MPR News PM Update
COVID in Minnesota TODAY
 
By David H. Montgomery (@dhmontgomery)
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Welcome back to COVID in Minnesota TODAY, an email newsletter from MPR News about understanding the latest developments in Minnesota's COVID-19 outbreak.
It's almost the Fourth of July, which has been pitched as a "COVID Independence Day" — a celebration of (near) victory over COVID-19 after almost a year and a half of pandemic life.

Whether or not the United States has actually beaten the virus or not yet is a whole other question.

(Though, to be pedantic, it took seven years after the original Independence Day for American independence to be confirmed, and even in the 1996 alien invasion movie, the president's "Today we celebrate our Independence Day!" speech was given before the final battle, not after it. So Independence Day has always been a bit aspirational.)

In Minnesota, and in much of the country, new cases are plummeting to record lows. There are exceptions, such as Missouri and Arkansas, where delta variant-fueled cases have been rising again. There's no guarantee Minnesota won't later join them, even if widespread immunity means any potential delta wave will sicken and kill fewer people than past waves did.

I'll take a look at where Minnesota is around this symbolic holiday below.
Three things to know

  • While Minnesota's own stats show the state below 70 percent of adults 18+ being vaccinated, more complete data from the CDC says we've crossed that mark
  • It's unclear whether enough Minnesotans have immunity to COVID-19 to prevent frequent, significant localized outbreaks
  • The state finally started sharing data on COVID-19 deaths by date of death, an important factor given how long it can take for deaths to be properly reported
Learn more of the latest on Minnesota's COVID-19 outbreak in MPR News' daily summary at MPRNews.org
I want start off by focusing on Gov. Tim Walz's statement yesterday that Minnesota had hit 70 percent of adults vaccinated against COVID-19. That was a little bit surprising to hear, since I've been tracking this stat for a long time, and by the state's own numbers, we're only at around 66 percent of people 16 and up vaccinated.
Graph of total COVID-19 adult vaccinations to date
There are two things going on here. The first is a little bit of subtle goalpost-moving by both President Joe Biden and Walz, who had both originally set a target of having 70 percent of people 16 or older vaccinated by July 4.

Both Minnesota and the U.S. came close but fell short of that goal. But rather than dismay, both men opted to celebrate passing a new, slightly less impressive goal: 70 percent of people 18+, instead of 16+.

But even accounting for that, the state's own data showed around 66.5 percent of the 18+ population vaccinated. So how was Walz declaring victory?

The answer is that Minnesota's COVID-19 vaccination data is incomplete. In particular, we're missing about 150,000 first doses, mostly those administered by federal agencies like the VA or Indian Health Service that don't necessarily have to report to the state. But the CDC does have that data, and by their count, Minnesota hit 70 percent of those 18+ yesterday.
Graph of the share of Minnesota's 18+ population with 1 or more dose, by CDC vs. MDH data
What we don't know, of course, is the degree to which this will be enough to choke off the spread of the more-contagious delta variant in Minnesota. The whole concept of "herd immunity" is that when only a small share of the population is susceptible to a disease, it can't find enough new hosts to reach most of the susceptible individuals. It's why we don't need to get to 100 percent vaccination to end COVID-19.

But herd immunity isn't all-or-nothing. We already saw, for example, how Minnesota's third COVID-19 wave was significantly less serious than its first two. There were fewer susceptible hosts after months of vaccinations and a year of infections, so the disease just didn't spread as much — even among the remaining unvaccinated population.
Graph of Minnesota COVID-19 cases per 100,000, adjusted for the unvaccinated population
The bigger question, as I've discussed, is the degree to which COVID-19 is effectively wiped out in Minnesota, a disease of the past that will occasionally infect a small group of people, or whether it goes from a pandemic to an endemic disease, one that is constantly having little localized outbreaks, even if it never again threatens the broader structure of society.

Now, Minnesota's vaccination rate has been plateauing recently, trickling along at a few thousand per day. (The below stats, and all other vaccination graphs unless otherwise indicated, are all based on Minnesota's stats, and so miss those extra 150,000 vaccinations recorded by the CDC.)
Graph of new first and final vaccine doses in Minnesota
It's a mistake to get too fatalistic about these slow rates, however. At some point, the vaccines are going to get approved for children younger than 12. There are some 500,000 Minnesota children aged 5 to 11. Based on what we saw happen with 12- to 15-year-olds, it'll probably be easy to get somewhere between 30 and 40 percent of the state's population vaccinated — low-hanging fruit, as it were.

