Welcome back to COVID in Minnesota TODAY, an email newsletter from MPR News about understanding the latest developments in Minnesota's COVID-19 outbreak.
Today Gov. Tim Walz announced a timeline for the lifting of almost all of Minnesota's COVID-19 restrictions. Outdoor capacity limits and early closing times for bars and restaurants disappear tomorrow. Everything except the mask mandate goes on May 28. And the statewide mask mandate itself goes on July 1, or when 70 percent of Minnesota adults have at least one vaccine dose — whichever comes first.
It's not my role to tell you whether this is a good or bad decision, just to tell you what the numbers say. So read on!
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Three things to know:
At current rates, 70 percent of Minnesota adults will be vaccinated against COVID-19, thus allowing a lifting of the mask mandate, by early June
Depending on supply and demand, we could hit that target a week earlier or weeks later
Minnesota's COVID-19 wave continues to recede, but perhaps more slowly
Under Walz's plan, 70 percent vaccination among adults 16 and up will end Minnesota's mask mandate (though businesses and local governments can continue to impose their own mask requirements).
What does this mean? Well, for context, around 58 percent of Minnesota adults currently have at least one dose.
But Minnesota's vaccination rate has been slowing dramatically lately. Under the diminished pace of the past week, about 0.35 percent of Minnesota adults have been getting their first dose each day. That means at the current pace, it'll take a little over a month to get that final 12 percentage points or so.
So if this holds, we can expect Minnesota's mask mandate to lift in early June.
Of course, there are plausible reasons to imagine this might come sooner or later than this target date.
On the optimistic side, Minnesota has shown the capacity to administer more than twice as many shots per day as we have been. Minnesota has been operating under constrained vaccine supply for weeks now. If supply were to go up, coupled with a PR campaign and various incentives, there's no reason Minnesota couldn't hit 70 percent and end the mask mandate before Memorial Day weekend.
On the other hand, Minnesota's vaccination rate has been trending downward. There's good evidence that most of the people who were enthusiastic about getting vaccinated already have been. That doesn't mean the remaining 40 percent of Minnesotans are anti-vaxxers, but they might be less eager, or busier, or less able to get to clinics, or have real or misguided concerns about cost or safety, or any number of other reasons. The idea that demand might continue to decrease as more of the population gets vaccinated is entirely plausible.
So any date from late May to July 1 wouldn't be too surprising for Minnesota to hit its 70 percent target.
If nothing changes to spur more demand, though, the pessimistic outlook may be more likely. I've argued for months now that supply has been the major constraint on vaccination rates in Minnesota, not demand.
But over the past week-plus, we finally have the first solid evidence that demand has fallen below even Minnesota's constrained supply.
That supply has been around 20,000 new first doses per week for a month now.
But for more than a week now, Minnesota has been administering an average of around 15,000 new first doses per day — considerably below its supply.
We don't know all the features behind this recent drop. I think we should understand it as two distinct drops, though, not one sustained fall from the mid-April peak.
That first decline, from mid-April to late April, represented Johnson & Johnson vaccines slowly falling out of the seven-day average, from more than 10,000 per day to zero, as first supply issues and then the "pause" turned off the spigot.
During this period, administrations of Moderna and Pfizer vaccines actually continued to rise. It's just that total vaccinations fell because the supply dropped.
But starting in late April, Pfizer and Moderna doses started to fall, too. Johnson & Johnson's return to the market has been in such small numbers that nothing has changed there. It's this new phase that finally has me thinking demand is becoming the dominant factor.
I would advise caution against over-interpreting this, at least for now. We don't know what the views are of this remaining 40 percent of adults, what factors have prevented them from getting vaccinated so far, and how many would choose to get vaccinated in the next few weeks if the supply is available.
No region of the state is yet at 70 percent of adults vaccinated, though Hennepin and Ramsey counties are close.
Note that this isn't quite a graph of what we care about — the share of the population 16 or older who've been vaccinated. The Census's dataset on age by county contains data on people 15 or older, and people 18 or older. I used the 15+ dataset as the closest analogue, but that means each of these lines slightly underestimates the share of Minnesotans 16+ with at least one dose.
Is the recovery stalling?
Minnesota's third COVID-19 wave peaked several weeks ago, but the news over the past week hasn't been as good. Cases continue to decline, but more slowly than they were a week or two ago.
And this decline in cases had happened at the same time that testing has fallen. Less testing finds fewer cases, so it's not at all clear how real this decline is.
To be clear, declining tests isn't a terrible thing. Fewer people get tested when fewer people have COVID-like symptoms or exposure to people with COVID, so we'd expect testing to fall as a wave recedes.
This just makes it hard to figure out how much the wave is actually receding, since we don't have tests from a representative sample.
When you account for the falling test total and falling case counts, Minnesota's positivity rate has actually been flat for some time, at around 4.9 percent.
Hospitalizations are probably a better metric for the severity of a disease where nearly half the population is already vaccinated (and more with resistance from a prior infection) — though they do lag behind cases as a metric by at least a few days. Here, the picture is rosier, with continued declines in both admissions:
And COVID-19 bed use:
Deaths continue to bounce around a bit. Overall they're up a bit from the lows we saw a few months ago, but haven't had any dramatic spikes.
Under the hood, though, something interesting is happening: deaths remain extremely low in long-term care facilities, but have risen in recent weeks for people outside these facilities.
Most long-term care residents are fully vaccinated. That doesn't provide 100 percent protection, especially for people as vulnerable as the elderly, but it has clearly made a huge difference in the death rate for this small but intensely vulnerable population.
In the non-institutional population, where vaccination rates are lower, the death rate has gone up a bit over the past month, as we might expect following March's spike in new cases.
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:
Children on path to have highest COVID-19 case rates
For most of the pandemic, the group with the most confirmed COVID-19 cases have been 20-somethings, followed by other adults, then seniors, and finally children.
This doesn't mean for sure that children have been infected less — it's possible that with generally milder symptoms, children with COVID-19 have been less likely to be taken in for testing.
But it's striking that now, cases are declining sharply in almost every age bracket except for children.
This is, to be clear, what we would expect given that only a fraction of this age group is eligible for vaccinations. But probably within the next week, we're going to see Minnesotans under 20 with the highest rate of new per capita COVID-19 cases in the state, for the first time ever.
A different way of tracking vaccinations by age
Periodically, I share a chart showing the rate of new COVID-19 vaccinations by age bracket:
But here's another way of looking at the data. This is more experimental, and frankly more confusing, but it does offer some unique insights, I think.
This is a chart of the rate of new vaccinations on the Y axis against the overall vaccination rate on the X axis. So you can see how fast each age group's vaccination rate when various shares of the population were vaccinated.
I've added some markers to indicate key dates.
So you can see that seniors saw their vaccination rates plummet at around 70 percent vaccinated. Adults 50-64 started to fall around 50 percent inoculated. This happened at around 33 percent for adults 18-49.
Don't over-attribute this to demand, though demand is likely a big picture here, with older adults more vulnerable to the disease. Remember that alongside demand, you had supply changing at different times, including both groups of adults starting to drop about the same time in mid-April as supply choked off.
But in conjunction with the chronological graph above, this gives a more complex picture of Minnesota's vaccination drive.
What's happening next?
These days, I'm just trying to find time to write these newsletters as often as I can! It's hard to think too ambitiously about what's coming next.
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