COVID-19 hospitalizations rose above 1,500 on Monday in Minnesota, bringing the state closer to its pandemic record of 1,864 hospitalizations on the same date in 2020.

Hospitals have responded by delaying some non-emergency surgeries and reducing non-COVID admissions. Total hospitalizations reached 8,220 on Nov. 17 but declined over the Thanksgiving holiday week and dropped to 7,598 Monday.

Hospital leaders said declines in hospitalizations could be temporary, though, and urged Minnesotans to reduce their risks by seeking vaccinations and taking other protective measures.

"This is largely driven by hospitalizations in unvaccinated persons, by a two-to-one clip," said Dr. Mark Sannes, an infectious disease specialist leading the COVID-19 response for Bloomington-based HealthPartners. "Of that group that is vaccinated that is getting hospitalized, it's largely the elderly and those with other compromising conditions."

Among HealthPartners' 367 COVID-19 hospitalizations over the past month, 71% involved unvaccinated patients. Thirty of 35 COVID-19 patients placed on ventilators were unvaccinated as well.

Minnesota ranks 22nd among the states with 73.3% of people 5 and older receiving a first dose of COVID-19 vaccine, according to the Centers for Disease Control and Prevention, but that leaves more than 1.4 million eligible people unvaccinated.

The pandemic has caused 912,370 coronavirus infections and 9,382 COVID-19 deaths in Minnesota. The totals include 12,632 infections that were reported on Tuesday and reflect pandemic activity over the weekend. No additional COVID-19 deaths were reported on Tuesday because the state didn't process death records over the holiday weekend.

Minnesota had the highest rate of infections and the eighth-highest rate of COVID-19 deaths over the past seven days among states, according to the CDC's COVID-19 data tracker. Minnesota's COVID-19 death rate is 11th lowest since the start of the pandemic, though.

Monday's 1,532 COVID-19 hospitalizations included 343 people receiving intensive care. Despite the decline in non-COVID admissions, hospitals remain busier now compared with last fall.

The record 1,864 COVID-19 hospitalizations last Nov. 29 combined with non-COVID cases to fill 6,991 inpatient beds. That is 7% lower than the hospital bed usage in Minnesota now.

Health care workers represented by SEIU Healthcare Minnesota said Tuesday that the pandemic has exacerbated long-standing pressures in hospitals, driving workers out of the profession and making the bed shortage worse.

Supportive care such as helping patients get to the bathroom and shower is being neglected because patient numbers exceed staff availability, said Emilee Greskowiak, a nursing assistant at United Hospital in St. Paul.

"I have 25 patients on a unit as the only aide, and we are short nurses," she said. "Basically, all I can do is empty trashes and let nurses know when people are drowning — having codes ... and struggling to survive through their traumas."

The workers argued for improved pay and benefits to keep people from leaving for lower-stress industries. While Gov. Tim Walz and Minnesota legislators could approve one-time bonuses for frontline workers, the base pay is not keeping up with inflation, said Steele Miller, an emergency room technician at Methodist Hospital.

"We're facing an expectation to pick up extra shifts despite already being burned out … It just feels like we are at a breaking point," he said.

Vaccine mandates have cost health systems workers, as well, but the losses have been relatively small. Allina Health in early November reported separation agreements with 23 workers who declined to be vaccinated or file for exemptions. HealthPartners and Sanford Health reported 99% compliance with Nov. 1 mandates. Suspended workers were given time after the deadline to comply.

Two emergency teams of 22 federal medical workers each have been deployed to HCMC in Minneapolis and St. Cloud Hospital to bolster staffing.

More than 70 federal teams have supported hospitals in 23 states since the start of the pandemic. Medical teams from the U.S. Northern Command are planned or in place in Idaho, Michigan, Montana, New Mexico and Utah as well — reflecting the northern spread of the pandemic wave this winter after severe outbreaks in the South over the summer.

State leaders said infection growth is related to the third of Minnesotans who are unvaccinated and the waning immunity in people who received their initial doses more than six months ago.

Boosters have been provided to more than 31% of fully vaccinated Minnesotans and are recommended for all adults to increase their protection against severe COVID-19 illness.

Sannes said waning immunity is a particular concern now because the earliest recipients were elderly or had health problems that weakened their responses to the vaccine in the first place. He said he is hopeful that waning immunity won't be as much of a problem in the next group of younger people who were vaccinated and that could in turn reduce breakthrough hospitalizations.

Minnesota's reported positivity rate of COVID-19 diagnostic testing dropped slightly to 10.6% from 10.9% the day before, but health officials suspect this is temporary progress and that viral transmission over the holiday weekend could increase infections.

Concerns about the new omicron variant of the coronavirus found in South Africa are secondary, Sannes said. "We have a delta variant that is causing us a world of trouble right now. Thinking beyond that to another variant of concern is looking beyond the problem that is staring you in the face."