Minnesota is experiencing one of the country’s worst COVID-19 outbreaks, despite a relatively high 68% vaccination rate for people over the age of 5.
The seeming contradiction has left many Minnesotans wondering why the number of cases is rising so quickly. Here are your questions about the COVID-19 peak in Minnesota, answered.
How bad is it?
Pretty bad. On Friday, Minnesota had the fourth-highest number of cases in the country, with 74 new cases per 100,000 people — surpassed only by Michigan (84 cases per 100,000), New Mexico (79 cases per 100,000) and New Hampshire (77 per 100,000). At one point in the week of November 15, we were the worst in the country.
Our number of cases, hospitalizations and deaths hasn’t been this high since this time last year, before the rollout of vaccines. That’s when the state experienced its biggest increase, with at least 4,000 new cases a day for much of November — and as many as 9,000 cases a day — and more than 60 deaths most weekdays in December. (There were typically fewer deaths reported over the weekend.)
Right now, we’re seeing about 22 deaths per day, based on seven-day averages, and about 4,000 new cases per day.
Hospitals are again overwhelmed as the surge pushes health workers to the brink, resulting in staff shortages and long wait times for care related to COVID-19 and other injuries and illnesses across the state.
Unvaccinated people are still much more likely to get sick and be hospitalized with COVID-19. As of early October — the most recent, complete data available from the state – 72,628 fully vaccinated Minnesotans had tested positive for COVID-19, or about 2.2% of vaccinated people. Of that group, 3,177 had been hospitalized, or less than 0.01% of vaccinated people.
However, Minnesota’s current wave is still not as severe as outbreaks in many southern states this summer. Louisiana, for example, saw growth rates peak at about 126 new cases per 100,000 residents in August, according to data from Centers for Disease Control. Mississippi and Florida also registered triple-digit cases growth.
Why is it happening?
The short answer: we don’t know for sure. A number of factors are responsible, said Dr. Rebecca Wurtz, a public health researcher at the University of Minnesota.
One-third of Minnesota’s population — or about 1.8 million people — is still unvaccinated.
“We know Delta will find you if you’re not vaccinated,” Wurtz said.
Vaccination rates are uneven across the state, leaving pockets where large swathes of people are extremely vulnerable to catching and spreading the virus. In 26 provinces, at least 50% of the population is not vaccinated. In five provinces the percentage is below 40%. However, low vaccination rates seem unrelated to recent high cases in some provinces. For example, both Jackson and Lincoln counties have vaccination rates of less than 50%, and their seven-day case rates are the lowest in the state, according to CDC data.
Immunity declines among people vaccinated in early 2020.
Many people are surprised that the number of COVID-19 cases is rising in Minnesota, given the state’s relatively high vaccination coverage, Wurtz said — nearly 70% of people over the age of 5.
Immunity seems to wane about six months after receiving the second injection of Pfizer or Moderna, or two months after receiving the Johnson & Johnson, which explains some of the increase, she said.
In addition, people at greatest risk of serious illness — those over age 65 or with underlying conditions — were vaccinated the earliest, meaning their immunity also started to decline the earliest.
“We knew the immunity would wane, but I don’t think we knew it would wane like a clock — right on schedule,” Wurtz said. “It’s just (happens) absolutely six months after people are vaccinated.”
About 2.2 million Minnesotans received two Pfizer or Moderna shots before May 20, and 293,000 received the one-shot Johnson & Johnson on September 20.
According to the state, about 715,000 people have received boosters, leaving about 30% of the state’s population vulnerable to getting sick at this point in the year, despite being vaccinated.
The highly contagious strain Delta is still widely circulating.
The Delta variant may be two times more contagious than previous variants, studies suggest, and may have a higher risk of serious illness. According to the CDC, it now accounts for more than 99% of cases in the United States.
Vaccines seem to offer less protection against the Delta variant, according to a recent study of nearly 800,000 US veterans, although they are still effective at preventing infection and reducing the chance of hospitalization or death.
In addition, the vaccines don’t seem to prevent people from transmitting the virus in breakthrough cases as experts had hoped, Wurtz said. Fully vaccinated people aren’t as contagious as unvaccinated people, but they’re still “pretty contagious, especially with this Delta variant,” she said.
We spend more time indoors.
Some experts have suggested that cold weather is the cause, as the virus is more likely to spread indoors. Wurtz isn’t convinced this is a significant factor, however, as it doesn’t explain patterns across the country.
“States that were on fire this summer — Florida, Texas, the south — are no longer on fire, and no one knows why,” Wurtz said. “There are more people inside now than in the summer, and they don’t experience what we are.”
Many of us lower our vigilance.
Unlike earlier this year, social distancing and masking are optional in many places, there are no longer any restrictions on indoor dining, and major events such as concerts, sporting events and weddings are back – although some have introduced vaccination or testing policies.
“Unfortunately, it is clear that many people are done with the pandemic, even though the pandemic is not over yet,” said University of Minnesota epidemiologist Michael Osterholm. told MPR News.
What precautions should I take?
Mask on, get vaccinated if you haven’t already, and get the booster six months after your second Pfizer or Moderna shot, or two months after your Johnson & Johnson shot. Boosters are available to everyone in Minnesota – call your doctor to see if they offer them, or find one here.
It’s also time to brake on riskier outings, including indoor events and anything with big crowds, Wurtz said. She said she personally doesn’t feel comfortable eating in a restaurant, going to a concert or a movie right now, but she’s fine with going to the supermarket or shopping in a mask.
Wurtz said she also feels comfortable having maskless Thanksgiving gatherings with fully vaccinated people who have no symptoms.
Minnesotans should also consider limiting potential exposures prior to holiday gatherings, especially if they plan to get together with people prone to serious illness or death, Wurtz said. She expects this wave to last at least until mid-January.
“We’re in this weird threshold phase that could last until January,” she said. “We need to step back a little bit, waiting for the next six weeks or so, and be more careful about our social circles and the events that we think are worth the risk of being exposed.”