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While daily COVID-19 case numbers have leveled off in recent days, the surge may be far from over — especially with Thanksgiving weekend approaching and a possible spike in viral transmission.

"We would need to see several weeks of a sustained decline, where the high days become increasingly lower and the low days become increasingly lower, to be able to say we may be turning the corner," said Kris Ehresmann, infectious disease director at the Minnesota Department of Health.

"But even then we would have to be careful to not let down our guard — we don't want to stop doing those things we know are effective at preventing spread. We wouldn't want to see another surge."

On Tuesday, the Health Department reported another 6,423 infections, along with 38 deaths. For the seven-day period ending Tuesday, officials reported an average of 6,567 new infections per day — compared with an average of 7,052 in the seven-day period ending Nov. 20. Minnesota's totals in the pandemic are 3,303 COVID-19 deaths and 282,916 infections verified through diagnostic testing.

Pressure has slowed over the past four days on Minnesota hospitals, which responded to rising COVID-19 admissions with delays of noncritical surgeries or procedures that were likely to require patient stays.

The state's response capacity dashboard showed a total of 1,828 patients with COVID-19 in Minnesota hospitals, including 379 requiring intensive care. Both numbers are records in the pandemic for Minnesota, which reported only 781 total COVID-19 hospitalizations on Nov. 1.

However, the total was 1,812 on Nov. 20. And total ICU bed usage has declined. The state reports only 997 of 1,440 immediately available ICU beds are filled by patients with COVID-19 or other unrelated medical issues.

But Thanksgiving is coming. And as Minnesotans gather for the holiday, with some expected to defy Gov. Tim Walz's four-week order limiting gatherings to a single household, the risk of a fresh wave of infections is real.

Dr. Yeng Yang, medical director at HealthPartners St. Paul Clinic, knows only too well how quickly the virus can rip through a family.

She is slowly recovering from a bout of COVID-19 she contracted in early November to the point that she can get through a clinic shift without needing a three-hour nap. But she is still struggling with one lingering consequence of her infection: guilt.

Yang doesn't know if she or her husband got infected first, but she's pretty sure she passed it along to her mother — who then passed it along to Yang's brother, sister-in-law and two nephews. Her symptoms emerged the same day she drove her mother to a medical appointment.

"It is very burdensome to carry that [knowledge]," she said, "that I might have been the one to bring that virus into their home."

While her mother is slowly recovering, her brother has suffered prolonged fatigue and fever symptoms while her nephews are coughing and exhausted.

Yang said she hopes people will learn from her family's experience about the need to take COVID-19 seriously and to do what they can to slow the spread of the virus within their own families, particularly over Thanksgiving.

State health officials have urged Minnesotans to comply with the four-week order limiting social gatherings to immediate households only and to continue the mitigation strategies of mask-wearing and social distancing that slow the spread of the virus.

The holidays can typically accelerate the spread of seasonal influenza, and health officials are worried that the same will happen with COVID-19 over Thanksgiving.

Mayo Clinic on Tuesday reported new unpublished research endorsing the protective benefit of those measures. The study used mannequins to simulate the spread of viral droplets and found that masks reduced the spread and that 3 feet of separation helped but that 6 feet was better.

"I think we had some knowledge about the importance of masks, and there's been a number of studies that have showed masks are effective in blocking viruses, but what's really important here is just how effective masking is when done by both parties," said Dr. Elie Berbari, Mayo's chair of infectious diseases.

Ehresmann said Tuesday that she's hopeful that Minnesotans will do what they need to do to keep themselves and their families safe.

"But we are realistic, based on our experiences from past holidays, in thinking that we could see an increase in cases after the holiday," she said.

If families defy the order and get together in larger groups anyway, she said she would encourage them to get tested in a few days in order to identify any asymptomatic infections "and to lay low for 14 days to avoid spreading the disease beyond their circle."

Jeremy Olson • 612-673-7744

James Walsh • 612-673-7428