Post-Thanksgiving COVID-19 bump in Minnesota, but RSV and flu hospitalizations down

A woman walks past a sign saying face masks required.
Minnesota is experiencing a post-Thanksgiving COVID bump. Five counties are rated high risk.
Derek Montgomery for MPR News

Unfortunately, it does appear that we are experiencing a post-Thanksgiving bump here in Minnesota.  Whether that bump turns into a more significant surge remains to be seen, but the increase is on top of other stressors hospitals are facing, RSV and flu in particular. There is some encouraging data this week on that front, however. Hospitalizations for both RSV and flu are down from the previous week, by about 25 percent and 11 percent, respectively.  

This week’s COVID-19 data shows a rise in cases across the state after several weeks in which trends remained relatively stable. Hospitalizations for COVID-19 are also up, the level of COVID-19 viral loads in wastewater increased across most of the state, including the Twin Cities metro, and Centers for Disease Control and Prevention data shows Minnesota now has more counties that exceed the CDC’s threshold for high community transmission than we have seen in several months.

COVID-19 hospitalizations are up this week, adding to already high hospital bed usage from RSV, flu and other ailments  

After weeks of being relatively stable, confirmed COVID-19 cases are up from last week in all regions of Minnesota. Because testing patterns may vary by region, comparing values among regions is not necessarily helpful. But looking at the general trend of increasing or decreasing cases in your specific region should give some sense of whether COVID is of more or less local concern at the moment.  

time series of recent weekly covid-19 cases across minnesota regions
Case rates went up in of Minnesota's regions in the most recent week of data.
David Montgomery

Last week, non-intensive care unit admissions for COVID-19 remained stable, but this week they jumped up. ICU admissions also remain higher than they have been since the end of the early 2022 omicron surge.  

time series of recent covid hospitalizations
Non-ICU hospitalizations have jumped in the past week, and ICU hospitalizations remain elevated.
David Montgomery
time series of covid hospitalizations since the beginning of the pandemic
COVID-19 hospitalizations are on the rise remain below what they've been in previous years at this time.
David Montgomery

COVID-19 hospitalizations are still well below what they were during this same time period in the last two years, but the recent increase comes at a time when hospitals are feeling the stress from other conditions as well. In the Twin Cities, non-ICU hospital beds have been more than 95 percent full since September 2020. These bed usage numbers are for beds used for any reason, not just for COVID-19 patients. In Greater Minnesota, the highest bed usage during the pandemic was in late 2021 and early 2022. But usage has slowly been climbing recently and is higher than it was during the first year of the pandemic. Trends are similar for ICU beds; see that data on the health department website.  

time series of adult hospital bed use during pandemic
Bed use in Metro hospitals has been near 100% for much of the pandemic. This metric encompasses beds used by COVID and non-COVID patients.
Elisabeth Gawthrop | APM Research Lab

The situation is similar for pediatric beds, with Metro bed usage being very close to 100 percent right now. While pediatric bed usage has also been relatively high throughout the pandemic, late summer 2021 through early 2022 also saw bed usage close to 100 percent, which coincides with the RSV and flu seasons seen during that time.  Pediatric ICU bed usage is also very high right now, with the health department reporting only four such beds currently available in the state.  

time series of pediatric hospital bed use during pandemic
Pediatric bed use in Metro hospitals is near 100%, as it also was this time last year. This metric encompasses beds used by COVID and non-COVID patients.
Elisabeth Gawthrop | APM Research Lab

Since late October, deaths related to COVID-19 have averaged around eight per day. We have not seen an average this high sustained for this long since the end of the early 2022 omicron surge, although, just as with hospitalizations, deaths do remain well below the amount seen during this time period in the past two years.  

Minnesota COVID deaths by year
COVID-19 deaths have been elevated in recent weeks, but still much lower than previous years.
David Montgomery

Increase in COVID-19 wastewater levels across the state, except in the southwestern portion 

The most recent wastewater analysis in the state, from the Metropolitan Council and the University of Minnesota’s Genomic Center, shows an 8 percent increase in viral load entering the Twin Cities Metro Plant for the week ending Dec. 5 as compared with the previous week, and the viral load is 66 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 May 24-30.” Last week, the Metropolitan Council noted that the weekly average load was the highest since early- to mid-July.  

