REGIONAL- Don’t look now, but community transmission of COVID-19 has reached a high level once again in St. Louis County, and the rate of spread is forecasted to remain high through much of the month.
It’s a marked change from the conditions as recently as last month, when the Centers for Disease Control, reported that all 87 Minnesota counties were experiencing low transmission. Yet, as of June 30, St. Louis County was one of nine counties that had jumped back into the high transmission category, while 31 others were experiencing moderate levels of community transmission. Mayo Clinic projections through July 16 point to continued high levels of transmission in St. Louis County, and increasing levels of transmission in Koochiching, Carlton, and Cook counties.
Despite the increasing transmission rates, the Minnesota Department of Health last week switched from daily to weekly reporting of COVID-19 information, due to the uncertainty of case data and shifting measures health officials use to track the pandemic’s severity.
More and more people have relied on home COVID tests in recent months, and positive results aren’t typically included in state reports, resulting in a significant undercount of cases. Hospitalizations, deaths, and sampling of wastewater for COVID virus levels are more heavily relied on now than in the past.
“As testing behaviors have changed to include more at-home testing and with the Centers for Disease Control (CDC) COVID-19 community levels focusing on severe disease, local disease activity, and related impacts, we are implementing more sustainable COVID-19 surveillance and data reporting efforts to align with the current state of COVID-19,” said a June 28 MDH press release. “These changes will still allow MDH to remain flexible and scale up response activities as needed.”
And with the highly contagious and vaccine-evasive B.5 Omicron variant becoming dominant this past week and numerous Minnesota counties shifting back upward to high levels of community transmission, that flexibility may be necessary in the days ahead.
CDC community transmission levels are based on a combination of case and hospitalization data, but an alternative CDC risk assessment using only case data paints a potentially troubling picture. Seventy-five of Minnesota’s 87 counties were reported as being at or above the high transmission level last week.
Monitoring of COVID virus concentrations in municipal wastewater systems also indicated a five-percent increase in northeast Minnesota last week.
The increased levels come at a time when the B.5 Omicron subvariant now accounts for 53.6 percent of the cases nationwide, and 54.5 percent in the region including Minnesota. Only a month ago, B.5 represented just nine percent of cases. Adding in cases caused by the B.4 subvariant, the pair is the cause of seven out of ten cases nationwide.
B.5 and B.4 are of particular concern because the subvariants have shown an ability to evade immunity from both vaccines and prior COVID infections. That significantly broadens the pool of people who could contract coronavirus for the first time or suffer a repeat infection. While cases are less severe overall than previous variants, health officials have said that the increased chance of getting COVID will likely result in more hospitalizations and deaths, though likely not to the degree seen in past waves.
But predicting long-term pandemic trends has often been difficult, as U of M infectious disease expert Michael Osterholm pointed out in a recent podcast.
“I’m not sure what to make of it all,” Osterholm conceded. “What will happen in the United States over the course of the upcoming weeks and months, based on what we’re seeing internationally, is in a large way a crapshoot. Regardless, I think most places can and should expect some rise in cases in the near future as these sublineages take off and for hospitalizations to grow as well.”
Osterholm pointed out that reinfections are of particular concern, with second and third infections increasing the risk of hospitalization and adverse health outcomes compared to a first infection, according to a recent study.
Vaccinations
The number of the youngest Minnesotans from six months through four years that have received first doses of the newly approved Pfizer and Moderna vaccines more than doubled in the second week of availability from 3,291 to 7,654, representing just two percent of eligible patients. Availability of appointments with primary care physicians and an overall “wait-and-see” attitude among a strong majority of parents of this age groups are contributing factors to the slow but steady rollout.
It will take from four to eight weeks for children to receive their second and final dose of the Moderna vaccine, while the three-shot Pfizer series will take up to 11 weeks to complete.
The number of people age 50 and over seeking a second booster shot has slowed somewhat as they consider whether to get the booster now or wait until fall. More appear to be willing to take their chances on waiting now that Moderna has announced a booster version with higher effectiveness against B.5 and B.4, which could be available by August. Current boosters show limited effects against the new subvariants, while still providing protection that diminished over time from other variants.
Overall, while 72.5 percent of Minnesotans have been completed their initial vaccine series, only 32.7 percent are up to date with recommended boosters.
Local data
The Timberjay has tracked weekly COVID case numbers from MDH for six North Country zip codes since early in the pandemic, but with the new state reporting format those numbers were not available for the past week. All six zip codes registered case increases across the prior three weeks.