement he released just three days earlier, which was highly critical of extending the stay-home order on the grounds it was unfair to small business.
Regardless, the House Republicans’ position on a bonding bill - often a key campaign tool for incumbent legislators in both parties - is just one political chip in the mix as the session winds down.
Another, as Daudt has noted, is Walz’s emergency powers declaration. The governor certainly is not shy about using the powers, having invoked them close to 50 times through executive orders. And all signs point to Walz renewing them beyond Wednesday.
Ending them can be accomplished by House and Senate majority votes. That could happen in the Republican Senate. Not so much in the DFL-majority House.
Really, though, the apolitical question is whether Minnesota is past an emergency status for addressing the pandemic. More than 40 other states’ governors took actions similar to Walz’s - and while some are being challenged in court, none appear to have declared the emergency over. Meanwhile, Minnesota’s hospitalization and deaths curves keep rising.
Finally, a report Tuesday from MinnPost highlighted a third key issue looming in St. Paul - contracts with about 47,000 state workers the governor negotiated last year but that need legislative approval by July 1. As MinnPost reported, the deal gave workers a 2.25% pay raise last year and calls for another 2.5% raise in July.
If the Legislature does not OK the plan or takes no action, there is no July 1 raise and the state could claw back the 2.25% raise from this year.
Republican Senate Majority Paul Gazelka, who does support a bonding bill, said he wants the state to revisit and renegotiate the contracts, especially given the state’s dire fiscal shift to a projected $2.4 billion deficit. (Not to mention giving 47,000 state workers a raise when a half-million Minnesotans are unemployed.)
So there you have it: With about a week left in the regular 2020 legislative session, three of the state’s most powerful politicians each hold levers that need to be pulled and pushed to craft a legislative deal that protects and benefits their constituents.
To achieve that:
- Walz should extend his emergency powers while agreeing to proposals that call for the Legislature to have some say in distributing portions of new pandemic aid. He also should agree to renegotiate the pending raise for state workers.
- Gazelka should back the governor’s emergency powers status and request a bonding bill in exchange for Walz revisiting the worker contracts.
- Daudt should provide enough Republican votes to pass a bonding bill in exchange for Walz ceding some control of any new pandemic aid to a bipartisan group of legislators.
Minnesotans need to focus their energies on surviving this pandemic - everything from personal health to economic recovery. They shouldn’t have to be distracted by a largely political fight over who gets to spend the public’s money. Save that for the next time we’re not in a pandemic.
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