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As Minnesota’s COVID-19 numbers continue to go the wrong way, state public health officials on Monday strongly suggested Minnesotans rethink their plans for traditional year-end holiday gatherings, saying those celebrations simply may be too risky in a pandemic.

Many of the state’s outbreaks are being fueled now by the kinds of informal get-togethers with friends and family that multiply during the November and December holidays.

Because of that, “it’s a really good time to consider not having the same kinds of gathering that you would in the past,” said Health Commissioner Jan Malcolm told reporters, acknowledging the painful reality of that advice.

“The transmission is everywhere, not just one or two sources or one or two kinds of settings. It’s the individual decisions that we’re all making fueling the rate of increase we’re seeing,” Malcolm cautioned. “We need to take this seriously.”

Malcolm’s remarks came hours after her agency reported active, confirmed cases of the disease climbing to record highs in the pandemic. 

While testing for the disease remains strong, it doesn’t explain the current case growth. Cases are growing more quickly than tests, and the rate of positive tests is staying above 5 percent, the threshold officials find concerning.

“We are seeing faster growth in cases than in testing. We’re still not able to catch all the disease that’s out there,” Malcolm said. “The rate of viral presence is still very high and growing.”

Of the 124,439 cases of the disease confirmed in the pandemic to date, about 88 percent have recovered to the point they no longer need to be isolated.

Five deaths reported Monday raised Minnesota’s toll to 2,239. Among those who’ve died, about 70 percent had been living in long-term care or assisted living facilities; most had underlying health problems. 

While reported deaths were in single-digits Monday, the death toll has risen significantly over the past 10 days.

Officials had anticipated seeing an October surge in cases expected from Labor Day weekend gatherings, sporting events and college student meetups at the start of fall semester. They also expected the wave would put more people in the hospital. That appears to be happening.

While surges early in the pandemic were driven largely by illnesses tied to long-term care facilities and workplace sites such as meatpacking plants, officials say the current spread is diffused, making it even harder to trace and isolate cases.

“Going out for happy hour after work with your coworkers or getting together with a bunch of friends that you haven't seen for awhile, all of that seems pretty innocuous. But in reality all of those different interactions can lead to transmission,” Kris Ehresmann, the state’s infectious disease director, told MPR News on Monday.

She said officials are concerned Minnesotans, fatigued by more than seven months of trying to stay vigilant, are letting their guard down in private settings, even as the virus spreads.

Later Monday, Ehresmann said Minnesotans should think about holiday gatherings of 10 or fewer this year instead of big potluck dinners across multiple families.

She and Malcolm again implored Minnesotans to take personal responsibility to stem the spread of the disease, including wearing masks in indoor public spaces, socially distancing and staying home if you feel ill.

Here’s what to do

What's behind the Midwest COVID-19 surge?

New cases are up dramatically over the past month in all age groups. That includes a concerning rise in the number of new cases among Minnesotans ages 60 and older.

People in their 20s still make up the age bracket with the state’s largest number of confirmed cases  — more than 28,000 since the pandemic began, including nearly 16,000 among people ages 20-24. 

The numbers help explain why experts remain particularly concerned about young adults as spreaders of the virus.

While less likely to feel the worst effects of the disease and end up hospitalized, experts worry youth and young adults will spread it to grandparents and other vulnerable populations and that spread could hamper attempts to reopen campuses completely to in-person teaching. 

The number of high school-age children confirmed with the disease has also grown, with more than 11,400 total cases among children ages 15 to 19 since the pandemic began. 

Cases surging outside the Twin Cities metro area

Regionally, central, northern and southern Minnesota have driven much of the recent increase in new cases while Hennepin and Ramsey counties show some of the slowest case growth in the state. 

Central Minnesota cases are leaping relative to its population. It’s not clear why. Northern Minnesota, once by far the region least affected by the disease, has also seen its caseload grow dramatically in recent weeks. 

Collectively, rural areas of Minnesota continue to report the most new COVID-19 cases.

Surge tied to everyday gatherings

With case counts surging across the Upper Midwest and other parts of the country, Americans should not plan on traveling to visit relatives for upcoming holidays to prevent the virus from spreading, Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said Sunday on NBC's "Meet the Press." 

In Minnesota and across the country, COVID-19 has hit 

communities of color disproportionately hard

Minnesotans of Hispanic descent are testing positive for COVID-19 at about five times the rate of white Minnesotans. They, along with Black Minnesotans, are also being hospitalized and moved to intensive care units at higher rates than the overall population.

Similar trends hold true for Minnesota’s Indigenous and Asian residents. Counts among Indigenous people have jumped in October relative to population.

Last week’s numbers also show newly confirmed cases continuing to accelerate among Latino people in Minnesota.

, together with deeply rooted health and economic disparities, have hampered efforts to boost testing among communities of color, particularly for unauthorized immigrants who fear their personal information may be used to deport them. 

A DFL state senator is in the quarantine phase after testing positive for COVID-19.

Sen. Dan Sparks of Austin said he test he took Oct. 8 came back positive. He sought the test after experiencing flu-like symptoms a few days earlier.

Sparks didn’t come to the Capitol for the recent special session and says he’s been doing his work remotely. A few other lawmakers have disclosed their own bouts with the virus since this spring.

