At this time two years ago, the novel coronavirus had already been detected in China, but was still months away from exploding in the United States and the rest of the world, months away from becoming an era-defining pandemic.
At this time one year ago, Minnesota was still recovering from its deadliest stretch of the pandemic, a brutal fall 2020 wave that killed dozens of people per day. We had also finally begun administering COVID-19 vaccines, which would transform but not, to date, end the disease’s spread.
Today, Minnesota is similarly recovering from a bad fall wave that filled the state’s hospitals and morgues. But it’s also facing an uncertain future, as other parts of the world are battered by surges of the new omicron variant.
Overall, several big things changed between 2020 and 2021:
Vaccines have been widely available for adults for most of 2021, while no one was fully vaccinated in 2020
The alpha, delta and omicron variants that circulated in 2021 were more contagious and in some cases more deadly than the original COVID-19 variant that hit in 2020
By 2021, hundreds of thousands of Minnesotans had at least some immunity from prior infections
This arms race between a more virulent virus and expanding population immunity made 2021 a somewhat different experience than the first year of the pandemic — the differences leap out from the COVID-19 statistics.
Here is a look at Minnesota’s 2021 in COVID-19, by the numbers.
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COVID in 2021 was almost as deadly as 2020
Comparing death rates is tricky because it often takes weeks for deaths to be formally reported. So we won’t have a final death count for 2021 until a month or more into 2022.
But looking at preliminary data showing deaths through the first 11 months of each year, we can see 2021 is only slightly behind 2020’s deadly pace.
December 2020 was the deadliest month of the pandemic for Minnesota so far, adding an additional 1,800 COVID-19 deaths for a total of 5,911. December 2021 is unlikely to match that — though numbers are still coming in, the death rate has been consistently lower than the year prior, and trending downward.
Based on trends so far, 2021 will likely total a bit under 5,000 COVID-19 deaths in Minnesota — lower than 2020, but still extremely high.
2021 saw fewer COVID deaths among the elderly, but more among younger people
While total COVID-19 deaths were comparable between the two years, there were significant changes between the two years in who died.
Coronavirus infection is most dangerous to the elderly or otherwise medically vulnerable. More than 80 percent of all recorded COVID-19 deaths to date in Minnesota have been people 65 years or older.
But between the years the age disparity has shrunk. In 2020, nearly 90 percent of all COVID-19 deaths were seniors. In 2021, it’s closer to 77 percent.
The incomplete data so far shows that COVID-19 deaths among seniors have fallen by 16 percent in 2021 compared to 2020. But the number of COVID-19 deaths among people under 65 has doubled, from 575 last year to at least 1,149 this year.
One big driver of this decline is a drop in deaths among residents of long-term care facilities. This vulnerable, predominantly elderly population, clustered together, was ravaged by COVID-19 in 2020, accounting for nearly 60 percent of all deaths despite Minnesota having fewer than 100,000 residents of long-term care facilities out of a population of 5.6 million.
That changed in 2021. Minnesota still recorded more than 1,500 COVID-19 deaths among long-term care residents, but that was a 50 percent drop from 2020.
Vaccines were largely effective
One of the biggest changes for 2021 was the spread of COVID-19 vaccines. After initial availability last December, vaccinations rolled out over the coming months, first to seniors and other priority populations, then in April to the general population.
By May about 50 percent of all Minnesotans had at least one shot, rising to over 70 percent by the end of the year.
Seniors — the most vulnerable sector of the population — were vaccinated in huge numbers early in the year. By April around 85 percent of seniors were vaccinated, which rose to more than 95 percent by the end of the year. In general, vaccination rates decline with each younger age group.
Minnesota got hit by a serious COVID-19 wave this fall despite close to two-thirds of the population being vaccinated at the time, so that level of vaccination isn’t enough to end the pandemic. But data released by the Minnesota Department of Health makes it clear that the vaccines are having a major effect.
The most obvious observed impact is the plunge in the death rate this year for Minnesota seniors — by far the most heavily vaccinated group.
But the impact of vaccines shows up across the spectrum.
For example, in the week beginning Nov. 21, 2021 — the most recent for which data is available — Minnesota recorded 9,120 COVID-19 cases among Minnesotans 12 or older who were fully vaccinated, and 11,272 among unvaccinated Minnesotans 12 or older.
That might look like vaccines were only mildly effective. But remember that nearly 75 percent of Minnesotans 12 or older are fully vaccinated. That means there were 9,120 cases among the nearly 3.5 million vaccinated Minnesotans, and 11,272 among the 1.3 million unvaccinated. Put differently, there were roughly 260 cases per 100,000 vaccinated Minnesotans vs. 860 cases per 100,000 unvaccinated Minnesotans — more than three times as prevalent.
The disparity is even larger when it comes to serious illness, more than 10 times more common among the unvaccinated. And these figures have held roughly steady for months. The exception: The arrival of the delta variant this summer coincided with a drop in the observed effectiveness of the vaccines against infection, even while their effectiveness against serious illness remained relatively constant.
How can this observed effectiveness of the vaccines be matched up against the fact that despite a majority of Minnesotans being vaccinated, COVID-19 continued to rage in 2021? That’s where the other big change from 2021 came in: the new, more dangerous variants.
In 2020, no one was fully vaccinated. So we can compare death rates per capita then against death rates among the unvaccinated now.
In late November 2020, during the deadly fall wave, Minnesota was averaging about one death per day per 100,000 unvaccinated people. In late November 2021, with the delta variant, Minnesota was averaging about three deaths per day per 100,000 unvaccinated people.
The death rate among vaccinated Minnesotans was about 0.22 deaths per day per 100,000 people.
Just in the unvaccinated populations, Minnesota’s COVID-19 death rate is three times as high as this time last year.
We’ve caught more cases, largely due to expanded testing
On a superficial level, Minnesota had far more COVID-19 cases in 2021: 490,419 this year against 320,548 last year.
But this isn’t an apples-to-apples comparison. For one thing, COVID-19 didn’t hit Minnesota in earnest until April; Minnesota recorded more than 100,000 cases in the first three months of 2021.
And the first few months of the pandemic were marked by extremely limited testing availability — meaning many infections went unconfirmed.
Controlling for testing volume, the numbers suggest COVID-19 infections were more serious in 2020 than 2021.
Overall, in 2020, about 7.4 percent of all of Minnesota’s COVID-19 tests were positive, compared to about 5.7 percent in 2021.
Hospitals were still slammed
Despite vaccines reducing the prevalence of serious illness among a significant share of the state, Minnesota hospitals were still nearly overwhelmed this fall when the delta wave sent thousands in need of inpatient care.
In fact, there were fewer available staffed hospital beds this fall than during the worst of the fall 2020 wave.
As with deaths, hospitalizations in 2021 were driven by the unvaccinated, who are about 10 times more likely to be hospitalized than fully vaccinated Minnesotans.
Hospital bed use was also constrained by other factors, including reduced availability of beds due to consolidation or staffing issues. There have been some suggestions that the delta variant is associated with longer hospital stays than earlier variants, meaning that an average admission is likely to tie up a scarce hospital bed for longer.