No sign of fall surge yet in Minnesota, but rising subvariants of global concern

An eight month old, baby sits
Griffin Becher, 8-month-old sits on the lap of her mother, Stephanie Becher, and gets a sticker to receive after receiving her first dose of the Pfizer Covid-19 vaccination the first dose of the Pfizer Covid-19 vaccination at the Mall of America vaccination on June 22 in Minneapolis.
Kerem Yücel | MPR News

COVID-19 cases and hospitalizations are trending down in Minnesota, over 14 percent of the state’s children from 6 months to 4 years old have at least one dose of the COVID-19 vaccine and the Centers for Disease Control and Prevention’s “Community Level” map rates none of the state’s counties as high risk.  

But, as always, the situation is more complex. The latest wastewater data shows varying increases throughout much of the state, and the Twin Cities Metro Plant has also seen a modest increase. Although we saw an uptick in wastewater levels this time last year during the delta wave, hospitalizations were already rising. Especially given the other data in this week’s update — hospitalizations have been trending down — the increase in wastewater levels isn’t a sure sign of a surge.

There is yet no definitive assessment of COVID-19’s seasonality, but there is reason for caution given simply the increase in indoor activities this time of year and the corresponding inherent risk. So for now, we have to wait and see. 

Globally, experts are watching the XBB subvariant — a recombinant of the omicron subvariants BA.2.10.1 and BA.2.75 that is immune evasive — which is now in 26 countries according to the World Health Organization and is particularly driving cases in India and Singapore.

Public health officials are also tracking BQ.1 and BQ.1.1, omicron subvariants that appear to be gaining steam in the U.S. There is a growing belief that unlike previous years where one dominant strain drove cases, we will see a large number of variants in circulation that could prompt future surges, a situation that the WHO noted is already happening.  

For now, though, we still have yet to see a fall surge here in Minnesota. Read on for details on this week’s data, plus a look at the most recent update of the APM Research Lab’s Color of Coronavirus project, tracking COVID-19 mortality data by race and ethnicity.

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No sign of fall surge in official cases, hospitalizations or deaths 

Cases continue to decline across the state, according to official reports.  

weekly covid-19 cases in Minnesota regions
Official case counts are trending down in all regions of Minnesota.
David Montgomery

The seven-day daily average of new COVID hospitalizations ending Oct. 13 was 54, the lowest it’s been since early May. This is particularly good news in light of how hospitalizations were trending at this time the last couple of years.  

new icu and non-icu hospitalizations in MN
Hospitalizations are at their lowest point since early May.
David Montgomery

Deaths have gone up somewhat after a relative low point in mid-September, but don’t appear to be on the way to the levels seen at times in July and August. If hospitalizations continue to decline, there is hope that deaths will as well. 

Minnesota COVID-19 deaths by year
Deaths remain close to the average level they have been since mid-May 2022.
David Montgomery

Wastewater showing recent increases in Twin Cities and the state’s northwest and southwest regions 

The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows a 14 percent increase in COVID-19 levels entering the Metro Plant compared to last week. The Metropolitan Council notes with this week’s update that there has been a one percent increase over the past four weeks, up from last week’s 11 percent decrease, but a 40 percent decrease since the end of June.  

COVID load in Twin Cities metro wastewater, by year
A recent modest uptick in the COVID-19 load measured in the Metro Plant wastewater is happening around the same time levels started to increase in 2021. But it is far too soon to say if we will see a similar fall surge.
David Montgomery

The Metropolitan Council’s summary this week also notes that the omicron variant continues to be dominant, and no new strains have arisen: “BA.5 constituted 91 percent of the viral RNA entering Metro, and BA.4 and BA.2 represented six percent and one percent, respectively, of the total viral RNA load.” Compared to last week, the prominence of BA.5 has increased slightly to where it was a few weeks ago, and the presence of the other strains has slightly decreased.  

The latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, tracking data from seven regions through Oct. 9, shows mixed results over the last month, ranging from a 56 percent decrease in COVID-19 levels in the southwest to a 43 percent increase in the southeast.

Data for the week ending on Oct. 9, however, shows mostly increases in COVID-19 levels throughout the state, except in the northwest and southeast, which register declines. The largest increases were seen in the northwest, 69 percent, and the southwest, 27 percent.   

CDC: COVID-19 “Community Level” map shows a lot of green space this week 

According to the CDC’s latest “Community Level” ratings Minnesota is looking very green. The CDC rated no counties in the state “high risk” this week. Those ratings place only 11 counties at medium-level risk — the lowest number since mid-July, at least.

Kittson County in the northwest corner of the state is one of those counties rated medium risk, while the others are largely in southern Minnesota. The 76 remaining counties are all rated low risk, including those containing the state’s major metro areas: the Twin Cities, St. Cloud and Rochester.  

While these numbers are good news, it’s difficult to tell if this trend will continue next week. We saw a similar map in our Sept. 30 update — no high-risk counties, 16 medium-risk counties and 71 low-risk counties. The next week, however, five counties were rated high risk.  

Although there are no high-risk counties on the “Community Level” map, the CDC also notes that 25 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.

The good news is this is significantly lower than the 35 counties above that threshold last week, and it continues the downward trend of that number from a high point of 83 counties in mid-August. Only three counties this week exceeded a weekly case rate of 200 per 100,000: Big Stone, Lac qui Parle and Kittson.   

Indigenous Minnesotans saw highest COVID mortality rate during April - June period

In recent months, white Americans have had the highest crude COVID mortality rate in the U.S., closely followed by Indigenous Americans but well ahead of other racial and ethnic groups. This week’s update to the APM Research Lab’s ongoing Color of Coronavirus analysis looks at the latest available numbers state-by-state. 

For the second quarter of 2022, white Americans had the highest crude mortality rate in 33 states. When incorporating all COVID deaths throughout the pandemic, that number drops to fifteen. And when age-adjusting the cumulative death rate, it drops even further to four.

Minnesota is one of ten states for which Indigenous residents had the highest crude mortality rate during the second quarter of 2022. Indigenous residents also had the highest crude and age-adjusted mortality rates in Minnesota when including all deaths from the pandemic thus far. 

The Washington Post published a story this week on this topic, highlighting in particular the difference between the pandemic’s impact on white and Black Americans. While it doesn’t focus as much on other groups, it does include several narratives that speak to the complexity and nuance of the data we’ve seen in our own analysis.