COVID-19 remains on high plateau in Minnesota

A group of people wearing masks talk to each other.
Nurse Andrew Dennis (left) works a shift Wednesday, Dec. 8, 2021 inside the intensive care unit at the St. Cloud Hospital.
Paul Middlestaedt for MPR News 2021

While some of you may have been excitedly waiting for Lizzo’s new album to drop today, we were nervously wondering whether omicron subvariant BA.2.75 would show up in today’s Metropolitan Council wastewater report.

It has not. Upon follow-up the Metropolitan Council indicated that “we are not yet monitoring for BA.2.75 in Metro Plant influent. We plan to start next week, however.” 

Why were we curious? Yesterday on MPR News, University of Minnesota epidemiologist Dr. Michael Osterholm noted “the variant of concern that we are looking at right now with regard to omicron is BA.2.75, first seen in India [and] now circulating in some parts of Asia. And it appears to have even increased immune evasion properties versus BA.5.”  

For now, highly-virulent omicron subvariant BA.5 continues to top the charts, making up 64 percent of the COVID-19 genetic material measured in metro wastewater. Still, other indicators remain mostly in the high plateau that we’ve been discussing over the past few weeks.

Reminder: This article includes only a few of the graphs we maintain on the COVID in Minnesota Key data page; which we are now typically updating on Thursdays and Fridays (hot tip: follow the APM Research Lab on Twitter to be the first to see when we’ve updated the page). 

COVID sits atop a high(ish) plateau

Just as in recent weeks, the levels of COVID-19 cases, hospitalizations and deaths persist without the major increasing or decreasing trends that we’ve typically seen in past waves. As this stagnant new phase of the pandemic drags on, we look at both where we are today and how it compares to the past couple of years. 

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On the one hand, a similar amount of people are dying every day from COVID in Minnesota as was the case around this time the past two years. But before feeling like we haven’t made any progress in fighting this virus, there are a few other factors to consider.  

In both of the last two years, deaths were at a relative low during mid-Summer. And, based on the reported case counts and hospitalizations, this was likely due to relatively low amounts of COVID circulating in communities at that time.  

Minnesota COVID-19 deaths by year
COVID deaths are up from their low point in early May, but much lower than previous waves.
David Montgomery

Although we don’t have great case data now, cases are still over double the rates we were seeing in 2020, and 10 times what we were seeing last year. And some epidemiologists think that real case counts could be 3-10 times the reported numbers. So, given the significantly higher number of people contracting the virus right now, it does seem that mortality is far less than in previous waves.  

Minnesota COVID-19 cases by year
Cases appear to be on a very slight decline, but official reports are under-counted due to prevalence of at-home testing.
David Montgomery

Hospitalizations point to another relatively good sign when comparing to historical waves. Looking at the percent of all hospitalizations that are admitted to intensive care, the ICU admissions have stayed at around 10 percent since early May. Although it did dip this low around this time last year as well, this longer stretch of lower ICU admissions is unprecedented so far during the pandemic.  

Share of hospital admissions that are to the ICU
ICU admissions as a share of overall hospital admissions are on a low plateau compared to previously in the pandemic.
Elisabeth Gawthrop | APM Research Lab

Nonetheless, unfortunately hospitalizations — and especially for the ICU — are back up this week after several weeks of declining.

Minnesota COVID-19 hospitalizations by year
Hospitalizations are higher than they have been at this point the last two years.
David Montgomery

Wastewater: Slight declines in COVID-19 loads across the state

Nowhere are the declines more slight than in the state’s single biggest wastewater treatment plant, serving some 1.8 million Minnesotans and routinely monitored by the Metropolitan Council and the University of Minnesota’s Genomic Center. Their latest result:

“The total viral RNA load in Metro Plant influent decreased by one percent last week compared to the previous week.”

COVID load in Twin Cities metro wastewater 7-15-22
COVID-19 levels measured in Twin Cities wastewater
David H. Montgomery | MPR News

It is worth noting that the amount of COVID measured in the Metro plant is not low. It is similar to earlier dates when hospitalizations and deaths were higher. This includes February when the initial omicron wave was finally receding and November 2021, in the middle of the delta wave’s ascendency.

The comparison is somewhat reassuring in that hospitalizations and deaths are now relatively low. But also cautionary in that today’s officially reported case levels may only be 1/3 or 1/4 of actual case levels, assuming that wastewater data are still as correlated to cases as they were in November and February, when case monitoring was more robust.

Wastewater monitoring in most other places in the state is also showing gradual- to significantly-decreasing COVID-19 levels. Most reassuring is that the reported decline in the North West is even larger this week after some revised numbers were issued by the University’s Wastewater SARS-CoV2 Surveillance Study. Also great to see negative numbers in South West and South Central regions, since COVID appeared to be making gains there in last week’s report.

CDC says ‘high’ again to three counties. (Or is it 68?)

The CDC’s “Community Level” risk rating map is not nearly as verdant this week as it was last week. Three counties — Renville, Wabash and most-commonly-orange Olmsted — are again assigned the orange high risk rating based on a combination of COVID-19 case levels and local hospitalization rates. The CDC recommends that people in these counties mask up. 

Twenty-two other counties, including Hennepin, which is home to one-in-five Minnesotans, are colored cautionary yellow. 

The CDC’s other risk rating, based on COVID-19 case rates, again looks much different. This metric raises a reddish flag of “substantial transmission” when weekly case rates exceed 50 per 100,000, and an even more red warning of “high transmission” when cases exceed 100. All but two counties are in trouble: Norman and Murray counties. Most, 68, meet the high transmission threshold, led by Koochiching, Renville, and Stevens counties, all with 300+ officially reported cases per 100,000 in the week prior.