COVID-19 cases and hospitalizations are declining in Minnesota

COVID-19 cases and hospitalizations are declining in Minnesota on the downside of the omicron pandemic wave while daily deaths have plateaued.

The 1,239 COVID-19 hospitalizations in Minnesota on Friday were a 24% decrease from Jan. 19 and eased pressure on the state's medical bed capacity. Hospitalizations of COVID and non-COVID patients declined to 7,727 Friday.

The relief is good news for beleaguered hospitals, which have fewer staff than at the start of the pandemic because of burnout and other factors, state Health Commissioner Jan Malcolm said.

"The omicron surge when it hit just really further exacerbated the staffing crisis in our hospitals," Malcolm said on Monday, addressing a Senate health committee about a $40 million contract to backstop understaffed hospitals with temporary nurses.

Malcolm said a $7.5 million decompression plan has helped as well by opening five makeshift transitional care sites to which hospitals can discharge recovering patients. In-home monitoring programs also have allowed hospitals to discharge patients more quickly and free up inpatient beds.

Four sites were opened in long-term care facilities to provide step-down care to non-COVID patients and a fifth was opened last week in Regions Hospital in St. Paul for COVID-19 patients who no longer needed inpatient care. The number of patients waiting four or more hours in emergency departments for inpatient beds has declined from more than 200 per day in early January to 93 at month's end.

"Four hours to wait in an ED for a bed is a long time" and has been associated with poorer health outcomes, Malcolm said.

The Minnesota Department of Health on Monday reported another 35 COVID-19 deaths, including two people in their 40s from Dakota and Ramsey counties. The additions raised Minnesota's toll in the pandemic to 11,634 but revealed a leveling off of COVID-19 deaths. Minnesota reached an average of 30 COVID-19 deaths per day in the week ending Jan. 10, but the rate has remained below that mark ever since.

Minnesota had the 15th highest rate of coronavirus infections among states over the last week as the omicron wave arrived and peaked earlier in other parts of the U.S. The state on Monday reported 5,829 more infections, but a decline in the positivity rate of COVID-19 testing from a peak of 23.6% on Jan. 10 to 16.7% in the seven days ending Jan. 28.

State breakthrough data on Monday showed COVID-19 vaccine remained protective against severe outcomes at the outset of the omicron wave, though less so without booster doses. People who completed at least the initial COVID-19 vaccine series made up 63% of the 79,401 coronavirus infections in the week beginning Jan. 2 — when omicron replaced delta as the dominant coronavirus strain.

Fully vaccinated people made up only 49% of the 153 COVID-19 deaths reported that week, but that rate was below 30% in late November and early December during the delta wave. The risk for severe COVID-19 outcomes remains highest in unvaccinated people, who make up the majority of hospitalizations and deaths but only 33% of the state's total population and 23% of its adult population.

Federal and state health officials urged eligible people to get vaccinated and take confidence in last week's full approval of the two-dose Moderna COVID-19 vaccine for adults. Immunity appears to wane around six months after initial doses, so additional booster doses are recommended. Minnesota ranks second among states with nearly 55% of fully vaccinated people receiving boosters.

The omicron wave met predictions by causing record infections, which in turn caused severe COVID-19 and hospitalizations. However, the number of COVID-19 hospitalizations requiring intensive care declined from 371 at the peak of the delta wave to 199 on Friday.

Malcolm said limited supplies of two new antiviral pills and COVID-19 monoclonal antibody infusions have helped, though antibody supplies became scarce in December when two of three types proved ineffective against the omicron variant.

Minnesota was allocated a weekly shipment on Jan. 10 of only 462 courses of sotrovimab, the remaining effective antibody, forcing the state to implement a lottery to select the highest-need patients for infusions. The supply increased to 960 on Jan. 31, allowing the state to end the lottery last week but still prioritize infusions for the neediest patients.

Malcolm said it was good fortune that an older antiviral, remdesivir, which was less effective against the delta variant, proved effective against omicron. The Food and Drug Administration last month expanded the use of remdesivir as an outpatient treatment to prevent severe COVID-19 and hospitalizations.

Minnesota's long-term outlook in the pandemic depends partly on other variants and how they interact with vaccines and treatments, Malcolm said. "That's the wild card. Will there be more variants? What will they be like?"

Sewage sampling at the Metropolitan Wastewater Treatment Plant in St. Paul has looked for a BA.2 omicron subvariant that has raised concerns because of its faster spread. No sign of that subvariant was detected last week.