Metrics show encouraging declines, while older adults continue to be at risk

While most COVID metrics this week show encouraging declines, wastewater data remains elevated and suggests COVID is still circulating. Health department data shows that older adults continue to be the most at risk. Hospitalization rates for Minnesotans 65 and older have been three to four times higher than any other age group in recent weeks, and death rates have been ten times higher than other age groups.   

These higher rates of severe COVID outcomes are despite the fact that Minnesotans 65 and older have the highest rate of receiving the original, full vaccination dose, at 92 percent.  

The number of older adults who have gotten a booster shot, however, is substantially lower, at 63 percent, even though older adults are inherently at more risk for severe COVID outcomes compared to those with younger immune systems. Among concerns of waning vaccine effectiveness, some may be asking, “how much does a booster shot matter?”  

Recent data shows that boosted older adults are less likely to be hospitalized or die from COVID, even in recent months. In the last 60 days, the rate of COVID hospitalizations has been similar for unvaccinated and (non-boosted) fully vaccinated Minnesotans 65 and older. But the rate of COVID hospitalizations among boosted Minnesotans in that age bracket is about 66 percent lower than the unvaccinated or vaccinated-but-not-boosted population.

While it seems the first round of vaccinations may no longer provide as much protection against hospitalization, those early vaccinations do appear to offer some protection against COVID-19 deaths. Mortality rates for vaccinated-but-not-boosted older Minnesotans are 37 percent lower than those who have not been fully vaccinated. The booster appears to provide further protection, with a mortality rate among Minnesotans 65 and older that’s 66 percent lower than those without full vaccination.  

The federal government has purchased its last round of COVID-19 vaccines to offer for free distribution – save any intervention from Congress. Free vaccines should still be available for some time, but it is unclear what that timeline looks like. When the government’s supply runs out, the uninsured will see the biggest changes in COVID prevention and treatment costs.  

A recent study out of North Carolina showed that the bivalent booster shot was more effective in preventing severe infection resulting in hospitalization or death than the monovalent booster shot. And a recent study by the Centers for Disease Control and Prevention suggests that the bivalent booster is as effective against XBB (a descendent of the BA.2 Omicron sublineage) as it has been against BA.5 Omicron sublineages. The effectiveness of the bivalent vaccine booster is supported by other studies, too, including ones we highlighted in our update in late January.    

Cases, hospitalizations and deaths are all on the decline 

Officially recorded COVID-19 cases are down across all regions. These represent cases reported by health providers. While this data does not include at-home tests, it gives some indication of how many people are seeking health care and testing positive for COVID.  

Intensive care unit hospitalizations for COVID are about half of what they were a couple of weeks ago. Non-ICU hospitalizations are also down.  

Non-ICU COVID admissions are recently averaging about 40 per day. This is down considerably from 60-70 admissions seen on most days from May to December 2022. Recent ICU COVID admissions are also lower than much of 2022.  

COVID-19 deaths have stabilized in recent weeks after swinging up and down in late 2022 and the early part of this year. Deaths are also lower than they have been since mid-October, averaging around six per day in the state.   

COVID wastewater data shows decreased levels in Twin Cities metro and around the state 

Twin Cities metro update 

 The total level of virus decreased by 43 percent for the week ending Mar. 6 compared to the previous week, according to the latest data from the Metropolitan Council and the University of Minnesota’s Genomic Center. The XBB subvariant now comprises 88 percent of the viral RNA load entering the Metro wastewater plant.  

Even with this recent decline, the COVID level is above what it was at the beginning of January, and it remains above the levels we saw in 2021 and 2022. 

Statewide update 

COVID levels in wastewater mostly decreased throughout the state over the prior month and prior week, according to the latest data out of the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study. For the period ending on Feb. 26, the study’s North West region saw a 39 percent increase in wastewater levels over the prior month and the South Central region saw a modest 4 percent increase. Over the prior week, however, the North West region experienced a 9 percent decline in wastewater levels and a 41 percent decrease over the prior week.  

The study’s North East region, which includes Duluth, saw relatively substantial declines of 40 percent over the prior month and 47 percent over the prior week, the largest one-week decline in this update, indicating that levels are continuing to drop significantly there. The Central region saw the largest monthly decline of 47 percent and a one-week decline of 28 percent.  

The Twin Cities Metro (the study’s largest region) experienced a relatively large decrease over the prior month of 35 percent and a 21 percent decrease over the prior week.  

In terms of variant prevalence among samples from COVID cases, XBB accounted for 76 percent of sequenced specimens in the latest two-week period ending on Feb. 26, compared to 66 percent in the prior period, according to the Minnesota Department of Health.   

Most of state at low risk according to latest from CDC; a handful of high- and medium-risk counties in western parts of state 

Western portions of the state are at heightened risk, but most of Minnesota remains at low risk, according to the latest CDC “Community Level” COVID-19 assessments. Only Big Stone and Traverse counties are rated high risk for the week ending Mar. 8, down from four high-risk counties last week.  

Both Big Stone and Traverse counties had hospitalization rates of 37.5 admissions per 100,000, nearly double the CDC’s threshold for classifying a county as high risk. While that is concerning, and CDC guidance suggests that residents in those two counties should take extra precautions, both counties have relatively small populations.       

This week, 15 counties are rated medium risk, which is up from 10 counties last week but down from 29 counties the week before. Those counties are scattered throughout western portions of the state, including the northwest and southwest corners.  

The number of counties with case rates exceeding 100 per 100,000 is also down this week, 11 counties compared to 37 the week before. This is low compared to recent numbers. Aside from the week ending Feb. 22, for which there were 14 counties that had a case rate exceeding 100 per 100,000, all other weeks since the end of January have had at least 20 counties that meet that threshold.  

Notably, Traverse County has a case rate over 300 per 100,000 this week.  

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