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Minnesota is emerging from another winter of increased COVID-19 mortality, though the toll of the past few months has been far below the prior two winters.

Thursday's weekly pandemic update showed that Minnesota had reached a peak of 10 COVID-19 deaths per day in January that has since dropped by half. While that was the highest rate since March 2022, it was below peak severity levels of 79 deaths per day in December 2020 — before vaccine was available — and 39 per day in December 2021.

Minnesota's per capita COVID-19 death and case rates are well below averages over the past week in the U.S. — with levels fluctuating up and down across states, according to the Centers for Disease Control and Prevention.

"COVID-19 is going to be here," said Rupali Limaye, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health in Maryland. "We're going to have to learn to live with it."

Where the pandemic goes as it enters year four in Minnesota is unclear. The latest statistical measures offer mixed forecasts regarding the spread of the coronavirus that causes COVID-19.

Lab-confirmed infections increased in Minnesota from 530 per day in mid-January to more than 700 per day in mid-February — despite the closure of state testing centers that disrupted access. On the other hand, the sampling of sewage from 40 treatment plants across Minnesota showed declining viral levels as of Feb 26.

Last week's sampling at the Metropolitan Wastewater Treatment Plant in St. Paul showed that an XBB coronavirus variant made up 82% of the viral material. The variant hasn't driven rapid growth in infections like others, though, despite concerns that it was able to evade immunity from prior infections or vaccinations.

Hospitals remained busy but with some capacity, reporting that 399 COVID-19 cases filled inpatient beds on Tuesday and that 7,898 inpatient beds were occupied overall. At their busiest in November 2020, Minnesota hospitals reported 8,500 beds in use.

Minnesota's COVID-19 death toll reached 14,401, with seniors remaining at greatest risk — making up 83% of the COVID-19 deaths overall and 91% in 2023.

Seasonal influenza diminished during the first two years of the pandemic, either because it was crowded out by the coronavirus or because mask-wearing and other prevention measures reduced its spread.

Flu activity is more typical this season, though Thursday's state flu report showed that it peaked unusually early in November and quickly receded. The state has identified 155 flu-related deaths so far, compared with 61 in the prior two seasons combined.

COVID-19 vaccination activity has stagnated in Minnesota, where 26% of people five and older are up to date with recommended initial doses or boosters. While 94% of vulnerable seniors have received at least one dose, only 62% are up to date with the latest boosters that were formulated against recent strains of the coronavirus.

New federal vaccine recommendations are needed to guide recipients of boosters in recent months who might be experiencing waning immunity, said Dr. William Moss, executive director of Johns Hopkins' International Vaccine Access Center.

If COVID-19 levels decline, then it might not be as urgent for young people to receive boosters, he said. A recent Lancet study showed that people with hybrid immunity — meaning they had been vaccinated and infected — could quickly lose immunity against infection but still be protected against severe illness and hospitalization.

However, Moss said a recommendation for another booster "would be quite reasonable in vulnerable populations for whom the last booster was some time ago. There will have been some waning of protective immunity."