COVID's September plateau continues into October

A pharmacist gets ready to give a COVID-19 booster.
Safeway pharmacist Shahrzad Khoobyari (left) prepares to give a Pfizer COVID-19 booster vaccination to Chen Knifsend (right) at a vaccination booster shot clinic on Oct. 1 in San Rafael, Calif.
Justin Sullivan | Getty Images 2021

Last week we reported that Minnesota has averaged five COVID-19-related deaths every day since May. For the most recent complete week of data, ending Sept. 15, that average ticked up to just over six deaths per day. Low relative to other points in the pandemic, but still far too many.

In light of COVID’s continued death toll, today’s morning missive from the New York Times, entitled “The underuse of COVID treatments is leading to many needless deaths” caught our attention. In it, David Leonhard cites several experts and studies indicating that Paxlovid, in particular, is both a wildly successful and a widely under-used COVID treatment.

For example, Epic Research’s analysis of 568,000 patients found that the death rate for COVID patients who did not get the drug was more than four time higher than those who did—and that “only about 25 percent of patients eligible to receive Paxlovid actually did, even though the drug is widely available and free for patients.”

If you or a loved one has COVID and you are interested in pursuing Paxlovid treatment you may wish to consult guidance from the U.S. Centers for Disease Control and Prevention. Baseline requirements are that the patient must be at least 12 and that treatment should start within the first five days of symptoms. The CDC encourages people to either consult their healthcare provider or visit a Test to Treat location."

Of course, experts also recommend staying up-to-date on COVID boosters — and the latest Department of Health Data show that only 6.1 percent of Minnesotans are currently up-to-date(many of us have yet to receive the bivalent booster). And regular in-home testing can help identify early or even asymptomatic cases so that we can take steps to avoid passing COVID to others. Minnesotans can still access up to 12 rapid at-home COVID-19 tests for free.

You may want to look into vaccines or testing more often especially if you are in the northern portion of the state, where cases and wastewater data indicate a small increasing trend in COVID in recent weeks. Read on for specifics, as well as information on which counties CDC is currently recommending masking indoors.

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Cases and hospitalizations mostly hold steady or decline from last week

Officially reported COVID-19 cases in Minnesota have for the most part plateaued for the last several weeks, but at lower rates than the plateau we saw earlier this summer. In August, case rates in Minnesota regions were between 150 and 200 weekly cases per 100,000 residents. Now, case rates are in the 100 to 150 range, and in most regions closer to the 100 mark. Northern Minnesota rates point to some cause for concern, with rates that have recently increased and are higher than other regions.

weekly covid-19 cases by region of minnesota
Cases are mostly holding steady, with some increase in northern Minnesota.
David Montgomery

Hospitalizations provide a somewhat more reliable metric when comparing to past years. At this point in 2020 and 2021, hospitalizations were increasing quickly. But so far this fall, hospitalizations continue to decline.  

ICU and non-ICU hospitalizations
Hospitalizations are down since August.
David Montgomery

Deaths also appear to be on the decline compared to August, although this data takes longer to come in.

Minnesota covid-19 deaths since the start of the pandemic
Deaths appear to be on the decline in recent weeks.
David Montgomery

Wastewater: COVID levels dropping or flat in most parts of Minnesota, but not the northeast

The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows virtually unchanged COVID levels as measured in samples from the Metro wastewater treatment plant for the week ending Oct. 3. Their weekly summary adds “the total load has decreased by 43 percent since June 21, but there has been no significant trend, up or down, for the past three weeks.”

COVID load in Twin Cities metro wastewater 10-7-2022
COVID levels measured in samples from the Metropolitan Wastewater Treatment Plant, which serves approximately 1.8 million Minnesotans, have been flat recently.
David H. Montgomery | MPR News

In addition to recent stability in overall COVID-19 levels measured by this project, the composition of the variants is also unchanged: “BA.5 constituted 90 percent of the viral RNA entering Metro, and BA.4 and BA.2.75 represented six percent and two percent, respectively, of the total viral RNA load.”

Similarly, via e-mail, the Minnesota Department of Health reports that since late August, nine percent of the COVID cases they have sequenced are BA.4 and only one percent are traceable to BA.2 sublineages (including only 11 cases of BA.2.75 and five total cases of BA.2.75.2). This is good news in that BA.2.75’s close relative, BA.2.75.2, may be able to evade vaccine immunity and may not respond to antiviral treatments.

The latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, tracking data from seven regions, once again shows largely good news. As of Sept. 25, COVID levels were dropping in most places, most notably in the study’s northwest and southwest regions where levels dropped significantly over both the past month and the past week.

Measured levels of COVID-19 are rising in the study’s sampling from the six North East wastewater plants, located in Crow Wing, Koochiching, Pine and St. Louis counties. This is consistent with increasing cases in northeastern Minnesota as shown in the first graph.

CDC: COVID-19 “Community Level” is high in five counties, medium in 19

Residents of Brown, Chippewa, Clearwater, Koochiching, Lac qui Parle and Brown counties should mask up when in public indoor settings according to guidance associated with the CDC’s latest “Community Level” ratings. Those ratings place an additional 19 counties, the largest of which is St. Louis County, on a medium-level watch list.

Most of the state’s major population centers — including the Twin Cities, St. Cloud and Rochester — are again low-risk according to the CDC’s community level ratings this week.

Despite the relatively green “Community Level” map, the CDC also notes that 47 of Minnesota’s 87 counties meet or exceed their threshold for high COVID-19 transmission of at least 100 cases per 100,000 over the last week. This includes five Minnesota counties that exceeded a weekly rate of 250 per 100,000: Chippewa, Red Lake, Aitkin and Koochiching.