After 3 years of pandemic, Minnesota’s new COVID-19 phase still brings death and heartbreak

Libby Erickson is haunted by what she said to her 86-year-old mother as they celebrated a third Christmas amid the pandemic.

“We kept you safe,” she told her mother, Sally Albers, “for almost three years.”

Sally Albers tested positive for COVID-19 a week later amid an outbreak at her assisted living facility in Alexandria, Minnesota. The retired teacher died two days later on December 31, 2022.

Minnesota may have returned to some normality in the third year of the pandemic as people threw off masks and returned to offices, theaters and public places, but the threat remains as the state enters in the fourth year. Minnesota hasn’t had a day without a COVID-19 death since June 10, and it’s averaged six a day since then.

COVID-19 fell to the second most common cause of death in Minnesota in 2022, but it still led to the deaths of 3,174 people last year. The pace has slowed in 2023, but the 442 deaths from COVID-19 so far this year exceed the 418 deaths from seasonal flu in the past four years combined.

People wouldn’t accept the current death rate if it was due to cancer, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, but they do with COVID-19 because six deaths per day are not as shocking as 75 per day at the height of the pandemic.

Minnesota’s early COVID-19 response involved short-term inconveniences, such as mask mandates and limits on crowds, that could be dialed in in response to pandemic waves. What the state encountered in the past year was different — a steady toll too small to demand emergency action but too big to dismiss.

“What we have is this confusion,” Osterholm said. “How can we respond to that? How can we even talk about it? »

The elderly, or those with chronic illnesses or weakened immune systems, have been most at risk of severe COVID-19 from the start. The delta coronavirus variant exploited a lack of vaccination in healthier young adults in the fall of 2021, but even then 75% of COVID-19 deaths occurred in the elderly.

The risks have declined in all age groups since then, but not as much for the elderly, who account for 93% of COVID-19 deaths reported in Minnesota this year.

Erickson said her mother was an inspiration as a sympathetic special education teacher who even returned to work after her retirement when her school could not find a replacement. Erickson provided direct care for his mother, but moved her to an assisted living facility last spring when her job returned to in-person work and it seemed safer.

“We thought the pandemic was over, you know,” even though fast-spreading virus variants were still circulating, Erickson said. “We didn’t want to move her before that, because of everything that was going on in the facilities.”

“relatively healthy state”

Minnesota’s COVID-19 death rate ranks 12th among U.S. states and lowest among border states. Another 6,000 Minnesotans would have died if the state had South Dakota’s death rate.

Most states with low COVID-19 death rates have high vaccination rates and used lockdowns and mask mandates early in the pandemic to limit viral spread. However, this does not explain all the variations. New Mexico has one of the worst COVID-19 death rates in the country despite its aggressive response to the pandemic.

Race fueled disparities in COVID-19 death rates early in the pandemic, in part because minorities had more low-income service jobs that increased their risk of exposure. States with high COVID-19 death rates also tend to have high poverty rates and people with chronic conditions such as diabetes.

“Minnesota generally ranks as a relatively healthy state, and your underlying conditions are predictors of how well you’ll fare with COVID,” said Kathy Como-Sabetti, supervisor of the department’s COVID-19 epidemiology section. of Minnesota Health.

Michelle Mattfield remained cautious, even at age 36, as the wife of Crystal, Minnesota suffered from exercise-induced asthma, severe sleep apnea and other breathing problems. She quit her ground crew job at Minneapolis-St. Paul Airport a few years ago due to his disability and was living at home with his mother and boyfriend.

When all three tested positive for COVID-19, they sought out Paxlovid antivirals. Mattfield took her first dose before bed, but died in her sleep on December 30. Her mother, Marge Bergman, remains confused by her daughter’s quick death and upset that her doctor did not recommend immediate hospitalization.

“I’m trying to follow up and find out more,” she said. “I haven’t done much yet, just because of the shock.”

While sudden deaths related to COVID-19 are still occurring, doctors face a new challenge in deciding when to officially attribute deaths to prior infections.

COVID-19 can lead to long-term heart complications, which can make it difficult to later assess its role in death from heart disease, said Dr. Rozalina McCoy, a Mayo Clinic physician who studies the impact of the pandemic on death rates.

“I think we’re both going to miss COVID as a contributing cause and overstate it at the same time,” she said.

living with the virus

The changes have come and gone since Minnesota reported its first death from COVID-19 on March 19, 2020, in an 88-year-old St. Anthony woman.

The state’s free testing and vaccination centers have closed. Mayo Clinic’s COVID-19 modeling predictions are gone. Public displays have been removed.

Yellow paper hearts once adorned Edina Town Hall in remembrance of more than 100 residents who died from COVID-19. Souvenirs were recycled in January, with the exception of a few kept for families upon request.

“The hearts that had been up there for three years were pretty sun faded,” said Jennifer Bennerotte, the city’s communications director. “It was time to take them down.”

Infectious disease experts have said there is a danger in interpreting these signs as if the pandemic is over.

Osterholm said high-filtration masks and properly worn vaccine boosters can further reduce the risk of severe COVID-19.

“I’m 70 and have underlying health issues,” Osterholm said. “I was at the Bruce Springsteen concert with 18,000 people, but I had my N95 on. We’re learning to live with this virus in that regard.”

Updated guidance is expected from federal health authorities regarding the COVID-19 vaccination schedule, as the effectiveness of recent boosters may have diminished. British and Canadian authorities have authorized spring recalls for those most at risk of severe COVID-19.

Erickson said his family doesn’t need any more reminders that the pandemic persists. When her mother was infected, she suspected the worst. She put on protective gear and brought chicken and wild rice to her mother as they talked about the good old days in the family cabin.

Now Erickson’s brother has COVID-19 with a sister-in-law undergoing cancer treatment. As the sister-in-law recovers, she remains weakened.

“People are like, ‘If I get it, I get it’ these days, she said, “but it still has implications for those at risk.”

Data editor MaryJo Webster contributed to this report.