Minnesota's rate of new coronavirus infections has dropped to 30th among U.S. states, but health officials remain concerned that holiday gatherings or the omicron variant could fuel a resurgence.
The decline at least provided temporary relief for Minnesota hospitals, which reported a drop in COVID-19 hospitalizations from 1,678 on Dec. 9 to 1,313 on Dec. 30. However, the decline could be short-lived — with the state's reported positivity rate of COVID-19 testing yo-yoing from a high of 11.5% to a low of 8.3% and then back to 8.9% last month.
State health leaders expected some increase in COVID-19 activity after the holidays — as occurred last year — but said omicron presents a new challenge that could disrupt Minnesota's progress and stretch hospital resources again.
Omicron might produce a lower rate of severe illness than other variants, but its rapid spread — even in people with immunity from vaccination or previous infection — could sideline swaths of critical workers at once, said Michael Osterholm of the University of Minnesota's Center for Infectious Disease Research and Policy.
The goal is to "limit transmission so that we don't create these very challenging conditions in our communities where people are at risk," he said. "We're hearing from pharmacies that are now putting notices out that it may take three to five days to fill prescriptions because so many pharmacists are out, so many truck drivers delivering the medications to local pharmacies ... are out."
Osterholm encouraged people to seek COVID-19 vaccinations and boosters — with the Food and Drug Administration approving boosters for the 12-15 age group on Monday — and take other measures to reduce infections. Most people could become infected with omicron over time. But delaying that eventuality reduces the exponential spread of the virus and buys time for drugmakers to produce more of the recently approved COVID-19 oral medications.
"We're never going to stop infections," he said. "What we can do though is greatly limit the number of infections, which then means less transmission" and less severe illness.
Minnesota's decline in the ranking of COVID-19 case rates is partly a function of other states seeing a renewed surge in coronavirus activity because of omicron. Florida and Missouri had severe COVID-19 waves caused by a delta variant in the summer and then low viral spread in the fall during Minnesota's wave. Both now have fast-rising infection rates — with Florida tripling Minnesota's rate of new infections over the past week.
However, the toll of the pandemic remains severe in Minnesota, which on Monday reported another 48 COVID-19 deaths and 6,780 coronavirus infections. The additions raise Minnesota's pandemic totals to 10,564 COVID-19 deaths and 1,028,986 infections. While more than 85% of total COVID-19 deaths in Minnesota were seniors, the additions on Monday included seven people 49 or younger.
Immunity levels are elevated in Minnesota right now because of recent vaccination progress and the prolonged fall delta wave, creating the optimistic possibility of a less severe omicron wave when compared with other states.
Mayo Clinic's COVID-19 model is pessimistic, though, recently revising its forecast from a seven-day average of 106 cases per 100,000 people in Minnesota on Jan. 12 to 137. If true, that would double the current rate of 60 cases per 100,000 and exceed the pandemic record of 125 in November 2020.
The model projects with 95% certainty that Minnesota will quickly surpass that peak rate, and that it could be worse if people don't try to limit transmission through vaccination and mask-wearing, said Curtis Storlie, a data scientist who leads pandemic modeling efforts at Mayo Clinic.
"If everyone who is eligible could go get a booster, that would help them, that would help their family and that would help the state as a whole," he said. "We haven't seen a rise like this yet in our state."
The burden on hospitals is unknown because omicron appears to cause less severe illness, but Mayo's modeling suggests it's likely that it will increase. Storlie said hospitalizations might continue to decline for several days before increasing.
"The fact that omicron is putting fewer people in the hospital on a case-by-case basis doesn't help us all that much when we're talking about that many cases," he said. "We're still going to see a rise in hospitalizations for an already stressed system. Staff absences are going to become a substantial issue everywhere."
Breakthrough infections in fully vaccinated Minnesotans have been increasing. The state reported that 45% of the 28,120 infections in the week ending Dec. 4 occurred in unvaccinated Minnesotans. However, only 29% of the 1,336 COVID-19 hospital admissions that week involved fully vaccinated people — and that rate has been declining since booster doses became widely available to address waning immunity of initial doses.
The majority of COVID-19 deaths and hospitalizations are occurring among unvaccinated Minnesotans, even though they make up only 35% of the state's population.
A high rate of breakthrough infections will be likely during the omicron wave, but the hope is that vaccination will continue to reduce severe illness and hospitalization, Osterholm said.
"There's no question about it, there is going to be widespread transmission here," he said. "The question is whether we are going to have a lower proportion of serious illnesses."
