Welcome back to COVID in Minnesota TODAY
, an email newsletter from MPR News about understanding the latest developments in Minnesota's COVID-19 outbreak.
With Minnesota's COVID-19 outbreak continuing to improve, the big area of focus now is vaccination. Minnesota has to date been a laggard when it comes to getting shots into arms. Our pace is picking up, but slowly. What's to blame for this slow pace? I can't promise definitive answers, but will explore this question in today's newsletter. (This newsletter was going to go out Monday afternoon, but got finished late, so we're sending it out Tuesday morning instead!)
Three things to know:
Some of Minnesota's COVID-19 metrics, such as cases and ICU hospitalizations, might be bottoming out
Minneota has only distributed about 63 percent of the COVID-19 vaccine doses it's received from the feds, with some providers much slower than others
But that vaccine supply remains extremely limited, even if the state were better at getting needles in arms
First, a look at the generally good news from the pandemic front.
The death rate continues to decline. Monday saw just three newly reported COVID-19 deaths. That's the lowest since Oct. 12, and just the 26th time since Minnesota's first COVID-19 death that any day had three or fewer cases. Still, 14 of those 26 were Mondays, which typically have below-average death reports. The better way to understand the falling death rate is that the seven-day average has fallen to 23 deaths per day, down from about 32.5 per day a week ago.
For the first time in months, Minnesota's average COVID-19 death rate is below its May peak. On May 30, Minnesota was averaging about 24.8 COVID-19 deaths per day. Minnesota broke that record on Nov. 8, and has been above that threshold ever since, until Sunday.
This slowing but still-high pace means Minnesota is on track to have its third-deadliest month of the pandemic in January — more deaths than May, but almost certainly fewer than November, and far below December's record.
Meanwhile, it looks like Minnesota's decline in cases might be leveling out at around 1,200 cases per day. If true, that would mean the disease isn't going to disappear any time soon, but will continue to spread throughout the population at relatively low levels, compared to our recent wave. (Or at least, it will continue to spread at relatively low levels until something happens to change that trajectory, for good or ill, about which more later.)
Minnesota is currently averaging just over 1,000 COVID-19 cases per day.
This isn't a function of testing volume, as positivity rate continues to decline, too. Today Minnesota's average positivity rate dropped below 4 percent for the first time since Sept. 16.
With regards to hospitalization numbers, it looks more and more like COVID-19 ICU admissions are leveling off at around 10 admissions per day, about the level it was at all summer. But non-ICU admissions continue to decline.
Vaccinations are improving, a little
With the November wave now firmly in the rear-view mirror and no sign yet of any significant rebound, the biggest questions right now have to do with vaccines. Vaccinating a large share of Minnesota's population is probably the fastest and safest way out of the pandemic, but so far, Minnesota hasn't been giving shots fast enough.
The past few days have, in fact, demonstrated some improvement here. Minnesota has administered more than 20,000 shots in each of the last three days, and its seven-day average has inched up to around 15,000 per day, from a low nearer 11,000 per day.
But even that improvement isn't close to enough. To vaccinate 80 percent of adult Minnesotans by mid-summer, Minnesota needs to be administering more than 40,000 shots per day.
State officials say Minnesota has been receiving 60,000 doses per week from federal officials. If you divide that out, that's about 8,500 doses per day. So — though the data is messy — it seems Minnesota might have actually been distributing doses faster than they come in lately. That could mean we're on track for this metric to fall even further, unless supply increases. It would take 280,000 doses per week to hit that 40,000 per day threshold. So going from 11,000 to 15,000 shots per day is nice, but it just changes the target date for vaccinating 80 percent of the population from August 2022 to May
So what's behind this slow vaccination pace in Minnesota?
As is often the case with COVID-19, there's no single answer. In general, though, there seem to be three general categories of answers:
Let's take those in order. First, slow vaccination paces aren't just a Minnesota issue, they're national, and they relate to limited supplies
of vaccines. The reason only the elderly and health care workers have been able to get vaccinated so far is because there aren't enough doses available for everyone. (There haven't even been enough for everyone in the first categories.) As of the most recent report, Minnesota had been shipped a total of 529,375 vaccine doses. With complete vaccination taking two shots, that's enough to vaccinate about 6 percent of Minnesota's adult population. This has happened over 41 days since the first vaccines arrived in Minnesota, which would be a pace of about 13,000 shots per day. Again, that's the most shots Minnesota could have possibly issued
given what it's received. So clearly supply is a huge part of the problem here — probably the single most important part.
