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Updated: Sept. 5, 2023 at 1:15 p.m. | Posted: Sept. 1, 2023 at 4:38 p.m.

Wastewater monitoring has become a crucial part of COVID-19 monitoring. The Metropolitan Council was among the nation’s leaders in initiating COVID detection efforts in wastewater, along with its partners at the University of Minnesota’s Genomics Center.  

Wastewater detection has been particularly useful over the past year due to waning COVID-19 testing and case reporting. But that informational stream is about to shift. 

the Minnesota Department of Health announced

 the Met Council’s environmental services division is transitioning away from regularly reporting on COVID levels at its Twin Cities wastewater treatment plant, the state’s largest. 

The state’s larger efforts to monitor COVID, however, are not ceasing. The Twin Cities’ Metro plant is one of 37 wastewater treatment operations around the state included in the University of Minnesota’s ongoing 

In addition, the state will continue to participate in Center for Disease Control’s 

 also regularly report on COVID-19 levels detected in select wastewater treatment plants in Minnesota.

The Minnesota Department of Health’s statement added that its lab and the U will work together on ways to add RSV, influenza A and influenza B to wastewater monitoring. 

Still, it remains to be seen whether the Met Council’s helpful reporting, which included variant tracking and easily downloadable data, will be replicated in the state’s other wastewater reporting efforts. 

COVID levels are up in Twin Cities wastewater 

The Met Council’s step away from wastewater reporting comes amid a continued modest rise in COVID levels. In its last week of wastewater monitoring, the Metropolitan Council reported: “The weekly average viral RNA load entering the Metro Plant increased by 18 percent this week compared to a week earlier.” 

As of the latest reported reading, Aug. 27, the seven-day moving average viral load, 68.2 million copies per person per day, is back up to levels not seen since early May, but that level remains notably lower than through much of the pandemic. 

the University of Minnesota’s wastewater SARS-CoV2 surveillance study

 shows increasing COVID levels in all but one of the study’s regions — Central — over the week ending Aug. 20.  

Additionally, all but two of the study’s regions — North West and South West — show an increase in COVID-19 over the latest four-week period. Increases are particularly notable in the North East and South Central regions.

COVID-19 load in Minnesota wastewater plants

Upward creep continues in COVID hospitalizations 

The bad news is that the number of Minnesotans newly hospitalized with COVID did not fall in the state Health Department’s most recent week’s data. The good news is that this week’s increase is very small, less than the increases of the past couple of weeks. 

On average, about 20 Minnesotans with COVID-19 are now entering hospitals daily throughout the state. This is up from less than the average of 10 per day throughout most of June and July, but still way below the numbers of patients seen with COVID in Minnesota hospitals at the start of the year. 

Average daily COVID-19 hospital admissions in Minnesota

Variants: No known BA.2.86 in Minnesota 

The rise in COVID levels in wastewater as well as hospitalizations would be even more concerning if it were tied to a new variant known to have harsher health impacts. That does not appear to be the case with the currently ascendent variants, EG.5 and FL 1.5.1 which 

 to account for 22 percent and 14 percent of COVID nationally.  

A more concerning variant, BA.2.86, has now been detected in several countries. As influential physician and writer 

, the BA.2.86 variant has many more mutations than most variants, making it “more difficult for our immune response to recognize … even with prior vaccinations, boosters, and infections — because it is new and different. It’s still SARS-CoV-2 so we have built some immunity... But the rapid ability to neutralize the virus depends on antibodies, and the levels of those neutralizing antibodies are bound to be much lower against BA.2.86 than versions of the virus we have previously been exposed to or immunized against.”  

Despite these concerns, we have yet to see widespread detection of BA.2.86 in the U.S. It does not yet even appear 

“Minnesota has not detected the presence of the BA.2.86 variant in circulation at this point,” Sara Vetter, assistant director of the Minnesota Department of Health’s public health laboratory, said in response to our query. "Our state public health lab is able to identify this new variant through sequencing, and we will continue to monitor the situation as it develops.” 

Vetter also noted: “The small increase in COVID-19 cases we are seeing is a reminder that COVID-19 is still around, and that the best way to protect our communities is to use the tools at hand: getting vaccinated, getting tested, getting treatment when applicable, and staying home when you feel sick. These are the best ways to stay safe, no matter what COVID-19 variant is in circulation.” 

In terms of the forthcoming new COVID booster, the federal government seems to still be on track with a rollout later this month or early next, with more details likely available following the Sept. 12 meeting of 

the CDC’s advisory committee on immunization practices

Adult diabetes trending higher in Minnesota 

Nine percent of Minnesota adults have diabetes, according to the latest data in CDC’s ongoing Behavioral Risk Factor Surveillance System. This is up from 7.3 percent in 2011, and 3.1 percent in 1995, although the system used somewhat different methodology prior to 2011. 

Graph: Diabetes rates have gradually increased in both the U.S. and Minnesota over the past decade

This increase may be due partly to the continued aging of Minnesota’s population. Diabetes is much more common among older adults. For example, in 2021, nearly 20 percent of Minnesotans ages 65 or older had been diagnosed with diabetes, compared with only 3 percent of those 25 to 34 years old.

Graph showing the proportion of adults diagnosed with diabetes in Minnesota, 2021

The disease also reflects disparities among the state’s major racial and ethnic groups.  

Almost one-fourth of Indigenous adults in Minnesota have been diagnosed with diabetes, compared with only 1 in 20 Minnesotans of Asian ancestry. Diabetes rates are also elevated among Black and multiracial Minnesotans. 

To tie together the two topics in this week’s roundup, diabetes is a risk factor for COVID-19. 

According to the American Diabetes Association

, “The problem people with diabetes face is they’re more likely to have worse complications if they get it, not greater chance of getting the virus. Also, the more health conditions someone has (for example, diabetes plus heart disease), adds to their risk of getting those serious complications from COVID-19.” 

Apparently, the state has much work to do regarding diabetes. Of the 17 items on the 

Minnesota Department of Health’s diabetes dashboard

, which was last updated on June 30, 12 are listed as “stable” and five are noted as “getting worse.” None are rated “improving.” 

In response to our query about this, a Health Department spokesperson wrote: “Minnesota is a National leader in per capita participation in two evidence-based programs supported by the CDC: the 

Diabetes Self-Management and Education Support

 for people with diabetes. …[W]e will continue work with community partners to increase access to culturally appropriate programs and participation in these programs among priority populations.” 

Finally, in a bit of relief for those dealing with diabetes, the out-of-pocket expense of some diabetes treatments is going down.  

As a part of the federal Inflation Reduction Act, 

costs for insulin are now capped at $35 per month

 that the popular diabetes treatment Jardiance is one of ten drugs that will be targeted for price negotiations under Medicare. 

Correction (Sept. 5, 2023): An early version of this article conflated Biobot Analytics and the WastewaterSCAN Dashboard. They are separate efforts, as now indicated.

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Craig Helmstetter

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Recent COVID-19 increases have, in part, been detected through wastewater monitoring. Friday the state announced that the Metropolitan Council is stepping back from reporting on reporting pathogens detected in wastewater at the Metro wastewater treatment facility. 

Health data roundup: COVID's creep continues; a deep dive into diabetes rates

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