What we know about COVID-19 — and what we don’t – TwinCities.com-Pioneer Press

After more than 2,000 COVID-19 deaths and nearly 100,000 infections in Minnesota, there’s still a lot doctors and health officials don’t know about the pandemic that has upended life here and around the globe.

Doctors and health officials are confident that older people and patients with certain pre-existing conditions are at the greatest risk of serious coronavirus infections and dying of COVID-19.

In Minnesota, 92 percent of the state’s deaths were patients age 60 or older and most of those fatalities, at least 1,435 people, lived in long-term care facilities. About 95 percent of those who died had serious underlying health conditions.

But young, otherwise healthy Minnesotans are dying, too.

About 8 percent of Minnesota’s COVID-19 deaths were under the age of 60. State death records show that with at least 16 of those fatalities, the patient did not have an underlying health condition that put them at higher risk.

For another 13 deaths, the impact of other health problems was undetermined.

Minnesota’s pandemic has also had a disproportionate impact on communities of color. Black and Hispanic Minnesotans are more likely to catch the coronavirus, need to be hospitalized or die of COVID-19 than their white neighbors.

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Additionally, doctors are discovering troubling, long-term health problems in some recovered coronavirus patients, even those who had mild cases.

Essentially, while scientists are learning more each day about this new coronavirus, there is much we still don’t know.

“I think we have learned a great deal in the last difficult eight or nine months,” said Jan Malcolm, Minnesota’s health commissioner. “Including the ways that risk for severity or even death might be more nuanced than we first thought.”

Malcolm noted that while most people who contract the virus recover, there are still a lot of unknowns about the long-term impact a COVID-19 infection.

“We have definitely learned about the disproportionate impact of the disease on certain communities and on vulnerable populations,” Malcolm added.


When Minnesota first started identifying coronavirus infections in March, health officials aimed much of the state’s limited virus testing at older residents and those with serious underlying health problems.

Federal data suggest as much as half the U.S. population has underlying health problems of some kind. Heart and lung diseases, cognitive disorders and diabetes are among the most common conditions contributing to COVID-19 fatalities.

Early on, long-term care facilities, such as nursing homes, assisted living, group homes and rehabilitation centers, were the epicenter of the pandemic, accounting for most of the cases and deaths.

The long-term care sector already faced significant staffing challenges and facilities struggled to prevent and contain outbreaks. Minnesota has a larger percentage of its COVID-19 deaths in long-term care than all but two other states.

At its peak in mid-May, Minnesota was recording about two dozen deaths per day. Most of those deaths were older residents living in long-term care.

As testing capacity improved, it was clear younger and middle-aged Minnesotans were also transmitting the coronavirus in large numbers.

After Gov. Tim Walz’s “Stay at Home” order was lifted in June, Minnesota’s outbreak began to shift. Test results made clear that young and middle-aged residents were transmitting the coronavirus at gatherings, many of which were in defiance of public health guidelines.

In the spring, the median age of Minnesota’s coronavirus patients was about 44 years old, the median age of hospitalized patients was 61 and the median age of those who died was 83.

As autumn begins, the median age of virus cases is now 35, but the median ages of those who are hospitalized or died has only declined slightly.

Minnesotans in their 20s are now the age group with the most cases with nearly 22,000 infections. Health officials worry younger Minnesotans will infect older, more vulnerable residents.

“It can spread from people who don’t have symptoms, and it can result in the very rapid decline of patients who are older and patients who have (underlying health issues),” said Dr. Ruth Lynfield, state epidemiologist.


Throughout the pandemic, Minnesotans of color have been at greater risk of contracting COVID-19, having a serious infection and dying of the disease.

For example, Black residents account for about 6 percent of the state’s population and were 18 percent of coronavirus cases, 22 percent of hospitalizations and 10 percent of fatalities. Hispanics are 5 percent of the state population and 16 percent of coronavirus cases and 15 percent of intensive care admissions.

The disparity is even more stark in younger patients. Of those under 60 who died, 53 percent were people of color.

State health officials are working to uncover why those disparities exist. They believe barriers to health care and jobs with higher chances of work-related exposure are key reasons why Minnesotans of color are contracting COVID-19 at higher rates.


There’s been a ton of debate about SARS-CoV-2, the official name of the new coronavirus, and how it compares to seasonal influenza. There’s a lot of similarities in the symptoms and there’s a lot health workers still don’t understand.

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