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Amid recent reports concerning increases in COVID-19 activity and a rising subvariant (EG.5), we take a closer look at one of the best remaining sources of COVID-19 data: wastewater monitoring. We also try to help you parse what percentage changes represent when baseline levels are low, as is currently the case with COVID-19 in Minnesota.  

And we look at some existing data related to the ongoing negative impact of opioid addiction on Minnesota’s health. 

COVID-19: Hospital admissions and deaths continue to be low—as does the vaccination rate 

You may have heard some reporting of an uptick in COVID. Indeed, in 

 we reported the first day of double-digit hospital admissions since late May. In the two weeks since that update the Minnesota Department of Health is now reporting six additional days of double-digit COVID-19 hospital admissions, including recent highs of 15 admissions on both July 16 and 20.  

These modest increases, however, remain far below the routine hospital admission levels of 50 or more per day throughout much of the first three years of the pandemic, not to mention the pandemic highpoint of 311 COVID-19 hospital admissions on Nov. 19, 2020.  

Beware that the potentially alarming percentage increases in COVID-19 activities that you may be hearing about result in part from the very low levels of COVID-19 now circulating. For example, if we were reporting based on last week’s department of health data release, we could be talking about an alarming-sounding 30 percent increase in COVID-19 hospitalizations.  

But that 30 percent increase only reflects the difference of the average of 7.7 daily hospital admissions for the week ending July 13, compared to the daily average of 10.0 daily hospital admissions for the week ending July 20. A 30 percent increase starting from a low level has much different implications than would a 30 percent jump if pre-existing COVID-19 hospitalization levels were higher. 

Further, recent reports of increasing COVID-19 activity would be more concerning if they were coupled with findings of a more dangerous new strain of COVID-19. Fortunately, this does not appear to be the case. 

 does suggest that a newer subvariant of COVID-19’s XBB lineage, this one labeled EG.5, has grown to now makes up 11 percent of the nation’s COVID-19 cases. However, 

University of Minnesota infectious disease expert Michael Osterholm recently noted

, “there is no evidence at this point indicating that EG.5 causes more severe disease or even immune evasion.” 

Finally, COVID-19 alarm bells are further calmed by the most recent week of data—which reflects a slight week-over-week drop in COVID-19 hospitalizations, instead of a continued climb. The daily average of COVID-19 hospitalizations dropped back to 8.0 for the week ending July 27. 

In terms of COVID-19 mortality, the health department’s most recent data show fewer than one COVID-19-related death per day for the week ending July 13. That most recent week of data includes four days with zero COVID-19-related deaths. 

As has been the trend for several weeks, Minnesota Department of Health indicates that 

27.2 percent of Minnesotans are up-to-date on their COVID-19 vaccinations

, including 69.1 percent of those age 65 or older. A new COVID-19 booster shot is expected to be available early this fall, and 

 that Pfizer’s CEO indicated their version of the new shot could receive the required Food and Drug Administration approval before this month is over. 

COVID levels in wastewater fluctuate in Minnesota, rise in Midwest and nation

The weekly average viral RNA load in wastewater entering the Metro Plant increased by 12 percent from the previous week, as of the week ending July 30, according to 

the Metropolitan Council and the University of Minnesota’s Genomic Center

. This follows last week’s 54 percent increase, bringing the COVID-19 load back up to levels measured in mid-May. These levels are still very low relative to nearly all of the pandemic, but the continued upward creep is worth watching. 

The picture across the state is a bit of a mixed bag, although overall wastewater levels remain very low, according to the 

University of Minnesota’s parallel statewide wastewater analysis

As of July 19, the study’s South West region has the biggest increase in COVID-19 levels in their wastewater with a four-week change of 255 percent and a one-week change of 100 percent. While it would be preferable to see declines, this is yet another case in this week’s data of large percentages resulting from small increases to very low initial measurements. Still, it remains to be seen if this is the start of a sustained uptick in COVID-19 levels or just a blip in the state’s southwest corner.  

