Minnesota's COVID-19 fatalities trend younger. Most were unvaccinated.

Oct. 27—Whenever the Minnesota Department of Health is notified of a death that is suspected to have been caused by COVID-19, Rich Danila logs the pertinent details into a notebook.

Nearly 20 months into the coronavirus pandemic Danila, the deputy state epidemiologist with the Minnesota Department of Health, has filled 18 of those notebooks with the details of more than 8,500 COVID deaths.

During the first year of the pandemic, before vaccines were available, the vast majority of deaths were among the elderly and people with serious underlying health conditions.

Now, more often, some of fatalities health officials are investigating are people who are younger and relatively healthy. They typically have one thing in common — they're unvaccinated.

"These deaths are preventable and didn't have to happen," Danila said. "Many of the more recent deaths in younger individuals — in their 20s, or 30s, 40s, 50s, — are persons who are not medically fragile."

'ONE OF THE MOST BEAUTIFUL SOULS'

Jeana Gullickson, a 26-year-old personal care attendant from Wabasso, was one of those COVID-19 deaths.

Gullickson got sick just after her 26th birthday and had been staying home from her job where she worked overnight and overtime to care for vulnerable people since the start of the pandemic.

"Her whole heart was in taking care of (her patients)," her sister Jennifer said. "They were like her family."

She experienced pneumonia-like symptoms about a week after first feeling ill and died at home just before 2 a.m. on April 19, just as vaccines were becoming widely available.

"It went so quick," Jennifer said.

Gullickson wasn't yet vaccinated, but she planned to be. Acute respiratory distress, pneumonia and COVID-19 are listed on her death certificate as the causes of her death.

She had no underlying health conditions that contributed to her death.

Her sister described her as a selfless person with a contagious smile who loved her family unconditionally.

"She was one of the most beautiful souls," Jennifer said.

Jeana had been engaged for a few years and was planning on setting a date for the wedding when she contracted COVID-19. She had just bought a house with her fiancé and was working on getting her GED.

WHAT THE DATA SHOWS

Throughout 2020, the average age of someone who died of COVID-19 was about 83. That average has declined by almost a decade in 2021 to about 74-years-old.

Early in the pandemic, nearly all of those who died were seniors or had multiple underlying health conditions that put them at serious risk of severe infections. This year, about 23 percent list no underlying conditions that contributed to a COVID-19 fatality.

Minnesota started vaccinating seniors and vulnerable adults in late 2020. By this past spring, all adults could get the shot and by summer teens were eligible.

As of Thursday, 73 percent of eligible residents had received at least one shot. About 62 percent of the state's total population has received at least one vaccine dose.

But a Pioneer Press analysis of vaccination records shows that rates vary considerably by county. Often, vaccinations are lowest in rural counties with fewer people where the impact of the pandemic might be harder to see.

It's those same rural counties that have some of the highest rates of COVID-19 deaths per capita.

"The overwhelming majority of people, when we have their vaccination status, who are dying are unvaccinated," said Elizabeth Schiffman, co-leader of the state Department of Health COVID-19 mortality tracking team.

But not all are unvaccinated. State health officials report 331 fully vaccinated Minnesotans were among the roughly 3,200 people who died of COVID-19 this year.

However, the true rate is not entirely clear because of limited information released by state health officials.

Health providers' frustration with unvaccinated patients is growing, Schiffman says. "We are actually seeing it documented right in the medical record — patient is unvaccinated."

Health officials are also documenting why people who've died from COVID-19 haven't gotten the vaccine.

"There's a whole wide spectrum of why people are unvaccinated," said Leslie Kollman, co-leader of the state Department of Health COVID-19 mortality tracking team. "They didn't want to, they don't believe in it, didn't have time, don't trust things."

Vaccination status is not included in the death records publicly available from the state Office of Vital Records. But health officials on the COVID-19 mortality team have access to other databases that include whether someone was vaccinated.

Danila, the deputy state epidemiologist, added that the mortality tracking team has also seen fatalities of patients who have refused proven medical treatments like monoclonal antibodies and the antiviral remdesivir.

"But have insisted, I guess until their dying breath, on things like ivermectin or vitamin D, vitamin C, zinc," Danila said. "Over the last six to eight weeks we have seen more and more of that in medical records."

HOW DEATHS ARE CLASSIFIED

In order to be included in Minnesota's COVID-19 death toll, a fatality must meet several standards investigated by the mortality team. Among them is having COVID-19 listed as a primary cause of death on a death certificate and also having a positive COVID-19 test.

Fatalities where a coronavirus infection is suspected, even listed on the death certificate, but never confirmed, is considered "probable" by state health officials.

Danila believes his team's work is more thorough and accurate than any other state in the nation. Every fatality is investigated.

"There's no other state in the nation that puts as much resources into theirs as we do," he said. "Our data in Minnesota is probably the most accurate in the country."

He scoffed at accusations that the death rate was somehow inflated or manipulated.

"This is the worst pandemic we've had in 100 years," Danila said. "We don't need to gin up deaths."

But there are times when reporting a COVID-19 fatality is delayed. Typically, that's because the team receives incomplete information or the filing of certain records by those who initially handled the fatality are delayed.

"It is possible that deaths get reported to us six months after they happen and then we investigate them as soon as we can," Schiffman said. "I think the big delay is waiting for information and making sure we have all the pieces."

A LAGGING INDICATOR

There are increasingly positive signs that Minnesota's fourth wave of coronavirus cases, now more than two-months-old, may be starting to ebb. But fatalities might not slow right away.

Deaths are considered a lagging indicator of a surge and typically are highest weeks or months after cases have spiked. COVID-19 fatalities have been higher in early October than almost anytime in 2021 — with the exception of January when the state's worst surge was receding.

Danila, Schiffman and Kollman are hopeful this will be the last spike in COVID-19 fatalities. But they're worried refusals to get vaccinated, rejection of mitigation measures like mask wearing and the overall anti-science attitudes in many communities could leave the state open to another surge.

"Stop the mentality that it is over," Kollman said. "I think that is a huge problem in a lot of communities. That life is back to normal when it is not."

Danila adds that so many of the death health officials are now investigating were preventable.

"Each one is a person who someone loved and cared for and who didn't have to die," Danila said. "It's really hard to see this go on like this."