More than 1,000 Minnesotans have now died in the COVID-19 pandemic, a grim milestone that the state reached Saturday, just 10 weeks after it reported its first coronavirus death.

Health officials on Saturday announced 30 more deaths, a one-day increase that pushed the statewide toll to 1,026 since the first COVID-19 loss was reported on March 21.

Cases are still on the rise in Minnesota, but declines in other states could be a worrisome sign that COVID-19 is following the pattern of influenza pandemics, said Michael Osterholm, of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“This is just the beginning,” Osterholm said. “This is not a milestone that is at the end of our COVID-19 crisis.”

Confirmed cases increased by 659 statewide, according to data Saturday from the Minnesota Department of Health. The increase in new cases seems to have leveled off. The state saw 174 deaths reported over the past seven days — the largest weekly tally thus far.

Minnesota is beginning to loosen social restrictions designed to slow the pandemic, including on houses of worship that on Saturday started hosting weekend services at 25% of capacity.

But state officials have said the Twin Cities metro is a hot spot for COVID-19 nationally. And they’ve suggested spread of the virus could accelerate as people gather to the protest the death of George Floyd, who died after being forcibly restrained by Minneapolis police Monday night.

To control the spread, health officials have suggested that people wear cloth masks when out in public, but some who have infiltrated protests simply to wreak havoc are wearing masks as disguises, Gov. Tim Walz said during a Saturday news conference.

“The masks worn by people there were to cause confusion and take advantage of this situation,” Walz said, “but the rest of us need to maintain that.”

ICU growth rate steady

COVID-19 is a viral respiratory illness caused by a new coronavirus that surfaced late last year. People at greatest risk include those 65 and older, residents of long-term care facilities, and those with underlying medical conditions. The medical conditions range from lung disease, serious heart conditions and cancer to severe obesity, diabetes and kidney patients who need dialysis.

Since the first case was reported in Minnesota on March 6, more than 3,000 people have been hospitalized. The number of COVID-19 patients in Minnesota needing intensive care is at an all-time high, Osterholm said, although the growth rate is steady.

Osterholm and colleagues published a paper in early May suggesting COVID-19 could follow the pattern of influenza pandemics, where an initial wave of illness in the spring subsides during summer and returns with a larger, second wave in the fall. The pattern might explain why some states in recent weeks have seen a decline in cases, Osterholm said, even as they’ve relaxed rules to slow the pandemic.

“The wind’s only picking up, and the sail is even flatter,” he said. “That doesn’t make sense. That tells me that this could be acting very much like a flu virus. … That has been my biggest fear all along.”

It’s “appropriate” to worry that COVID could be following such a pattern, said Dr. Mark McClellan, a health policy expert at Duke University. Another concern is the possibility of local outbreaks this summer driven by “super-spreaders,” or individuals who infect dozens.

“We’re seeing a steady increase in the number of deaths — that hasn’t stopped,” said McClellan, who was a top health care official in the administration of President George W. Bush.

“As we go about reopening, it’s just another extra, very serious, reminder of how thoughtful and vigilant we need to be.”

Another wave coming?

The federal Centers for Disease Control and Prevention reported last week that the U.S. death toll from COVID-19 had surpassed 100,000. In a separate report Friday, the CDC said illness reports and test results across the country continue to show that cases are declining or remain stable.

The overall decline is somewhat misleading because it’s driven by a falloff in cases in states such as New York, New Jersey and Massachusetts that initially were hit hard by the virus, said William Hanage, an epidemiology professor at Harvard University. Meanwhile, cases continue to rise in Minnesota and other states.

There’s also variation in the extent to which states are loosening restrictions on businesses and group gatherings, Hanage said. That’s why he expects a “kind of stuttering outbreak” in coming months.

“The big question is what’s going to happen over the fall and the winter, because that’s when we anticipate there being another wave,” Hanage said Friday. “Going by the experience of other outbreaks and other pandemics of this kind, I would expect it to be playing out over the next few years with the most important period being the fall and winter of this year, but potentially starting before that.”

COVID-19 has been tough to predict thus far, so it’s hard to know exactly what’s coming, said Dr. Michael Melia, an infectious disease expert at Johns Hopkins University. But one lesson from the 1918 influenza pandemic could be playing out in coming weeks, he said, as relaxed restrictions drive more virus transmission.

“It’s hard to feel confident that things are getting better,” Melia said. “An important message to communicate is to continue to practice physical distancing [and] avoidance of crowds.”

State health department numbers released Saturday show Minnesota’s confirmed case count of 24,190 grew from Friday’s tally of 23,531 cases.

Residents of long-term care facilities accounted for 26 of the 30 newly announced deaths. There were 263 patients in the ICU, compared with 259 in intensive care on Friday. A total of 17,864 Minnesotans once infected with the novel coronavirus no longer need to be in isolation.