But that's not to say Minnesota has had a smooth time distributing what few doses it did receive into people's arms. Out of those 529,375 doses, Minnesota has administered just 63.3 percent. In other words, there are nearly 200,000 doses out there in freezers, not working their magic inside people's immune systems.
This problem isn't the same across the state. Today, Gov. Tim Walz announced that the state was setting a target that vaccine providers should administer 90 percent of their doses within three days of receiving them, and all of them within seven days — or get reduced vaccine distributions in the future. At the same time, the health department released stats on how this was going. Some providers — Allina, Children's Minnesota, Essentia Health and the Mayo Clinic — have on average given 100 percent of their received doses within three days. Others — especially the pharmacies with a federal
contract to vaccinate long-term care facilities — are averaging less than 50 percent of doses within three days. The statewide average is 71 percent.
In the long run
the ultimate constraint on vaccination is supply, but in the short run, these kind of inefficiencies mean delays in people getting vaccinated. Those delays could mean some people will get sick because they didn't get vaccinated in time.
Finally, there's demand. This is harder to quantify, but there have certainly been anecdotal reports of some health care workers refusing to get the vaccine; it may also be an issue with long-term care residents and other key groups. This could be a contributing factor to the relatively slow pace of distributing vaccines in Minnesota — it's hard to give a shot that the recipient doesn't want.
Ultimately, though, there are clearly huge numbers of Minnesotans who would happily roll up their sleeves right now if a shot were available. While vaccine skepticism might conceivably be a short-term issue in key communities, such as the elderly who are at greatest risk of dying, or health care workers who might be most likely to be exposed to the disease, right now there just aren't enough doses to go to the people who want them, even before you start considering people who don't.
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 about the COVID-19 outbreak:
Last time we checked in with the geographic distribution of deaths in Minnesota, they were down in most places, but not everywhere, with suburban counties around the Twin Cities in particular lagging.
Now, thankfully, deaths are on the decline everywhere. Again, this statistic can be a bit messy and prone to bounce around, especially in smaller areas. But the overall pattern is clear. Deaths are trending down across the state. In Hennepin and Ramsey counties, they're almost back down to the levels seen over the summer, when Minnesota statewide was averaging less than 10 deaths per day.
Understanding the current case rate
Above, I mentioned how it seems like Minnesota's average cases per day is plateauing at around 1,200 newly reported cases per day. There's no guarantee cases will stay at that plateau, but what if they did? How risky would that level of sustained cases be?
What follows is a crude calculation I first did back in the fall, transforming a per capita rate into odds using probability math. Basically: if 1,200 people kept getting COVID every day for the next month, what would be the odds that a random individual got it?
This is just a thought experiment that has so many assumptions it shouldn't be taken seriously. For one thing, it doesn't account for resistance in the population, from vaccination or prior infection, that makes some people less likely to get sick. It also isn't a good proxy for individual
risk because it doesn't account for factors like how much a person interacts with others, and with what precautions. It's just a way to adjust something tiny — 1,200 people getting sick each day out of a population of 5.6 million – to account for the fact that a pandemic is an ongoing risk, not a one-time risk.
With all that said, if current levels of confirmed cases continued for a month, that would translate into an 0.63 percent chance of getting sick, or about 1 in 160. At the height of the outbreak in late November, the odds of getting sick if cases continued at that rate for a month was about 3.6 percent, or about 1 in 28.
If the current rate of about 1,200 confirmed infections per day continued for a full year — a much less likely level of consistency — that would be about a 7 percent chance of getting sick, or one in 13.5.
What's happening next?
In a future update, I hope to re-tackle the question of the spreading levels of COVID-19 immunity in Minnesota's population, and when and what impact we can expect spreading vaccination to have on Minnesota's infection rates. (This was going to go in today's update, but I was long past deadline already!)
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