Minnesota has reported its first COVID-19 death in a child amid a rise in cases of the infectious disease among children and young adults.

The death of a 9-month-old baby from Clay County is one of the youngest reported in the U.S. in the pandemic.

The child had no underlying health conditions and was not hospitalized. State Health Commissioner Jan Malcolm described it as an "isolated incident related to this infant's very specific situation."

Details and lab samples are being sent to the U.S. Centers for Disease Control and Prevention for further investigation of why this infant died with an infectious disease that has taken a much harsher toll on the elderly. Of the 1,545 COVID-19 deaths so far in the pandemic in Minnesota, two have involved people in the 20 to 29 age range. But none until now had involved anyone 19 or younger.

"An infant death is devastating," said Kris Ehresmann, state infectious disease director, "and thankfully there have not been a lot of infant deaths in the country, but we want to make sure that we're understanding as much as we can about ... the changes that occurred with this infant in terms of the progression of their illness."

COVID-19 is a respiratory disease caused by infection with a novel coronavirus, SARS-CoV-2. Risk increases with age or underlying health conditions such as diabetes or heart disease. People 70 and older make up only 10% of the state's known COVID-19 cases but 81% of the deaths.

Even so, health officials have warned that COVID-19 can pose risks to younger people, including breathing and other health complications. The state has reported pediatric cases of COVID-19 that required hospital admissions and intensive care, as well as at least 13 cases of multisystem inflammatory syndrome in children. The condition affects multiple organs and appears tied to earlier SARS-CoV-2 infections.

State officials did not release the name of the child and referred additional questions to the medical examiner, who ruled the cause of death as "upper and lower respiratory tract infections and nasal culture positive for COVID-19."

Monday was highest count

The COVID-19 case count in Minnesota reached 47,107, including the addition of 922 cases reported on Monday. That is the highest single-day total reported in Minnesota since the start of the pandemic, though state health officials said they have yet to vet about two-thirds of those reported test results due to a switch this weekend to a new data management system.

Ehresmann said the final daily number could decline, but the overall trend is upward.

Minnesota is now reporting a rate of 9 new cases of COVID-19 per 100,000 people per day, an increase from 6 per 100,000 on June 16. The actual rate based on the latest COVID-19 data is more than 10 cases per 100,000 — enough to likely keep Minnesota for a second week as a state from which travel to New York is restricted.

Minnesota's target goal is no more than 5 cases per 100,000, and is one of five measurements the state uses to assess the adequacy of its response to the pandemic. Upcoming decisions using this data include whether to loosen restrictions and capacity levels on businesses and whether to allow in-person school classes in the fall.

Cases among children and young adults have fueled the increase in the outbreak in the state over the past month. Total cases in Minnesota have increased 87% since June 1, but 144% among people 29 and younger in that same time period.

Total cases include 40,742 people who have recovered to the point they are no longer considered infection risks or required to isolate themselves.

Other age groups spiking

Case growth has started to accelerate in other age groups, though, Ehresmann said, as the initial spikes tied to young adults at restaurants and bars have spread to older adults and other social activities.

Beltrami County has seen its cases nearly double to more than 100 in the past week, and Ehresmann attributed that rise to group gatherings, sporting events and other activities rather than an outbreak tied to one eating establishment, residential facility or workplace.

"As we see cases in individuals who are a little bit older, what we're seeing is the impact of broader gatherings — whether it's family get-togethers [or] people that are enjoying the summer and not social distancing like they could," she said. "So we're seeing this evolution of who is getting COVID because of the evolution of our activities."

State health officials are concerned that cases among the lower-risk younger population could eventually spread the virus to people at greater risk of complications or death due to their ages or underlying health status.

Hospitalizations have increased in Minnesota over the past two weeks — with 247 people admitted with COVID-19 on Monday and 115 of them needing intensive care. That is well below the peak of 606 hospitalizations in the state during the first COVID-19 wave on May 29, but above the low of 227 reported on July 10.

Gov. Tim Walz and state officials are deliberating on a mask-wearing mandate to slow the spread of the virus. Twenty-eight states have taken this action in response to the pandemic, which has seen a surge in cases and hospitalizations in many Southern and Western states this month.

The Minnesota Hospital Association expects the current rise in cases to turn into a new wave of hospitalizations, and its leader called on Walz last week to impose a mask mandate sooner rather than later.

"The second surge is here," said Dr. Rahul Koranne, association president and chief executive. "We're in the middle of it, so let's not let up now."

Jeremy Olson • 612-673-7744