Nearly half of St. Louis County’s total cases of COVID-19 were reported in September, a figure driven mainly by long-term care facilities and traditional college-aged students.

In September, St. Louis County recorded 803 diagnoses of COVID-19. Of those, over 180 were found in the county’s long-term care facilities and more than 160 were linked to higher education institutions.

However, cases in higher education and long-term care facilities aren’t exclusive, as many college students work in long-term care facilities, said Amy Westbrook, St. Louis County’s public health division director.

Past monthly totals haven’t neared September’s total. August saw over 480 new cases, while June and July saw nearly 290 and over 60, respectively. And the three months leading up to summer months only saw double-digit numbers, according to specimen collection data from St. Louis County.

“September has been a really busy month,” Westbrook said.

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Approximately two-thirds of all St. Louis County residents recorded to have COVID-19 in September live in the Duluth area, which includes surrounding communities such as Hermantown and Proctor.

Although a majority of the cases are in the Duluth area, dozens of other communities have reported infections. When a virus is present in a community, it puts their organizations, like long-term care facilities, at risk of outbreak, said Andy Clade, of the Northeast Healthcare Preparedness Coalition.

Higher education

Increasing case counts in the 20- to 24-year-old population, which is mainly made up of college students, contributed to the month’s total cases, Westbrook said.

A majority of the higher education numbers, 108, can be linked to the University of Minnesota Duluth, which is by far the largest higher education institution in the county with a campus community of more than 12,000 students, faculty and staff.

The majority of those 108 cases at UMD are students who live off campus.

Since the Minnesota Department of Health does the contact tracing, UMD spokesperson Lynne Williams couldn’t speak to whether there had been any classroom exposure or how many of the cases have been in employees.

“We have had cases on campus, but tracking back exact exposure is difficult,” Williams said.

Overall, it's becoming harder to pinpoint where people were exposed to COVID-19, Westbrook said.

"It's harder now because we're seeing more community transmission," she said. "People can have more than one likely exposure."

As of Sept. 26, only 38 of all UMD students and employees who had tested positive for COVID-19 since Aug. 1 were believed to have been on campus while infected, according to UMD's COVID-19 dashboard. Public health officials determine each person's infectious-window period in interviews with those who tested positive.

Sixteen of those 38 live in university housing. As of Oct. 1, 33 students were utilizing campus quarantine and isolation rooms.

Lake Superior College has recorded 23 students and eight employees with COVID-19 between late August and Sept. 30, according to the Minnesota State Colleges and Universities dashboard.

Hibbing Community College has recorded three students with COVID-19 in September. None of the other Minnesota State colleges in St. Louis County are reporting COVID-19 cases.

Ray Jobe, public health educator with St. Louis County who now oversees the county's COVID-19 liaisons, said the uptick in cases among college-aged students isn't driven so much by the return to campuses themselves, but by what college students are doing off campus.

"It's maybe increased because we have so many students from around the state and country and then they congregate in one place," Jobe said. "They want to enjoy themselves or have fun, which they might not be doing if they're still at home."

The College of St. Scholastica has recorded 17 cases of COVID-19 in students and one case in an employee in September as of the 24th. Those cases include people who have been tested off campus.

St. Scholastica has a team of 15 people helping to support the Minnesota Department of Health’s contact tracing and so far none of the COVID-19 cases have been traced to classroom exposure, said Christine Sandal, the clinic manager for the college’s Student Health Service.

Instead, the most common source of exposure contact tracers have come up with is through living situations, mostly off campus, matching the countywide trend.

“In speaking with students, what they’re doing is no different than what I would do. I take off my mask and I live at home,” Sandal said. “However, their unit is a new family unit and so that’s what we’re up against.”

Christine Sandal
Christine Sandal

While some of the isolation rooms on campus have been utilized, Sandal said most diagnosed students are choosing to isolate back home or in their off-campus home.

Close-contact roommates of those who test positive still have to quarantine, said Julie Zaruba Fountaine, COVID-19 public health coordinator for the college. A quarantine and isolation coordinator with the college helps provide groceries, medications and mental health support to on- and off-campus students in quarantine and isolation.

"The things that work to keep our community safe are social distancing, are wearing the masks. If you feel like you have the symptoms related to COVID-19 — shortness of breath, loss of smell, a fever — stay home. Quarantine yourself. Keep your community members safe. It really does work."

None of the student cases at St. Scholastica have been linked to large off-campus gatherings. Overall, Zaruba Fountaine said the students she's talked with are aware of the importance of following safety protocols and want to keep their community safe.

At least seven of the diagnosed St. Scholastica students had presented asymptomatic, Zaruba Fountaine said. In those situations students have gotten tested when they realized they'd been in close contact with someone diagnosed.

Westbrook, the county's public health division director, expects high case counts among young people to continue.

“We know that there's risky behavior," she said, pointing to higher-than-average sexually transmitted infection rates in young adults as a similar example. "And I think that would extend to social distancing and wearing face coverings."

Long-term care facilities

As of Thursday, 10 long-term care facilities had active cases of COVID-19 in St. Louis County.

This can be partially attributed to a growing number of staff reporting infections. They're also likely tied to increasing cases in college students, as many of them work in these facilities, Westbrook said.

Even though a higher percentage of cases in the pandemic’s early months were located in long-term care facilities, the county is seeing more cases and related deaths in the facilities this month, she said.

Long-term care facilities hold a population that’s at the highest risk of serious consequences if infected with the virus. Seventeen of the 18 deaths recorded in September were residents of long-term care facilities, according to the county.

The Waterview Pines in Virginia is one of the county’s facilities grappling with coronavirus infections. It recently cleared all residents of the virus after locating the first case in a resident Aug 21. One staff member remains in at-home quarantine, said Marc Halpert, chief operating officer for Monarch Healthcare Management, the facility’s parent company.

In total, Waterview Pines saw seven staff and seven residents infected with the virus. Three residents, who were in hospice care prior to a coronavirus infection, died due to the virus. They were 99, 93 and 83 years old, Halpert said.

The facility is currently testing residents and staff with hopes they can reopen to family visits, he said.

“It's got to be tough to know that your mom or dad are in the facility and you can’t come in and visit them,” Halpert said.

Waterview Woods in Eveleth, under the same parent company as Waterview Pine, is another facility experiencing an outbreak.

As of early this week, 23 residents and 11 employees had tested positive after the first case affiliated with the facility was identified Sept. 5, Halpert said. Four residents, who were very vulnerable to begin with, have died after contracting the virus.

Asymptomatic cases — or someone who has the virus but no symptoms — have challenged these facilities. When an asymptomatic case is identified, it may have already spread to others in the facility, Westbrook said.

Benedictine Living Community of Duluth is one facility that struggled with asymptomatic cases.

In late June, nine cases were found at Benedictine. Seven of the cases were found in residents, and all but one of the residents were asymptomatic. This made it difficult for them to determine the source of the virus.

As of Tuesday, 28 residents and 20 employees tested positive for the virus at Benedictine. Three residents died due to the virus, according to a family update on the facility’s website.

There’s only one active case in a staff member who hasn’t worked since Sept. 25, but they “believe there is little risk of exposure to any of our residents or employees from this individual,” the statement said.