MINNEAPOLIS — Minnesota’s latest wave of coronavirus infections was different than previous surges.
Vaccines, more contagious variants and fewer restrictions on gatherings helped to illustrate what life may look like in the near future as the U.S. works toward herd immunity to COVID-19.
Jan Malcolm, state health commissioner, said coronavirus vaccines helped “stem what otherwise could have been a catastrophic rise in cases and hospitalizations” that could have been “far worse” than the November surge.
The late fall spike in cases sickened hundreds of thousands of Minnesotans, put more than 10,000 in hospitals and killed thousands of residents. This year’s surge wasn’t as severe or as deadly.
That doesn’t mean it wasn’t dangerous.
New variants of the coronavirus are driving the latest wave of cases and are responsible for about 60 percent of new infections. These strains are often more contagious and can cause more serious disease.
Minnesotans needing hospitalization have trended younger by about a decade during the latest surge at an average age of 58. Patients hospitalized because of variants were even younger with an average age of 37, health officials said.
The vast majority of those with severe illness in the latest surge have not been fully vaccinated. Luckily, the death rate has been dramatically lower during the latest spike.
Overall, the average age of new cases is also getting younger. Health officials attribute that shift to vaccine availability as well as the reopening of schools and other parts of society.
Unfortunately, residents have become less deliberate about mitigation measures like masks and social distancing that are simple ways to dramatically reduce spread of the coronavirus.
Finally, Minnesota’s vaccine administration rate has declined after an early April peak when more than 400,000 doses were administered in one week.
While 4.1 million doses have been administered so far and 2.5 million residents have gotten their first shot, Minnesota is a long way from the 80 percent vaccine threshold that could offer herd immunity and help snuff out COVID-19.
Who's getting sick?
Early in the pandemic, elderly Minnesotans accounted for the most coronavirus cases largely because testing was very limited and focused on the highest-risk residents.
By summer, with testing plentiful, twenty-somethings were the age group with the most infections. They held that distinction until the latest wave.
Now, school-age children, specifically teenagers, are getting COVID-19 in the greatest numbers. While few young people develop severe illness, they can easily pass the coronavirus to family members and others who can get very sick.
That’s reflected in the latest hospitalization data. Health officials say the number of patients over the age of 65 hospitalized with COVID-19 has been cut in half while the number of younger patients needing care has climbed in every younger adult age group.
“Our hospitalization rate, although it has stabilized, remains high,” said Kris Ehresmann, director of infectious disease prevention for the state Department of Health. On Friday, 619 patients were hospitalized, including 166 in critical condition.
There also are geographic trends to where new cases are emerging. While the most coronavirus cases are in the Twin Cities metro, the highest numbers per capita have been in less-populous counties, some of them with meat-processing facilities.
The trend continued in the latest wave. Lake of the Woods, Pope, Carver, Kanabec, Cook and Isanti countries all saw new cases grow by more than 30 percent during the latest surge.
Rural counties are also where vaccine uptake has slowed in recent weeks. Vaccine administration jumped by more than 200 percent during March and April in much of the Twin Cities metro, but it grew much more slowly in nearly all the state’s rural counties.
State health officials have gone to great lengths to encourage all eligible Minnesotans to get one of the three vaccines that currently have emergency federal approval. The Pfizer vaccine is available to everyone 16 and older, while the Moderna and Johnson & Johnson vaccines are approved only for adults.
The Minnesota Department of Health’s message on vaccines has been straightforward — vaccines work and will help the state get back to some semblance of normal.
“One of the most dramatic things we are learning recently is the degree to which vaccines are working to protect some of the folks at highest risk,” Malcolm said.
That is supported by the latest outbreak data.
Most convincingly, only 1,163 of more than 1.25 million fully vaccinated Minnesotans have developed COVID-19. The so-called “break-through rate” of less than one-tenth of a percent is significantly less than efficacy rates reported during vaccine trials.
Vaccine effectiveness is also evident in the state’s hospitalization and fatality data. About 4,000 Minnesotans needed hospital care during the latest wave, compared with about 11,000 during the November surge.
There were nearly 660 deaths from COVID-19 during March and April in Minnesota, compared with almost 2,900 during the last surge.
Fatalities in long-term care have dropped significantly since the state started vaccinating seniors in late December. The decline occurred even as the rate of exposures in long-term care increased during the last wave, largely due to unvaccinated caregivers.
Shooting for herd immunity
Gov. Tim Walz was adamant last week that the slowing rate of vaccinations wasn’t because Minnesotans were hesitant to get their shot. Instead, Walz says the state needs to do much more to meet busy people “where they’re at.”
Walz has set a goal of Minnesota having the best vaccination rate per capita of any state.
To make vaccines more accessible, state officials have opened community clinics and created seven mobile vaccine units from Metro Transit buses. Walz says such efforts will help them vaccinate in “every corner of Minnesota.”
“We’ve shifted from the place where people have been willing to drive three hours across the state to find vaccine,” Ehresmann said. “I think it is early to say this shift is due to hesitancy. We are at a place where people aren’t coming to us to get the vaccine. We have to bring it to them.”
Health officials also continue to focus on vaccinating residents from communities hit hardest by the pandemic. Minnesotans of color experienced rates of severe disease and death higher than white residents when the differences in population size are taken into account.
Dr. Nathan Chomilo, the state’s coronavirus vaccine equity director, announced Thursday that the state would focus 40 percent of its vaccine doses on high-risk communities over the next month. Doing so will help the state get “ahead of the worst outcomes by going to communities that are hardest hit and most likely to experience outbreaks going forward,” Chomilo said.
Politicization of vaccination is another challenge. Polling has repeatedly shown conservative voters are less likely to get vaccinated, a factor that is reflected in the slowdown of vaccination rates in rural Minnesota counties.
Walz has called on Republican lawmakers to speak out publicly and urge constituents to get the shot, but so far, few have. One exception is former Republican Gov. Tim Pawlenty, who got the Johnson & Johnson vaccine with Walz in March.
Walz and health officials have emphasized how important it is for trusted community leaders to encourage residents to get vaccinated.
“I need Republican legislators to help me if there’s resistance,” Walz said. “It’s just the reality now that if I tell some of those counties it’s Tuesday, they’ll disagree with me.”