ROCHESTER, Minn. — After months of decline, hospitalizations for COVID-19 have begun to approach the highs last seen during the springtime peak of the epidemic, according to the Minnesota Department of Health.

At 9.5 hospitalizations per 100,000 residents, the statewide rate of serious COVID-19 has more than doubled from the 4.1 posted in late June. The state's current COVID-19 hospitalization rate is closing in on a statewide high-water mark of 11 hospitalizations per 100,000 residents set on May 21.

Also troubling, according to state director of infectious disease Kris Ehresmann, ICU use in the metro Twin Cities is now over 90% capacity. Statewide the rate fares little better, with ICU use hovering between 80-90% of available capacity.

There are currently 469 Minnesotans in the hospital with COVID-19, 137 in an ICU setting.

Minnesota is watching hospital capacity closely as neighboring states post some of the highest case-positivity rates in the country. Currently, cases are rising faster than testing in Minnesota. While rates above 5% are considered concerning, Minnesota is now at 5.8% case positivity, meaning that nearly six out of every 100 tests are coming back positive.

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That number is a beacon of success however compared to the spread now seen in Minnesota's neighboring states, regions that have taken a much looser approach to lockdowns and mask orders.

As of Monday, with more than 24% of all tests coming back positive, Wisconsin has four times the case-positivity as that of Minnesota. At over 36%, South Dakota has six-fold the case positivity of its neighbor to the east.

But it is the runaway COVID-19 spread across Iowa that now has the attention of Minnesota's health officials. The nation's agricultural heartland, Iowa is apparently paying the price for not having developed mask orders or shutting down football games. One in every two Iowans tested are coming back positive.

That's more than eight times the case-positivity rate of Minnesota, where Gov. Tim Walz continues to fend off charges of over-reacting to the pandemic from his political opponents, a chorus of preferences for looser mitigation like those adopted in Wisconsin or Iowa. Meanwhile, last week the White House COVID-19 Task Force called Iowa a "red zone" of spread, and it has become clear that red states adopting open mitigation strategies make up the greatest spread of COVID-19 in the country.

Also on Monday, state health officials began to develop talking points for families eyeing the approach of holidays.

"It's a really good time to consider not having the same kind of family gatherings that you've had in the past," state commissioner of health Jan Malcolm said during an afternoon news conference. "We're in a very high-risk environment. Avoiding those gatherings around the holidays, as painful as that can be, is prudent as we approach this winter season."

Other suggestions for the coming family get togethers hewed to the larger objective theme of reducing, rather than trying to eliminate all risk of spread.

Officials suggested gatherings limited to ten persons or less, with social distancing indoors and the use of masks for those outside of your household. Other recommendations include regular opening of windows to ventilate rooms, frequent hand washing, and cancelling events altogether if you feel at all sick.

The state reported 1,616 new cases of COVID-19 on Monday, Oct. 19. Cases were especially high in Anoka, Dakota and Stearns counties. The state reported an additional 100,000 cases between Friday and Sunday.

The new cases Monday come on 22,098 tests for the day.

An additional 5 deaths were reported on Monday, striking down residents of Aitkin, Mille Lacs, Ramsey, Redwood, and Stearns counties. Of the 5 deaths, 4 were residents of long-term care.

A total of 2,239 Minnesotans have died of COVID-19. Between Friday and Sunday, the state recorded an additional 35 deaths.

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  • Minnesota Department of Health COVID-19 hotline: 651-201-3920.
  • COVID-19 discrimination hotline: 833-454-0148
  • Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.