Minnesota reported a near record number of new COVID-19 cases Saturday and another 14 deaths, pushing the weeklong virus death toll to its highest point since June.

With case numbers soaring in Minnesota's border states and signs of distress from crowded medical centers in Wisconsin, health officials are growing worried as winter approaches.

Minnesota has reported more than 1,000 newly confirmed COVID-19 cases for more than two consecutive weeks, with Saturday marking just the second time since the pandemic began that the statewide count has exceeded 2,000 new cases.

"Health care is nervous, because we think this is going to continue to get worse," said Dr. Marilyn Peitso, president of the Minnesota Medical Association.

Hospitals across Minnesota say they still have room to treat those with serious illness, but doctors are worried as cold weather forces people indoors and promotes the virus' spread. They say Minnesota could avoid the same fate as neighboring states if people wear masks, avoid group gatherings and keep their distance.

"Minnesota is headed in the wrong direction — as is most of the country," said Dr. Thomas Tsai, a researcher at the Harvard T.H. Chan School of Public Health. "The question is ... 'What is Minnesota going to do with testing and contact tracing to keep from becoming Wisconsin?' "

Minn. 20th in case growth

The Minnesota Department of Health reported 2,268 new infections off 36,488 tests, the second-highest number of tests since the pandemic began. But health officials say the percentage of positive tests also is rising, suggesting that the outbreak is growing.

Of the 14 newly reported deaths, nine were residents of long-term care facilities. The total of all Minnesota deaths from the past week is 111, the most since 112 were reported during the week ending June 13.

The state now ranks 20th in the nation in terms of case growth, with a tracking website from Brown University showing an average in recent days of 26.7 new cases for every 100,000 residents. That's not quite half the growth rate in Wisconsin and far shy of North Dakota's nation-leading 101.2 new cases for every 100,000 residents.

If Minnesota saw North Dakota's rate, the state's health care system would be "pretty overwhelmed," said Dr. John Hick, an emergency medicine physician at Hennepin Healthcare and adviser to the state on pandemic planning.

The good news, Hick said, is that while Minnesota and Wisconsin are similar in terms of population, Minnesota has about half as many COVID-19 patients in the hospital right now. Wisconsin last week admitted its first patient to a temporary pandemic hospital.

Even so, Hick said, hospitals in Minnesota are "tight" and feeling pressure. He said he now sees many COVID-19 patients during every hospital shift, whereas he routinely might not have seen one while pulling shifts in August and September.

"This curve is not showing any signs of slowing down," Hick said. "Unless we are more diligent about masking and social distancing, we may very quickly start getting to those trigger points where we ... have to shut bars and restaurants and other stuff down...

"It's still a numbers game. You're not going to escape the fact that a certain percentage of those that get this disease are going to get sick to the point of needing a hospital, or are going to die from it."

State Health Commissioner Jan Malcolm said in a call with reporters Friday that some out-of-state patients are now using hospital beds in Minnesota.

But Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association, said he was not aware of any cases where crowding at hospitals in neighboring states was driving patients to Minnesota facilities. It's common for some patients to come from the Dakotas and Wisconsin for certain treatments, Koranne said, adding that hospital leaders say the volume right now is no greater than usual.

COVID-19 patients last week were using just 14.5% of the state's ICU beds, he said, and just 6% of all regular hospital beds. He added that patients were using only 71% of the state's intensive care capacity.

"That is very manageable," Koranne said. "The hospitals and health systems are prepared and there are no concerns from a space standpoint."

Hospitals on high alert

Hospitals are maintaining enough staff to care for patients, he said, but they recognize that spread of the virus in communities could sideline health care workers. Last week, the leader of Mayo Clinic's network of community hospitals and clinics highlighted operations in the Wisconsin cities of Eau Claire and La Crosse in an online video that promotes adherence to public health measures.

"We are alarmed by the high COVID-19 infection rates in many of our communities, especially in Wisconsin," Dr. Bobbie Gostout, president of Mayo Clinic Health System, said in the video.

Bloomington-based HealthPartners owns three hospitals in western Wisconsin, where officials last week were contemplating whether they might need to delay some elective procedures at some point, said Dr. Marty Richards, the health system's chief of emergency medicine in the region.

As the virus spreads, more staff members are staying home, Richards said, because a child or spouse shows COVID-19 symptoms but doesn't yet have a test result. If the test comes back positive, the clinic or hospital might need to scramble for a replacement.

Richards anticipates people will get fatigued with helping out "at the drop of a hat. It's going to be a real challenge going forward."

The overlap in symptoms between mild cases of COVID-19 and seasonal ailments like the common cold might be fueling the virus' spread, Richards said, as people "excuse whatever symptom they're having as a non-COVID illness."

The similarities also promise to compound the stress some people are feeling with COVID-19, said Tai Mendenhall, a therapist with the University of Minnesota Medical Reserve Corps.

"As we go into the winter months ... there's going to be a lot more fear, just because every symptom that is normal for winter — like a scratchy throat — is going to be connected to these worries," Mendenhall said in a Friday call with reporters.

Despite the gloom, there are reasons for hope, Harvard's Tsai said. His research group has pushed states to expand testing programs, such as Minnesota's opening last week of a new testing lab.

"There are two messages," Tsai said. "One is, yes, there's a wildfire. The second is that we can control this."

Christopher Snowbeck • 612-673-4744