December offers a glimmer of hope in Minnesota's battle against COVID-19, with a steady decline in the number of new cases and hospitalizations despite being the deadliest month of the pandemic so far.

The Minnesota Department of Heath announced 57 fatalities Saturday, pushing December's total to 1,187 reported deaths, the most of any month since the pandemic's start. The state says 4,780 residents have now died due to COVID-19, putting Minnesota on track to pass the 5,000 death mark by year's end.

But new hospital admissions continue to decline, resulting in less stress on medical center capacity. And daily tallies for new coronavirus infections — including 2,772 reported Saturday — are well shy of last month's peak of more than 8,500 cases reported in one day.

Health officials caution that the state's rate for new cases is still considered high risk. They add that holiday travel and gatherings still threaten to reignite the outbreak, although the absence so far of a surge in new infections after Thanksgiving gives reason for hope, too.

"Our case numbers have come down from the highs of November — though close to 3,000 cases is still higher than we want to be," Kris Ehresmann, the state's director for infectious diseases, said via e-mail. "I am thankful to all the Minnesotans who altered their Thanksgiving holiday celebrations — it appears to have made a difference."

"Despite this positive news, we have to keep in mind December has been our most deadly month of the pandemic thus far," Ehresmann added. "There are too many families that are grieving for the winter holidays."

Tennessee, Rhode Island and California held the top three spots across the nation Saturday in terms of population-adjusted rates for recent case growth, according to a tracking website from Brown University. Arizona reported the fourth-highest rate.

States in the Upper Midwest, which led the nation in new case rates for an extended period this fall, have clearly relinquished the dubious distinction. Minnesota ranked No. 32 on Saturday, and none of the neighboring states ranked among the top 10.

Minnesota is seeing a "more favorable trend" than many states, Jan Malcolm, the state health commissioner, said during a Friday news conference. She stressed, however, that Minnesota is adding infections at a rate of 63 new cases per day per 100,000 residents — about half of its peak, but still well above the state's high-risk threshold of 10 new cases per day per 100,000 people.

"These are positive signs," Malcolm said. "But again, there's still a lot of virus circulating in our communities. And as we head into the end-of-year holidays, it's just really critical that we keep our guard up."

Last week, COVID-19 patients in Minnesota accounted for about one-fourth of all intensive care patients across the state and 14% of patients in general medical-surgical beds — "much lower" percentages than at the end of last month, said Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association. Over a recent 14-day period, Koranne added, the number of hospitalized COVID-19 patients dropped by about 30%.

"That is a good decline," he said, but added: "There are a lot of patients with COVID in our ICUs and medical-surgical units."

The nine hospitals operated by HealthPartners are among those seeing improvements, said Dr. Mark Sannes, an infectious disease specialist. More people seem to be getting the message about the importance of wearing masks and avoiding indoor gatherings, Sannes said, although he warned: "We've seen how quickly this can go back in the wrong direction."

"I think the key will be: How do you stay with this momentum and drive case numbers down even further?" he said. "We may have caught a break following Thanksgiving — certainly that wasn't the case in California, Arizona or on the East Coast in many locations."

With the deaths announced Saturday, Minnesota's December total pushed beyond the one-month record of 1,136 COVID-19 deaths reported in November. Yet the rolling seven-day average for deaths declined for a third consecutive day, according to the Star Tribune's coronavirus tracker. Declines in cases and hospitalizations should eventually spell fewer deaths.

Since the virus started infecting Minnesotans in March, the state has reported 394,635 positive cases and 20,468 hospitalizations. It's hit long-term care and assisted-living facilities, where residents accounted for 34 of the deaths announced Saturday and 3,104 deaths since the start of the pandemic, particularly hard.

It's been tough on families, too, as restrictions designed to slow the virus in long-term care have kept them away from loved ones. Long-term care workers try to fill the void, but the mounting fatalities among residents are tough on them, too, said Dr. Larry Leadbetter, an internal medicine doctor with Essentia Health in Park Rapids.

"After you lose a fair number of these folks," he said, "you've lost a lot of friends."

During the first seven months of the pandemic, Dr. David Goodwin said he didn't sign any death certificates that listed COVID-19 as a cause of death — a contrast with October and November, when state records show more than a dozen of his patients died from the virus.

Caring for seniors at facilities across the Iron Range, Goodwin has seen influenza spread through nursing homes and assisted living centers over the years, but never with the virulence of COVID-19.

"Is it aggressive? Yes. Is it really hard on these people? Yes," Goodwin said. "It's a real illness and I have been humbled that I don't have much to offer them. … I've had residents in my experience now who look good on Monday and they're gone on Friday. And it's like: What happened?"

Minnesota hospitals last week started receiving vaccine made by the pharmaceutical giant Pfizer, and federal regulators on Friday authorized emergency use of a second vaccine. At HealthPartners, vaccinations for health care workers are scheduled to begin this week.

"This is the first step to getting to the other side of this pandemic," Sannes said. "We are still going to be, practically speaking, doing all of the same COVID-19 mitigation efforts for the foreseeable future, until we get a critical number of people vaccinated."

At North Memorial Health Hospital in Robbinsdale, nearly 1,000 doses arrived Tuesday morning in a 66-pound box. A weighty block of dry ice kept the vaccine extremely cold.

"The whole normal is different now," said Dr. Kevin Croston, the chief executive at North Memorial. "The way we look at things, and the way we consider how we're going to move forward. The way we manage our staff. Everything changes starting today. It becomes a different kind of war."

Christopher Snowbeck • 612-673-4744