The study’s North East region also saw a notable increase of 168 percent over the prior four weeks, but the data shows there was no change over the most recent week. The South East experienced comparatively modest four- and one-week increases. 

This regional data aligns with the slight uptick in hospitalizations recorded through July 20, but it is good to keep in mind that the levels we are currently seeing are well below those from this past spring and early summer, which is evident in the line graphs below. And even though the bumps in these graphs that correspond to mid-May to early-June look large, they represent levels that are much smaller when compared to what was recorded in February and March, and even those were profoundly smaller than at earlier points in the pandemic.  

COVID-19 load in Minnesota wastewater plants

National wastewater levels at highest since March 

To further check on the headlines about a potential national uptick in COVID, we took a closer look at wastewater surveillance data, which remains one of the best sources of data for tracking COVID trends.  

, the contractor for the CDC’s National Wastewater Surveillance System, the nationwide level of COVID virus concentration in wastewater is at its highest point since late March. The overall level of virus had declined from that point until June 21, from which point it started to increase. As of Aug. 2, the national level of COVID-19 in wastewater has more than doubled from late June, increasing by 126 percent. It rose by 10 percent over the most recent week and 33 percent over the last two weeks.  

What about regional differences? Since mid-May, the Midwest (including Minnesota) has had the lowest COVID-19 level of the four regions in Biobot’s analysis. This holds true according to the latest data. As of Aug. 2, the South and Northeast are roughly tied for the highest level, followed by the West.  

But recently, the Midwest has seen the sharpest increase in COVID levels. The COVID level in Midwest wastewater increased by 42 percent in the week ending Aug. 2 and 103 percent over the last two weeks. By comparison, the other three regions have had a one-week change of between 2 and 17 percent and a two-week change between 24 and 34 percent.  

 provides important context to this data, pointing to summer travel and waning immunity as likely drivers of this uptick. Overall, while COVID-19 levels remain low the increases in COVID as measured both in local and national wastewater bears continued attention. 

Yes, opioid use is still up—and still deadly 

As Kirsti Marohn of MPR News recently reported, 

child hospitalizations due to opioid exposure have increased in recent months

. This increase, which included 66 children under age 3, got us wondering about the broader opioid use trends.  

the Minnesota Department of Health’s latest statewide data on opioid use

 lags back to 2021. In that year 978 Minnesotans died from opioid-involved overdose, more than double the number reported just two years earlier. Further, the department reported 4,349 nonfatal emergency department visits for opioid-involved overdose in 2021, up dramatically from just under 2,000 in 2018.  

Opioid fatalities and emergency department visits are both up sharply in Minnesota in recent years

, Minnesota’s opioid death rate was lower than most of the nation, ranking 13th lowest on an age-adjusted basis.  

More recent data shows a continued high level of opioid use in the state. For 2022, Hennepin County, home to over one in five Minnesotans, reports 10,237 opioid-involved admissions to hospitals and emergency departments located in the county, nearly identical to 2021, but up from 5,517 ten years earlier. And in January through June of 2023, Hennepin is reporting nearly 5,300 opioid-involved admissions, a seven percent increase over the same period in 2022.  

340 opioid deaths in 2021, of which 320 involved fentanyl

One factor in recent deaths is xylazine. In April the White House listed xylazine combined with fentanyl as an emerging threat. Nationally, the CDC is reporting increased mortality among opioid users and others 

, which is traditionally a horse tranquilizer and may not respond to overdose-reversing medications. 

 that xylazine was already detected in 11 deaths in Hennepin, Dakota and Scott counties in 2021.  

Note: Those in need of immediate help can text “MN” to 741741. Those looking for addiction services can find listings at 

 (search for “addiction” by city or zip code). 

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Craig Helmstetter

Amid recent reports concerning increases in COVID-19 activity, we take a closer look at wastewater monitoring. We also look at some existing data related to the ongoing negative impact of opioid addiction.

Minnesota health data: Opioid impacts remain high, COVID-19 levels remain low

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