Osterholm: Next 6-12 weeks will be 'darkest of the entire pandemic'

A University of Minnesota expert on infectious disease said that while coronavirus vaccines are in development, he's predicting that the worst of the pandemic is yet to come.

"The next six to 12 weeks are going to be the darkest of the entire pandemic," Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said Sunday on NBC's "Meet the Press." 

"Vaccines will not become available in any meaningful way until early to third quarter of next year and even then half the U.S. population at this point are skeptical even taking the vaccine,” he added.

Osterholm said the trend in case increases is going in the wrong direction heading into winter, and he that the nation still is lacking a strong unified message on how best to combat COVID-19. He said Americans should not plan on traveling to visit relatives for upcoming holidays to prevent the virus from spreading.

Smith tests negative after event attendee gets COVID-19

DFL Sen. Tina Smith said she’s tested negative for the coronavirus after learning someone at a recent campaign event now has COVID-19. 

Smith briefly quarantined after learning of the potential exposure. But the senator said she was never in close contact with the person. Masks were required at the outdoor event held more than a week ago.

Smith announced Monday that she had a new test that didn’t detect the virus. She said she would travel back to Washington for Senate proceedings.

Minnesota health care leaders say they're concerned the rapid spread of the coronavirus will cause staffing problems at clinics and hospitals.

Hennepin Healthcare CEO Jennifer DeCubellis told reporters Friday the problem isn't so much nurses, doctors and other employees being exposed to patients with COVID. She said staff are contracting the virus outside of their workplaces.

"Community spread is not just a community problem — it's a health care problem," she said. "When our workers have exposure or their family members do — just like everybody in the community, they need to quarantine. That takes them out of providing that critical health care service."

DeCubellis said staff exposures to the coronavirus from the community have more than doubled in recent weeks.

Capitol event called off after state inquiry about compliance with pandemic-related rules

Organizers of a planned Women's March event at the Minnesota Capitol on Saturday said they called it off after being warned about state rules for large gatherings amid the pandemic.

 that the Attorney General's Office contacted organizers and "we were told we were facing a $25,000 fine if we didn’t limit the event to 250 people, get names and contact information (for contact tracing) and 9 pages worth of other restrictions."

Attorney General Keith Ellison’s office said Saturday that it made a "routine inquiry" to event organizers to make sure the event was in compliance with pandemic-related state requirements. It said it encouraged organizers to take steps to meet those requirements.

"The Attorney General’s office, the Department of Health, and the Department of Labor and Industry have contacted more than 70 large indoor and outdoor public events across Minnesota in the last several months — everything from sporting events and car shows to flea markets, campaign events, and dog shows — to make sure they are complying with requirements to stop the spread of COVID-19," Ellison's office said in a statement. "This work is all the more important now with the recent spike in cases in Minnesota and the dramatic spikes in the states that border Minnesota."

State officials said they're focused on education — and that to date, they've only taken enforcement action against one event, the 

Women's March events did take place Saturday in several other communities around the state as well as hundreds of cities nationwide. Organizers of the Capitol event said they're planning an online event on Nov. 1 in place of the canceled gathering.

More free testing sites scheduled around Minnesota

As Minnesota continues to see more than 1,000 newly confirmed COVID-19 cases a day, state health officials are planning another round of free testing sites this week.

They said the testing is vital to determining the spread of the coronavirus across the state.

Free testing will take place Tuesday, Wednesday and Thursday in Crookston, Montevideo and Monticello, as well as Wednesday and Thursday in Cambridge, and Thursday and Friday at St. Peter's AME Church in Minneapolis.

Find more details — and schedule an appointment — on the 

Officials said the free testing sites are targeted to areas with COVID-19 outbreaks, or barriers to accessing existing test sites.

Free saliva testing sites are now open in Duluth, Winona and Moorhead — with a Brooklyn Park location scheduled to open Tuesday. 

Anoka’s huge Halloween festival returns to its roots amid pandemic:

 This year marks a century of Halloween celebrations for the Twin Cities suburb. While COVID-19 is forcing Anoka to rein in many of its traditions, the 2020 festival has not been canceled. Here’s what the “Halloween Capital of the World” has planned.

COVID-19 cases tied to MN campaign events — but full impact is unclear:

 Sixteen cases stemmed from President Donald Trump’s Sept. 18 rally in Bemidji — and four more from the protests outside. So far, only three cases have been traced to Trump’s Sept. 30 rally in Duluth. And one case has been connected to Democratic challenger Joe Biden’s campaign stop at a union training center in Duluth.

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As Minnesota’s COVID-19 numbers continue to go the wrong way, the state’s health commissioner on Monday urged Minnesotans to rethink their plans for traditional year-end holiday celebrations.

MPR News reporter Catharine Richert provides an update on the COVID-19 pandemic

A sign reads "reads COVID-19 testing site appointments"

Derek Montgomery for MPR News file

Active, confirmed COVID-19 cases in Minnesota

David H. Montgomery | MPR News

New COVID-19 related deaths reported in Minnesota each day

Graph of new ICU and non-ICU COVID-19 hospitalizations

Percent of COVID-19 tests to come back positive

New Minnesota COVID-19 cases by age, adjusted for population

MN counties with the fastest per-capita growth in COVID-19 cases

Oct. 19 update on COVID-19 in MN: Big holiday gatherings too risky?

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