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COVID-19 continues its surge to alarming new highs in Minnesota. 

State health officials on Thursday reported 7,228 newly confirmed or probable cases — the first time the daily count has crossed 7,000. 

That pushed the state above 200,000 confirmed cases in the pandemic, with about 37,000 of those coming in just the past seven days. 

The agency reported 39 more deaths from the disease, the second-highest ever behind only 

. The seven-day average is up to 34 deaths a day.

The seven-day hospital admissions trend rose to a record, crossing 200 for the first time in the pandemic. 

Minnesota public health leaders for weeks have warned the state’s skyrocketing COVID-19 caseload would bring more hospitalizations and deaths. Those warnings are coming to pass. The past week has brought a succession of new highs in cases, hospitalizations and deaths.

The disease’s rampant spread is being fueled by informal gatherings and get-togethers with family and friends, transmitted unknowingly by people who have the virus but do not have symptoms, officials say. 

State officials say that’s been especially true among 18- to 35-year-olds, who are the most likely age group to unwittingly transmit the virus. This week, the state launched a push to get more people in that age group tested regularly, opening additional saliva testing sites around the state and announcing a statewide program that allows people to order and conduct saliva tests in their home.

"This is just inevitable if we do not change our behaviors and take some mitigation efforts, this will continue to spike,” a frustrated Gov. Tim Walz said Wednesday, a day after he 

 on late-night social life to stem the spread of the disease. 

Earlier Thursday morning, Walz told the state’s executive council that Minnesota is on pace to reach 300,000 cases by Thanksgiving.

Of the 201,795 confirmed or probable cases identified in the pandemic to date, about 79 percent have recovered to the point they no longer need to be isolated.

The deaths reported Thursday raised Minnesota’s toll to 2,793. Among those who’ve died, about 69 percent had been living in long-term care or assisted living facilities; most had underlying health problems.

New cases have been spiking the past two weeks in all age groups.

People in their 20s still make up the age bracket with the state’s largest number of confirmed cases  — more than 43,000 since the pandemic began, including nearly 24,000 among people ages 20-24. 

The number of high school-age children confirmed with the disease has also grown, with nearly 17,000 total cases among children ages 15 to 19 since the pandemic began. 

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

Although 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. 

It’s especially concerning because people can have the coronavirus and spread COVID-19 when they don’t have symptoms. 

Walz on Tuesday said the state has data showing infection rates rising around bar and restaurant activity after 9 p.m. among people ages 18 to 35, noting that people who have the virus but don’t have symptoms are unwittingly spreading it.

“This is dangerous because we can’t see it,” Walz said. “They are not sick,” he said of asymptomatic people, “but they are infected and they are contagious.”

Virus surges in swaths of rural Minnesota

Regionally, central and northern 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. 

Northwestern Minnesota no longer has the state’s fastest-growing outbreak. It’s been passed by east-central Minnesota. But new cases are rising at accelerating rates nearly everywhere.

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

MN critical care doctors sounding the alarm

In Minnesota and its neighbors in Upper Midwest

Northern Minnesota, once the region least affected by the disease, has also seen its caseload grow dramatically in recent weeks. 

In Itasca County in northeastern Minnesota, COVID-19 cases are surging to the point that county health officials have suspended individual contact tracing, citing a record high rate of infections through community transmission.

“If you are in a group setting, just assume that someone has COVID,” said Kelly Chandler, department manager for Itasca County Public Health, in a press release.

Itasca Co. suspends contact tracing as infections surge

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

communities of color disproportionately hard

 in both cases and deaths. That’s especially true for Minnesotans of Hispanic descent. 

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

Similar trends hold true for Minnesota’s Indigenous residents. Counts among Indigenous people

Cases among all races and ethnicities continue to rise, although currently the growth is slowest among Black Minnesotans, who reported the most new COVID-19 cases per capita for much of the spring and summer.

‘So much virus circulating in our state’

The overall numbers continue to paint a troubling picture of a rapidly worsening pandemic in Minnesota not limited to just one region or demographic group, like earlier in the pandemic.

There’s increasing concern about the ability of hospitals to handle more. They were already filling in the summer and fall from normal use, and the surge in COVID-19 patients is putting hospitals in the Twin Cities “near the top of their capacity,” Health Commissioner Jan Malcolm said last week.

Staffing is becoming a challenge as more health care workers get sick, she added.

“Minnesota is in a bad spot … and it’s going to get worse before it gets better,” Kris Ehresmann, the state’s infectious disease director, told reporters last week.

While more testing is uncovering more cases, “it’s not the testing that’s the problem,” Ehresmann said. “It’s the sheer fact that we have so much virus circulating in our state.”

Here’s what to do

Minnesotans can now get saliva test at MSP, at home

Minnesota is expanding its COVID-19 saliva testing capabilities across the state through a free at-home mail service. The state also opened a saliva testing location at the Minneapolis-St. Paul International Airport on Thursday.

Testing is free to Minnesota residents. Although reservations are encouraged, walk-in appointments are also available. Turnaround for mail-in testing is expected to be about 48 hours plus delivery time. 

"All the results come on email, if a person doesn't have an email, some people don't have access to that technology, those patients will receive a phone call with their results within a 24- to 48-hour period,” said Shawn Baxley who works for Vault Medical Services that is partnering with the state for the new tests.