We may see youth vaccination rates shoot up in August, too, as the start of the school year nears. Many white-collar businesses are planning to return to the office after Labor Day, which could possibly spur some working-age holdouts.

Other people may be waiting until the COVID-19 vaccines receive full, formal approval from the federal government, rather than the current "emergency use authorization" they're all currently operating under. That isn't imminent but is expected at some point between now and the end of the year. To quote Jaimy Lee, Jillian Berman and Andrew Keshner of MarketWatch:

Approval will allow drug manufacturers to advertise their vaccines and, in some cases, set their own prices. It may also mean that employers and schools will have an established legal precedent to require vaccination, and it could tip people in the wait-and-see category to get vaccinated once they know the vaccines have gone through a more rigorous regulatory screening.

“A third of people who are unvaccinated said that they’d be more likely to get the vaccine if … one of the vaccines received full approval from the FDA,” said Liz Hamel, director of public opinion and survey research at the Henry J. Kaiser Family Foundation, which has studied COVID-19 vaccine hesitancy.
All that could be too late for currently unvaccinated people if the delta variant arrives in Minnesota in the next month and if current immunity rates are low enough to allow it to spread freely among the unvaccinated population.

The CDC only updates its variant reports every two weeks, so there's no fresh data from the chart I shared last week. But as a reminder, that data showed the delta variant on the rise in Minnesota:
Graph of the prevalence of COVID-19 variants in the Midwest
Below, I'll explore a few more stats about Minnesota's COVID-19 outbreak. If you want to learn more, I also recommend these other articles:  

Death date vs. report date

On Thursday, the Minnesota Health Department finally released a dataset many of us had been requesting for the past year: COVID-19 deaths by date of death.

Previously, the state had only ever reported deaths based on the date MDH received and published the data. But while COVID-19 cases are usually (except in rare backlogs) entirely reported within seven to 10 days, deaths can take anywhere from a few days to many months to be confirmed and reported.

For example, when we use this new data to compare deaths by actual death date against what was reported, we find that usually — as one would expect — there's a little bit of a lag between when someone dies and when it gets reported. So when deaths are rising — as they were last April — the reported death rate on a given day is lower than the number of people who actually died. When deaths are falling, as they were last June, the reported death date is higher than the actual death date. It's what you'd expect with deaths taking some time to trickle in.

But during the fall COVID-19 surge, health officials seem to have fallen behind on counting and processing all the COVID-19 deaths. Reported death rates fell far below the actual death rates and only caught up gradually over January.

Note that the most recent few weeks of data by death date in the chart below are almost certainly an underestimate, because of that reporting lag. That is, the apparent decline in deaths by death date in June shouldn't be trusted yet — it'll take time to understand exactly where things are.
Graph of Minnesota COVID-19 death rates by death date and date reported
COVID hospitalizations continue to fall

Over the past week, Minnesota has averaged just over one new Minnesotan admitted to the ICU with COVID-19 per day and nine Minnesotans admitted to non-ICU hospital beds.

Both figures are as low as we've seen since the earliest days of the pandemic. One month ago, we were averaging nearly nine ICU admissions per day and 25 non-ICU admissions.
Graph of Minnesota COVID-19 hospital admission rates
Meanwhile, hospital occupancy rates for COVID-19 patients are also as low as we've seen them. Minnesota is averaging around 100 COVID-19 patients occupying hospital beds, about one-quarter of whom are in ICU.

That's about 2 percent of where things were at the peak of the fall wave.
Graph of Minnesota COVID-19 hospital bed use
What's happening next?

I hope everyone has a great holiday weekend! I'll be back in the next week or so with more COVID-19 updates, including fresh data on the delta variant's prevalence in Minnesota.

In the long-term, a weekly COVID-19 data newsletter is going to gradually lose its relevance. But keep watching — we may have something new to offer down the road...

Thanks for subscribing to this newsletter and for all of you who've sent me your feedback. As always, if you like this newsletter, please share it and the sign-up link with others who you think might enjoy it.

— David
 
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