As Minnesotans wait to hear whether a statewide stay at home will extend beyond May 4th, many have been watching and listening to daily coronavirus briefings led by Minnesota Department of Health Commissioner Jan Malcolm.
Malcolm has helped advise Governor Tim Walz on the public health impact of his executive orders, and this week she sat down with KARE11 reporter Kent Erdahl to explain how she is approaching the decision, the push for expanded testing and how Minnesotans should think about the months ahead.
Kent Erdahl: "Every day you make yourself available, you answer a lot of questions on a variety of topics. I want to know though, what keeps you up at night as you look at this?"
Jan Malcolm: "I have to confess there are a few nights like that. I think it's how much we still don't know. Testing is a great example of that. We all feel that more testing is really critical to understanding how far the disease really has spread in our community and where we should be focusing next. But there is so many unanswered questions about when, in the course of an illness, tests are most valid. I just think we've got a lot to learn in terms of where tests are helpful and, frankly, where they're not."
Erdahl: "When you spoke last week on this, you had said, it should be a matter of just a day or two before someone can go into their doctor and get a test lined up. Is it that easy right now?"
Malcolm: "We're not there. We're not to the point where anyone can get to a test the same day. We do know that the testing stations around the state are in a good place. Well over 90 percent of the population is within an hour of a testing site that already exists, so I'm pretty confident we'll be in the range of 5,000 (tests) a day during next week."
Erdahl: "What's the major obstacle to getting there right now?"
Malcolm: "Believe it or not, one of the biggest issues right now is the nasopharyngeal swabs. Certain testing platforms need, literally, different sizes and shapes of swabs. So figuring out how to procure the right volumes of the right type of swab has been what's occupying, more time than you would imagine."
Erdahl: "If it were up to you, how willing would you be to start rolling back the stay at home order?”
Malcolm: Well, you know, I absolutely understand the tradeoffs and the difficulty of the decisions, but it presents such an unusual risk. Even if we didn't have business closures or stay at home orders in place, if we've got this widespread illness in the population and huge parts of workforces unable to work because they're sick, that's a threat to the economy as well. As more workplaces return to operation, they need to do so in new ways. With social distancing and with engineering controls to minimize that face to face, close, prolonged contact.
Erdahl: "Regardless of what happens in the next week, what would you tell Minnesotans about how they should think about the next year?"
Malcolm: "We're all going to have to keep in mind that we, still, are in a sort of stay at home strategy no matter what. Unfortunately, some of the things we enjoy the most are going to be the hardest things to get back to."
Erdahl: "It's sounding like you would be surprised if there is a State Fair."
Malcolm: "Well, I would. I know that that is such a tough decision, but it's frankly hard to imagine, from where we are today, that things would have changed that dramatically within these last few months, to make that safe to do. We know the virus is still out there. We know not a large enough part of the population is going to have been exposed to the virus by then, to make such a large gathering safe. That's really painful, but we're going to have to just keep some of these behaviors with us for a long time."
Her Public Health History:
Though many Minnesotans might not have known her name until about a month ago, Malcolm is a Minnesotan with a long track record in public health.
In the 1970s Malcolm attended Minnetonka High School, then moved on to Dartmouth where she pursued a health policy career. She graduated with degrees in psychology and philosophy.
For several years she worked for HMOs and as an adjunct faculty member of the U of M's School of Public Health.
She made the jump to public service in 1999, after a certain pro-wrestler became governor of Minnesota.
"A friend literally said to me, if you're so worried about what he's going to do why don't you try to help him?" Malcolm recalled in an interview.
Malcolm submitted her application for Minnesota Health Commissioner, and held the job under Governor Ventura.
"I have no idea why he chose me but to my great delight he did because it was absolutely the experience of a lifetime," Malcolm said.
After her first stint as commissioner, she served as CEO of the Courage Center, a non-profit rehabilitation center for people with disabilities. When it later merged with the Sister Kenny Rehab Institute she became President of the Courage Kenny Foundation.
In 2018, she got the call back to public health. Governor Mark Dayton asked her to take the helm of a troubled Health Department, which was awash in complaints about elder abuse in long term care facilities and facing an opiod epidemic.
Malcolm agreed to rejoin MDH and when Governor Walz took office in 2019 she stayed at her post. She is now by his side every day at 2 p.m. to help explain how the pandemic is impacting the state and how public health is working to address it.
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The state of Minnesota has set up a hotline for general questions about coronavirus at 651-201-3920 or 1-800-657-3903, available 7 a.m. to 7 p.m.
There is also a data portal online at mn.gov/covid19.