COVID update: Recent declines continue, modestly in some cases, as we head into fall

“We don’t really have a good understanding yet of what is ahead for us,” Michael Osterholm, infectious disease specialist at the University of Minnesota, recently said on the Center for Infectious Disease Research and Policy podcast. “And as hard as that is for people to hear, it’s the truth.”   

The recent downward trends we have seen over the last month mostly continued into this week, but in some cases, far more modestly compared to previous weeks. 

Although we have not seen a recent uptick in cases or deaths in Minnesota yet, it’s important to remember that around this time in 2021 and 2020 is when we started to see a substantial increase in COVID-19 cases and deaths. We have no idea whether this pattern will repeat, but the much cooler weather we’re experiencing with the advent of fall means that more gatherings will be moving indoors. And, as Osterholm also mentioned in the podcast, we may have to contend with the population’s waning immunity. 

With that in mind, this update ends with a closer look at vaccination rates in Minnesota. But first, let’s explore this week’s data, starting with three key takeaways:

  1. It now looks like September brought us a new, lower plateau in COVID-19 cases and hospitalizations.

  2. Wastewater data from around the state shows increasing levels of COVID-19 in North East and South Central treatment plants but falling levels elsewhere. The most recent data out of the Twin Cities shows a modest decrease compared to the prior week. 

  3. The CDC’s weekly “Community Level” ratings put zero counties in high risk; 71 counties are rated with low risk. 

Cases and hospitalizations at a new, lower September plateau 

The official count of COVID-19 cases reported by the Minnesota Department of Health are level once again this week after last week’s uptick. On average there were 914 cases reported per day for the week ending Sept. 22, compared to 910 the prior week and 846 the week before that. Looking at the graph’s green trend line, it appears as though the state may be developing a new lower plateau, dropping down from the averages of around 1,400 new cases identified per day June through August. 

Trend in COVI-19 cases in Minnesota Sept 30 2022
Officially reported COVID-19 cases per day
David H. Montgomery | MPR News

Last week we had reported that case rates had ticked up a bit in six of eight regions of the state. That concern is not continuing this week. Rates bumped back down in four regions, leveled off in three and increased noticeably only in Southwest—which was one of two regions that had not seen last week’s increase. 

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COVID-19 case rates by region in Minnesota Sept 30 2022
COVID-19 case rates have ticked down or leveled off in the last week in most areas of Minnesota.
David H. Montgomery | MPR News

The trend in new hospital admissions due to COVID-19 statewide is similar to the trend in case rates. Through Sept. 22 the state averaged 64 admissions per day (about 8 to intensive care units and 56 to non-ICU hospital beds), compared to slightly higher averages of 74 in August, 69 in July and 65 in June. 

Trend in COVID hospitalizations in Minnesota Sept 30 2022
Daily new non-intensive care unit hospitalizations have dropped recently.
David H. Montgomery | MPR News

It takes the Department of Health longer to identify and report COVID-19 deaths, so we only have solid numbers through Sept. 8. For those first 8 days of the month, Minnesota lost an average of 5 people per day to COVID-19, virtually identical to the daily death toll in the four prior months. 

Trend in COVID-19 deaths in Minnesota 9-30-2022
Over 13,000 Minnesotans have died due to COVID-19.
David H. Montgomery | MPR News

As of today, the state’s department of health is reporting that a total of 13,285 Minnesotans have lost their lives to COVID-19, including 2,423 so far in 2022. 

Wastewater: Modest decline in Twin Cities and recent increase in North East and South Central

The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows a continued decline in COVID-19 wastewater levels from that of last week, but a more a modest decline from that of the prior week: a 5 percent decline for the week ending September 25 compared to the prior week’s 29 percent decrease.  

COVID load in Twin Cities metro wastewater Sept 30 2022
The level of COVID-19 measured in Twin Cities-area wastewater has generally trended downward since early August.
David H. Montgomery | MPR News

BA.5 continues to be the dominant strain detected entering the Metro Plant, at 90 percent. The Metropolitan Council’s summary also notes, “We continue to see BA.2.75 at levels around 1% in Metro Plant influent.” This is good news so far and means that levels of the subvariant in Metro wastewater have remained steady and small since it was first detected several weeks ago.  

The latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, tracking data from seven regions through September 18, shows largely good news over the last month but more of a mixed picture for the one-week change. Monthly and weekly decreases were observed in all regions except North East and South Central plants. In both regions, there was a decrease in the viral RNA load over the last four weeks but an increase over the week ending on Sept. 18. 

Zero counties are considered high-risk this week, according to the CDC 

For the first time since early July, there are zero orange counties on the Centers for Disease Control and Prevention’s “Community Level” COVID-19 risk assessment map released yesterday; orange signifies high COVID-19 risk.  

To put this new lull in context, the CDC’s “Community Level” COVID-19 risk assessment identified 22 counties at high risk in their August 11 update. And the update at the end of August still placed 13 counties at high risk before starting to decline significantly in September.   

Additionally, the CDC’s latest weekly “Community Level” COVID-19 assessment identifies 71 counties at low risk, down slightly from 73 last week. The small decline in low-risk counties from last week is accompanied by a small increase in medium-risk counties, from 13 last week to 16 this week. But that number is less than one-third of the 51 medium-risk counties identified at the end of August. 

In spite of the good news from the “Community Level” map, fifty of the state’s counties have weekly COVID-19 case rates that exceed 100 per 100,000, which is the CDC’s threshold for high transmission. Five counties have rates at or above 200 cases per 100,000 for the week ending Sept. 28: Koochiching, Pine, Traverse, Kandiyohi and Fillmore. And Koochiching has a rate of 433 COVID-19 cases per 100,000 for the last week, which is significantly higher than its rate of 278 cases per 100,000 for the prior week 

Who is vaccinated in Minnesota? 

Sixty-eight percent of Minnesotans have received their initial vaccine series (one dose of Johnson & Johnson or two doses of Pfizer or Moderna for most). At last check Minnesota ranked 20th in overall vaccination.  

With the advent of the new bivalent COVID-19 vaccines targeting both the original and omicron strains, however, there is a bit of a reset in tracking vaccination rates. Only 4.3 percent of Minnesotans are now considered “up to date,” having received their bivalent booster, or having just completed their initial series or latest booster within the past two months. 

So which Minnesotans have the highest rates of COVID vaccination? In short, older, female, and Asian Minnesotans, and some of those living in the far northeastern, southeastern and metro parts of the state. 

Over 90 percent of Minnesotans age 65 or older have completed their initial series of vaccinations. No other age group comes close, but rates are higher among those age 50 to 64 (77%) than those age 18 to 49 (70%). Children became eligible later in the process and to date only 41 percent of 5 to 11 year olds in the state have completed their initial series.  

COVID vaccine rates by age in Minnesota Sept 30 2022
COVID-19 vaccination rates are highest among those age 65 or older.
David H. Montgomery | MPR News

Older Minnesotans also lead in terms of being up to date at just over 10 percent. The next most up-to-date age group is 5 to 11 year olds (8%); that group is not yet eligible for bivalent vaccines. 

In terms of gender, women have the lead over men in the state. According to the Department of Health, 71 percent of women have completed their initial series compared to 64 percent of men.  And nearly five percent of Minnesota women are up to date with their COVID vaccines, compared to only four percent of men. 

By race and ethnicity, Asian and Pacific Islander Minnesotans have a much higher rate of vaccination than any other group. White Minnesotans are next. In Minnesota less than 60 percent of Black, Hispanic and Indigenous Americans have completed the initial COVID-19 vaccination series. (It should be noted, however, that these groups are younger on average than white Minnesotans.) 

Cook County, the tip of Minnesota’s northeastern Arrowhead Region, is the county with the state’s highest COVID-19 vaccination rate, 84 percent. Olmsted County, home to the Mayo Clinic, follows closely at 81 percent. The only other counties with initial vaccination rates above 70 percent are all parts of the Twin Cities metro: Washington, Hennepin, Dakota, Carver, Ramsey and Scott counties.  

On the other end of the spectrum less than half of the residents in nine counties have completed their initial round of COVID-19 vaccination: Clearwater, Todd, Wadena, Pine, Kanabec, Mille Lacs, Morrison, Isanti and Meeker. 

“Up to date” vaccination rates follow a similar pattern, with Hennepin, Olmsted, Ramsey, Washington and Dakota counties currently leading, all with at least 5 percent. Less than one percent of the population is considered “up to date” in Roseau, Kittson, Lincoln and Mahnomen counties. 

For additional graphs and background information see the COVID-19 in Minnesota Key Data webpage maintained by APM Research Lab.