COVID load in Twin Cities metro wastewater
COVID-19 load in Twin Cities wastewater has increased over the last few weeks. According to the Metropolitan Council, the recent wastewater analysis shows an eight percent increase in the viral load entering the Twin Cities Metro Plant for the week ending Dec. 5 compared to the previous week.
David Montgomery | MPR News

We plotted the recent case rate data and wastewater data for the Twin Cities Metro, as we did last week, to better connect the wastewater trends with official case trends. Last week we suggested that an increase in COVID-19 wastewater levels often predicts a corresponding increase in official COVID-19 cases a week or two later, but it doesn’t necessarily predict the magnitude of that increase. With several weeks now of increasing COVID-19 wastewater levels, we do see a corresponding increase in the level of cases. Although we will have to wait and see, the magnitude of the recent increase in COVID-19 wastewater load suggests that we could continue to see a rise in cases.   

time series of covid-19 wastewater levels and covid cases in Metro
Case rates in the Twin Cities seem to lag wastewater levels by a week. How much more cases will go up remains unpredictable.
Elisabeth Gawthrop | APM Research Lab

In terms of COVID variants, the Metropolitan Council reports, “BA.5 constituted 89 percent of the viral RNA entering Metro last week, and BA.4 and BA.2 represented one percent and eight percent, respectively.” This is a slight drop in the level of BA.4 from the prior week but a slight increase in BA.2. Notably, the BQ.1 subvariants, a subset of the BA.5 lineage, “made up approximately 51 percent of the viral RNA entering the Metro Plant” for the week ending Dec. 5. While this is still a high proportion of BQ.1 compared to several weeks earlier, it is a small decline from 58 percent the week before.  

The latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, which tracked data from seven regions through Nov. 27, shows a general increase in COVID-19 levels across most of the over both the prior month and week.  

The North West region and the Central region experienced the largest one-week increases, with 152 percent and 74 percent, respectively. The four-week increases for these two regions were modest in comparison, indicating a recent spike in the COVID-19 load detected in the wastewater for those regions after recent declines. The South West region, however, saw a 67 percent increase over the prior month and a 45 percent increase over the week ending Nov. 27. Looking back at the data, the South Central region has seen a steady increase in COVID-19 load since early October and a more pronounced uptick in the last two weeks.  

The South West region is the only region that saw declines over the prior month and in the week ending Nov. 27, with 45 percent and seven percent declines, respectively. The region has seen a steady decline in COVID-19 loads in their wastewater treatment plants since Oct. 26.  

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 monthly and weekly increase after the declines reported in last week’s newsletter. There was a 17 percent increase over the week ending Nov. 27 and a 3 percent increase over the prior month. Note that this study’s data goes through Nov. 27, but the Metro Plant wastewater data from the Metropolitan Council, mentioned above, is more recent.  

CDC: Five counties rated high risk, 68 counties exceed the threshold for high community transmission 

Minnesota has five counties—Rock, Grant, McLeod, Mower and Morrison—rated high risk according to the CDC’s latest “Community Level” ratings. This is up from two counties rated high risk the week before. The CDC also rated 38 counties medium Risk, including all seven counties that make up the Twin Cities metropolitan area, in their Dec. 8 update. The number of medium-risk counties is the highest we have seen since late August. 

The high- and medium-risk counties are largely concentrated in central and southeastern Minnesota, with several counties along the western and southern borders and in the northeast warranting those ratings, too.  

The number of high-transmission counties for COVID-19 has increased considerably this week, according to the CDC. Sixty-eight counties exceed the threshold for high COVID-19 transmission of at least 100 cases per 100,000, up from 18 as of the Dec. 1 CDC update. Thirteen counties had over 200 cases per 100,000, and Pope and Yellow Medicine counties exceeded 300 cases per 100,000. 

This week’s number of high-transmission counties is at its highest point since Sept. 1, when the CDC recorded 74 high-transmission counties in Minnesota.  

While these numbers are concerning, the rate of hospitalization has not changed much since last week’s update. According to the latest data from the CDC, 33 of Minnesota’s 87 counties had a hospitalization rate of 10 or more persons per 100,000, which is down slightly from 36 last week.