Concerns over rising COVID-19 infection rates across Minnesota gave way Wednesday to a grim statistic: a spike in deaths.

State health officials reported 29 COVID-19 deaths on Wednesday — the highest one-day total since June.

“This reflects the increase in disease we have been seeing in the community for many weeks, with deaths as a lagging indicator,” said Kris Ehresmann, state infectious disease director at the Minnesota Department of Health. “We should not be surprised if we continue to see the number of deaths from COVID moving forward higher than we have seen in the last months.”

State health officials reported the 29 COVID-19 deaths and 1,214 confirmed infections along with a new category of probable infections based on antigen diagnostic testing.

The state as of Wednesday tallied 115,763 total infections with the novel coronavirus that causes COVID-19 that were confirmed through standard molecular PCR testing and another 180 probable infections verified since Sept. 1 through antigen testing.

The COVID-19 death toll has reached 2,180, including six deaths with probable links to COVID-19 via antigen testing. The death count on Wednesday was the highest single-day total reported by the state since June 4 and was still the highest total since June 12 even if omitting the deaths linked to COVID-19 through antigen testing.

State health officials previously warned that rising infection counts in the late summer would eventually lead to more hospitalizations and deaths. The 487 Minnesotans admitted to hospitals for COVID-19 in the seven-day period ending Oct. 11 was the highest total since the first peak of the pandemic in late May.

On Wednesday, Dr. Priya Sampathkumar, an infectious disease physician at Mayo Clinic, took a close look at the data and noted the recent increase in infections may be a result of more testing. But an uptick in hospitalizations means these cases are more severe, she said.

“And the fact that we’re seeing more deaths is concerning. It means we’re having more of a problem than would be indicated by increased testing,” Sampathkumar said. “But I think we need to give it a couple more days to see if this trend continues.”

An awareness about the rise in cases might prompt people — especially those who’ve grown weary of COVID-19 and the restrictions to stop its spread — to be more cautious, avoid crowds and diligently wear masks especially as cold weather drives more people indoors, she said.

“Being exposed to someone with COVID indoors increases the chance that transmission will happen,” Sampathkumar said.

Among the 23 deaths with demographic information available, 12 involved people who lived in private residences while 11 involved people who lived in long-term care or assisted-living facilities. Residents of such facilities still make up 70% of all COVID-19 deaths in Minnesota, but that was mostly due to a disparity in the spring. Broader community spread of the virus has resulted in an even split of deaths between such facilities and private residences since that time.

The 23 deaths included people from 15 Minnesota counties. All were older than 50 and 18 were older than 70.

People 70 and older make up 80% of all COVID-19 deaths so far in Minnesota and remain at elevated risk along with people who have chronic health conditions such as diabetes or heart disease.

As the coronavirus becomes more widespread, it’s more likely that people who are more vulnerable to the disease will become infected, said Helen Strike, president of Allina Health’s Regina Hospital in Hastings and River Falls Area Hospital in Wisconsin.

The rising number of infections and deaths has health care systems on alert and working together to ensure there’s enough capacity in their systems for those who fall ill.

Whether the latest numbers are the beginning of a surge or a random spike should put people on notice once again that COVID-19 is a serious illness, Strike said.

“And people are dying from it,” she said. “These are warning signs that we need to up our game.”

PCR testing is considered the most accurate diagnostic approach — breaking down patients’ nasal or saliva samples into genetic components and then reproducing viral RNA — while antigen testing looks for evidence of proteins produced by the spread of the virus.

While antigen testing is faster and gaining broader use in Minnesota, state health officials said they wanted to report the test results with caution because antigen tests have higher error rates.

“Federal officials have embraced antigen tests and are aggressively encouraging states and institutions across the country to use them,” Minnesota Commissioner of Health Jan Malcolm said in a written statement. “We believe it’s a good idea to add this equipment to our tool kit as long as we keep the information in proper context.”

Antigen testing has gained particular use in Minnesota’s long-term care facilities, where they can quickly indicate a potential high-risk outbreak.

While state health officials recommend confirmatory PCR testing in certain situations, they noted that antigen testing is reliable enough to at least include in Minnesota’s total COVID-19 case count.

Some proponents argue that antigen testing might be less accurate but is actually better than PCR testing at finding people who not only carry the virus but are actively infectious to others.

Gov. Tim Walz noted in a Tuesday media briefing that Minnesota just received 110,000 BinaxNOW rapid antigen tests and that he talked with the chief executive from manufacturer Abbott Labs about how to use them most effectively in response to the pandemic.

Walz’s comments came amid an announcement of Minnesota’s expanded use of saliva-based PCR testing that will produce faster results for people wanting to know if they have COVID-19.

The state has a free test site in Duluth already and is adding new sites in Winona, Moorhead and Brooklyn Park — along with a lab in Oakdale that will be able to process up to 30,000 saliva samples per day.

The SARS-CoV-2 virus that causes COVID-19 is primarily spread from the droplets of people speaking, singing or breathing at others nearby.

State health officials recommend mask-wearing, maintaining a social distance of 6 feet from others in public, washing hands and staying home when sick to reduce the spread of the virus.

“It is very important to understand that testing — even rapid testing — is not a substitute for other preventive actions,” Ehresmann said. “Tests can have false positives or negatives, and people can develop illness after they are tested.”