Assistant Health Commissioner Dan Huff said wearing masks, social distancing and getting tested are all ways to help stop the spread of the coronavirus in Minnesota. 

The airport site is the ninth saliva-testing facility open around the state. Another saliva-testing site is opening next week in Burnsville.

N.D. governor OKs infected nurses to keep working

The North Dakota Nurses Association says it doesn’t support a move to allow health care workers who have tested positive for COVID-19 but don’t have symptoms to remain on the job.

Gov. Doug Burgum supports the idea to ease stress both on hospitals and medical personnel amid skyrocketing coronavirus cases in North Dakota. Burgum says hospital administrators asked for the action and interim State Health Officer Dirk Wilke amended an order to allow it to take effect.

The nurses’ association says guidance from the CDC says the decision should be left to the COVID-19 positive nurse whether to work. The association says other measures, such as mask wearing, should be used to reduce the demand on the health care system before implementing this strategy.

Burgum, a Republican, has not supported a statewide mask mandate. Instead, he’s stressed personal responsibility.

North Dakota has the highest number of new cases per capita in the nation, according to Johns Hopkins data, with one in every 83 residents testing positive in the past week.

State prison in St. Cloud locked down to combat COVID

The Minnesota state prison in St. Cloud is under modified lockdown due to a recent spike in COVID-19 cases among inmates and staff.

Recently the facility has reported 381 total positive or presumed positive cases in St. Cloud since the pandemic began, up from 179 in late October. One hundred sixty-nine of those cases have recovered.

St. Cloud serves as the intake facility for the state prison system. In July, the Minnesota Department of Corrections temporarily moved intake operations to Lino Lakes due to a COVID-19 outbreak in St. Cloud.

Corrections Commissioner Paul Schnell said they are considering whether to do that again. 

"We are looking at what the alternatives are. The challenge really, at this time, we're trying to do everything we can to reduce intakes altogether,” Schnell said. “We've asked the county jails, if they would hold people for two weeks, to allow us to try and settle this."

However, Schnell says many county jails are dealing with their own spikes of coronavirus cases. 

Schnell said facilities across the Midwest are seeing similar spikes, as community spread of the virus increases.

"Whether it's a correctional facility, nursing home, you can't have a massive growth in the community and not expect that to ultimately influence these congregate settings."

Schnell said the department is taking steps to contain the spread of the virus, including minimizing inmates' movement with a modified lockdown, testing of staff and inmates, and quarantining newly arriving inmates for two weeks.

Vikings bar fans from final games as virus deaths hit record

The Minnesota Vikings have given up on trying to host larger crowds and said Wednesday that the team will close the remaining home games to fans, as the state blew past its record for new deaths in a day.

The Vikings said in a statement that while players, coaches and staff have missed the energy and passion that fans bring on game day, the team would no longer seek approval to host more than 250 fans for the remaining games at U.S. Bank Stadium. The state's health guidelines currently cap crowds at 250.

“While we have worked hard to develop a safe and responsible plan to bring back a limited number of fans, our decisions have been based on medical guidance with public health as the top priority," the team said. "We take seriously Minnesota’s rising COVID infection rates and increasing hospitalizations and believe closing the final four home games to fans is the right decision to help protect our community.”

As COVID-19 takes dire turn, Minn. lawmakers avoid clash: 

The Legislature convened and adjourned a special session without taking a vote to reel back Gov. Tim Walz’s executive powers. It followed news of another record day of COVID-19 infections.

Michael Osterholm speaks at St. Olaf College on facing winter of 'COVID hell': 

On MPR News Presents, we hear University of Minnesota infectious disease expert Michael Osterholm, who took questions from staff, students and alumni of St. Olaf College. He talked about his role on President-elect Joe Biden’s coronavirus task force, how to make sense of new news about vaccines, and what to expect in the long winter ahead — which he has described as “COVID hell.”

More Minnesota schools halt in-person classes as COVID-19 cases rise: 

Schools across the state are beginning to suspend in-person learning as COVID-19 case rates rise. Duluth, Bloomington and Hopkins public schools have announced plans to transition their students to distance learning. 

What you need to know about Minnesota's new limits on bars, restaurants, gatherings:

 The restrictions are primarily aimed at venues: bars and places that host weddings and other events, which, to this point, have been the nexus of hundreds of COVID-19 clusters. And they're focused on an age group — 18- to 35-year-olds — that appear to be prevalent asymptomatic transmitters of the virus and make up the bulk of Minnesota's cases.

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The newest numbers pushed Minnesota’s caseload above 200,000 in the pandemic. Gov. Tim Walz said Thursday that the state is on pace to reach 300,000 cases by Thanksgiving.

Gov. Tim Walz discusses the latest coronavirus numbers and the new statewide restrictions at bars, restaurants. 

Gov. Tim Walz on the latest coronavirus numbers

A person wearing a face mask is reflected in a side mirror. 

Derek Montgomery for MPR News file

New COVID-19 related deaths reported in Minnesota each day

David H. Montgomery | MPR News

New COVID-19 hospitalizations in Minnesota

Active, confirmed COVID-19 cases in Minnesota

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

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

Percent of COVID-19 tests to come back positive

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

Nov. 12 update on COVID-19 in MN: Record 7K new cases; 39 deaths; hospitalizations climb

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