COVID-19 has put Minnesota in a "desperate and dangerous place" with case counts soaring, the death toll climbing and fears growing that hospitals could become overwhelmed if the trend isn't restrained.

The Minnesota Department of Health reported a record 8,703 new cases Saturday, a one-day tally that surpassed the previous record by nearly 1,500.

Health officials stressed the skyrocketing count wasn't due to a backlog or some other reporting anomaly, but rather, the rapid spread of a virus that will likely produce rising death counts and hospitalizations for weeks to come.

"These are the unvarnished numbers for today and reflect the very desperate and dangerous place we are at in Minnesota," Kris Ehresmann, the state's director for infectious diseases, said Saturday in a statement.

Another 35 deaths were reported Saturday, adding to the total of the deadliest week yet and putting November on pace for the most fatalities in one month since the pandemic's start this spring. On Friday, Minnesota set a record for hospitalized patients, including nearly 300 who required intensive care.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, compared the situation to an "avalanche," saying that unless people act to slow it down, the crisis will keep building.

"This is the part of the pandemic game that I most feared," said Osterholm, who was named last week to a new coronavirus task force by President-elect Joe Biden. "We need now more than ever for people to understand what they must do to protect themselves.

"At the same time, the other thing that's happening that's totally independent of this, is the vaccine picture. While we still have some time to go before we're going to have widespread vaccine availability in our communities, it's coming."

Numbers from Minnesota's neighboring states are sounding alarms, too. After weeks of leading the nation in population-adjusted case growth, North Dakota moved late Friday to limit capacity at bars and restaurants and require face coverings at indoor businesses and public settings across the state.

Midwest still leading

On Saturday, North Dakota ranked second among all states in recent case growth, ceding the top spot to South Dakota, according to a tracking website at Brown University. Iowa jumped to No. 3, while case growth in Wisconsin was fifth highest in the nation. Minnesota ranked No. 8 — six spots higher than last week.

North Dakota hospitals and nursing homes now have state approval to address staffing problems by bringing back health care workers who have tested positive for COVID-19 but are not showing symptoms. In Wisconsin, 20 patients on Saturday were being treated at an alternate care facility that has been providing overflow capacity for several weeks.

Coordination across hospitals has helped Minnesota avoid those steps, said Dr. Rahul Koranne, president of the Minnesota Hospital Association. Even so, Minnesota hospitals are under stress while they treat more COVID-19 patients as thousands of workers have been sidelined by virus exposures.

Doctors are troubled by the current spike in cases because it often takes weeks for patients to develop serious disease, said Dr. Matthew Prekker, an emergency and critical care specialist at Hennepin Healthcare.

"We know we're sort of staring down the barrel of the gun in the ICU, so to speak," Prekker said. "I worry there's going to be a more intense surge — and need for critical care in the coming weeks — than there has been even so far."

Walz 'still confident'

Since March, the state's pandemic tallies include 216,028 positive cases, 12,915 hospitalizations and 2,874 deaths. Amid the grim statistics and stress on hospitals, Gov. Tim Walz told reporters Friday that he was "still confident that Minnesotans can get the care."

Hospitals can treat more pandemic patients, doctors say, by delaying more elective and non-emergency procedures. But they say such delays, which can have serious consequences, could be avoided by public adherence to mask-wearing and social distancing.

"There are multiple ways the current surge could go," said Dr. David Niccum, a critical care medicine specialist at Regions Hospital in St. Paul. "If we are able to stay on the lower ends of those trajectories by using the techniques and methods that we know prevent the spread ... we're going to be able to save a lot of lives and really take a lot of burden off the health care system."

Older people and those with certain health conditions are much more likely to suffer serious illness or die from COVID-19. Of the 35 deaths reported Saturday, 27 were residents of long-term care or assisted-living facilities. Only a few were under the age of 70.

Dr. Andrea Boehland was startled earlier this month when she treated, in one day, three COVID-19 patients who were all relatively young.

"It really shook me, actually," said Boehland, an emergency medicine physician with Essentia Health in Duluth. "[They] all had very life-changing consequences from their COVID and they were all young, healthy people."

At St. Cloud-based CentraCare, about 28% of all hospital patients have COVID or COVID-related illnesses, doctors say. Nearly one-fourth of coronavirus tests are coming back positive, which suggests the virus is spreading faster than increased testing.

'Failure of … accountability'

"To me, those numbers mean a failure of both individual and corporate accountability," said Dr. Kenneth Holmen, the CentraCare chief executive. The lack of corporate accountability means some groups and businesses aren't working to control the spread, Holmen said. At the individual level, it "means that people are not wearing masks, they're not socially distancing and they're not using well thought-out science for them personally to take accountability."

Osterholm contrasted the coronavirus pandemic with the great influenza of 1918, which he said struck communities for periods of six to 10 weeks. With coronavirus, people are mentally fatigued because social limits to control the spread have lasted for such a long time.

"It was devastating, but it came and it left," Osterholm said of the 1918 pandemic. "This one just comes and comes and comes. … Unfortunately, we are now in the very, very worst stretch of this pandemic, and people are tired."

Last week, the pharmaceutical giant Pfizer announced promising results for one of several vaccines under development. Vaccines are "a light at the end of the tunnel," Osterholm said, even as large family holiday gatherings threaten to further the spread.

"The vaccines will be here eventually, hopefully in the first quarter of next year," he said. "That could really make a difference."

Christopher Snowbeck • 612-673-4744