Flu shot uptake low in Minnesota; COVID levels up in Twin Cities region

Prevalence of BQ.1 variant is on the rise

A man fills a test tube with a sample of water.
The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows a 24 percent increase in viral load entering the Twin Cities Metro Plant for the week ending Nov. 28.
Courtesy of Metropolitan Council

The COVID-19 situation this week remains relatively unchanged from what we have seen over the last month. Some of this week’s COVID-19 data, including case rates and general hospital admissions, is relatively positive, insofar as trends remain steady. Other data, including metro wastewater and intensive care unit admissions, gives us pause and may mean those who are more vulnerable should take extra precautions.  

Influenza and RSV also continue to strain the health care system, but the latest data from Minnesota shows a decline in the last week of both flu and RSV hospitalizations. Hospitalized RSV cases went from over 190 to about 150, while flu hospitalizations went from 275 to 241.

Earlier this week, MPR News host Cathy Wurzer spoke to Dr. Sameer Gupta, a pediatric critical care physician at M Health Fairview Masonic Children's Hospital, about the latest respiratory concerns. You can read or listen to their conversation here.

APM Research Lab asked the Minnesota Department of Health for the preliminary number of Minnesotans that have received their flu vaccine this fall. In an email response, the Minnesota Department of Health reported that “comparing doses administered through October, about 13 percent fewer people are vaccinated with flu vaccine this year compared to the 2021-22 season and 30 percent fewer than the 2020-21 flu season.”

Before the COVID-19 pandemic, influenza vaccine uptake rates in Minnesota were around 50 percent of the population, higher among young children and older adults. “Those old rates were not what we could consider good or ideal by any means,” explained Garry Bowman from the Minnesota Department of Health. “But we need to be working to see those rates again and improve on them. People seem to have somewhat forgotten about flu in the midst of the pandemic, but it’s time to prioritize your flu shot again. You can safely get a flu shot at the same time that you get a COVID shot or booster.”

Cases remain flat, and hospitalizations and deaths are well below previous years at this time

This week’s case data shows little change in known COVID-19 infections over the last couple of weeks throughout Minnesota. All areas of the state are also at or below the rates reported six weeks ago.

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weekly covid cases in minnesota regions
Cases have remained relatively flat across the state.
David Montgomery

Intensive care unit (ICU) hospitalizations went up this week, to the highest point since the latter part of last winter’s omicron surge. Nonetheless, they still remain well below the ICU admissions seen at this time in 2020 and 2021. In better news, non-ICU hospital admissions took a dip down and remain in the ballpark of where they’ve been this fall, which is lower than they were this summer.

 new ICU and non-ICU covid hospitalizations in MN
ICU COVID hospitalizations went up since last week, while non-ICU COVID hospitalizations went down.
David Montgomery
yearly comparison of covid hospitalizations
Despite the increase in ICU COVID hospitalizations, both ICU and non-ICU hospitalizations remain well below previous years of the pandemic.
David Montgomery

COVID-related deaths have unfortunately remained elevated since the end of October, especially in comparison to the relative low point in deaths last April. But again, compared to the last couple of years, deaths are much lower.

minnesota covid-19 deaths by year
Deaths have been somewhat more elevated in recent weeks, though still far below this time last year or in 2020.
David Montgomery

Wastewater: substantial increase in COVID wastewater levels according to latest Metro data

The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows a 24 percent increase in viral load entering the Twin Cities Metro Plant for the week ending Nov. 28 as compared with the previous week, and the viral load is 54 percent higher than it was two weeks prior. According to the Metropolitan Council, “the weekly average load is the highest it has been since the week of July 5-11.”

Covid load in twin cities metro wastewater
COVID-19 load in wastewater has increased for a couple of weeks in a row.
David Montgomery

Does this increase mean we’re in for a surge? The pandemic continues to surprise, so we can’t predict the weeks and months ahead. But, we did plot recent case rate data and wastewater data for Twin Cities Metro to see how the two have compared in the recent past.

covid wastewater and case rates in twin cities metro
COVID-19 wastewater load and case rates have followed similar trends since early May.
Elisabeth Gawthrop | APM Research Lab

Several peaks in wastewater have been followed by a relative peak in cases, suggesting that wastewater could indicate earlier than case rates that COVID is indeed on the rise. But, that doesn’t mean it will be a significant or lasting increase in cases. In September, wastewater levels jumped up, and case rates followed a week later with a more modest rise before falling back down again. This week’s wastewater increase, however, is larger and follows an increase in the week before as well.

In terms of COVID variants, the Metropolitan Council reports “BA.5 constituted 91 percent of the viral RNA entering Metro last week, and BA.4 and BA.2 represented two percent and seven percent respectively” of the total viral RNA load. Notably, the BQ.1 subvariant, a subset of the BA.5 lineage, “currently make up approximately 58 percent of the viral RNA entering the Metro Plant.” This is a dramatic increase since mid-October in the prevalence of BQ.1 in Metro wastewater.

The Minnesota Department of Health reported that for the most recent two-week period (Nov. 6 through Nov. 19), “we are seeing the continuation of a trend we noted a few weeks ago with BA.5 prevalence falling to about 60 percent of sequenced specimens in Minnesota.” Additionally, “the Omicron BQ.1 lineages continue to rise and now account for approximately 22 percent of sequenced specimens, which is up from 19 percent in last week’s report.”

The latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, tracking data from seven regions through Nov. 20, shows a general decrease in COVID-19 levels across much of the state, over both the prior month and week. The South Central and South East regions were exceptions – both saw increases over the prior month and week. The Central region saw a modest seven percent increase over the prior month but a 22 percent decrease over the prior week.

The COVID-19 levels of wastewater in the Twin Cities Metro (the study’s largest region, including 13 plants serving 2.8 million Minnesotans) show a decrease with this update after a steady increase. Note that this study’s data goes through Nov. 20, but the Metro Plant wastewater data from the Metropolitan Council, mentioned above, is more recent.

CDC: Two counties rated high risk, but much of central and northeastern Minnesota at medium risk

Minnesota has two counties — McLeod and Rock — rated high risk according to the CDC’s latest “Community Level” ratings. This is down from the five counties rated high risk that the CDC reported on Nov. 24. The CDC also rated 28 counties medium risk, including both Hennepin and St. Louis counties, in their Dec. 1 update. The number of medium-risk counties is back to the level we saw a month ago. The high- and medium-risk counties are largely concentrated in central and northeastern Minnesota, with several counties along the western border of the state warranting these ratings, too.

The number of high-transmission counties for COVID-19, however, has declined this week, according to the CDC. Eighteen counties exceed the threshold for high COVID-19 transmission of at least 100 cases per 100,000, down from 41 counties as of the Nov. 24 CDC update. The following counties had 200 or more cases per 100,000 in the latest update: Rock and McLeod.

Since at least mid-July, there have been only three weeks where the number of counties that exceed the threshold for high COVID-19 transmission has been in the teens, and all three of those weeks have been in the last month. Except for one week where the number of counties with high COVID-19 transmission was in the 20s, all other weeks since at least the summer have seen 30 or more counties that exceeded the high-transmission threshold.

While this is overall good news, the rate of hospitalization is still concerning. According to the latest CDC update, 36 of Minnesota’s 87 counties had a hospitalization rate of 10 or more persons per 100,000. Most of those counties with high hospitalization rates correspond to those that the CDC rates at high or medium risk.