Seven COVID-19 outbreaks have been identified in the past week in Minnesota at fairs and festivals, underscoring concerns ahead of the Minnesota State Fair that could result in mask-wearing or other protections at the much-anticipated get-together.

State Fair General Manager Jerry Hammer said on Monday that mask-wearing could be required for indoor attractions on the fairgrounds, but no decision has been reached on the 12-day event that starts Aug. 26 and draws more than 2 million people. While vaccination is strongly encouraged, he said it is unlikely that the fair will require visitors to present proof of shots or a recent negative COVID-19 test — as was done at the Lollapalooza music festival July 29-Aug. 1 in Chicago.

"We just haven't gotten to that point yet" of making an announcement on masks or other measures, Hammer said. "Everything we've done has been in a very compressed time frame. We didn't even know until the first part of May that there might even be a somewhat normal fair."

The outlook for an open, unrestricted fair looked good in June but worsened in July as vaccinations declined and a new delta coronavirus variant caused a surge in infections and COVID-19 hospitalizations.

The Minnesota Department of Health for the second consecutive reporting day on Monday announced more than 1,000 infections. The 1,120 new infections raised the state's total to 618,906. The state also reported four new COVID-19 deaths, and 7,698 overall.

The positivity rate of COVID-19 testing increased to 4.5%, nearing the state's caution threshold of 5%, and the number of COVID-19 hospitalizations in Minnesota reached 299, up from 90 in mid-July.

Gov. Tim Walz at a press event on Monday said he is "optimistic for Minnesota" but concerned that the state could see a COVID-19 spike in the fall, following pandemic surges this summer in several Southern states.

"We still rank as one of the best states, but the delta variant is causing problems," he said. "Our case counts are up. Our hospitalizations are up."

One positive: 26,500 Minnesotans have signed up since last Wednesday for a $100 incentive for new vaccine recipients, exhausting the initial budget of $2.5 million in federal funds. Another $13 million in federal funding has been added to continue the incentive program. Nearly 3.2 million Minnesotans 12 and older have received at least a first dose of COVID-19 vaccine — amounting to 68% of the eligible population.

Unvaccinated people make up most of the infections in the latest COVID-19 wave, but state heath officials said the high transmissibility of the delta variant has contributed to a slight increase in rare breakthrough cases among vaccinated people.

The state on Monday reported a total of 5,599 breakthrough infections out of more than 2.9 million fully vaccinated Minnesotans — a rate of 0.19% that has increased from 0.11% a month ago but still indicates that the vaccine is protective.

"Vaccination is a highly successful strategy to reduce COVID-19 spread," said Kris Ehresmann, state infectious disease director.

Unvaccinated people still have a chance this week to be fully immunized before the fair, Hammer noted. While the Pfizer and Moderna vaccines are given in two doses — separated by three and four weeks, respectively — the Johnson & Johnson version for people 18 and older requires only a single dose. It then takes 14 days for the vaccine to produce maximum protection.

Hammer said COVID-19 risks appear low for people seated side by side at outdoor concerts, so restrictions at the fair's grandstand shows are unlikely. Certain attractions have been relocated to reduce crowds, such as some of the extreme amusement rides, and other steps have been taken to reduce congestion on the fairgrounds, he added. Capacity caps for popular indoor attractions have been discussed.

Outbreaks at fairs or festivals are defined in Minnesota as three infections involving unrelated people who attended the same event. Of 13 such outbreaks reported since the start of the pandemic, nine occurred last month and seven were verified in the past week. The outbreaks in total involved 181 people.

The state also has identified two outbreaks linked to concerts in July and its first outbreak involving customers of a bar or restaurant since mid-June. The threshold for bar and restaurant outbreaks is higher — requiring infections among seven customers from different households who only visited one establishment in the previous month.

Health officials said they are watching closely for signs of viral spread at large events, such as the WeFest country music festival that took place without COVID-19 restrictions in Detroit Lakes last weekend and the Sturgis Motorcycle Rally in South Dakota that is ongoing this week.

Wisconsin officials last week reported that nearly 500 coronavirus infections were linked to celebrations and events around the Milwaukee Bucks stadium during the team's NBA championship run. The Centers for Disease Control and Prevention recommended mask-wearing in K-12 schools and counties with substantial or high transmission rates after reporting an outbreak with a high rate of breakthrough infections in the resort town of Provincetown, Mass.

Seventy of Minnesota's 87 counties have substantial or high transmission levels, according to the latest CDC data, an increase from 14 two weeks ago.

Staff writer Hunter Woodall contributed to this report.