Less than two weeks in, December has already become the second-deadliest month for COVID-19 in Minnesota, with a record 439 deaths reported over the past seven days alone.

The state reported 67 more deaths Saturday and has recorded 766 virus deaths since the start of the month, a pace that puts Minnesota on track to surpass 5,000 total pandemic deaths by year's end. Through Saturday, 4,359 people had died in Minnesota due to COVID-19.

Recent moderation in new virus cases continued Saturday, seemingly taking a bit of pressure off hospitals, which are reporting stable or declining COVID-19 patient numbers. But health officials remain wary about the potential for accelerated case growth since thousands of new infections still are being confirmed daily.

"The huge challenge is: Where do go we from here?" said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "Will we see this number stabilize or drop in terms of new cases, or will we … see a surge upon the current level of cases around Christmas and then in the two weeks after?"

While hospital numbers show signs of improvement, "that could change quickly if we see additional transmission occurring around the holiday season," Osterholm said.

At St. Cloud-based CentraCare, health care workers are pulling extra shifts and working overtime to meet the high volume of critically ill patients, said Dr. Jacob Lyons, a critical care medicine specialist.

The health system's first wave of patients in the spring included meatpackers and more younger adults who died at a rate below the national average. Now, the mortality rate is higher as patients tend to be older and suffer more health problems, he said.

"We've had multiple nursing homes hit hard, several homeless shelters, but more and more we're seeing community spread," Lyons wrote in an e-mail. "Much of the public discourse has been about age and co-morbidities as risk factors, but that undersells the simple fact that the vast majority of these patients would still be alive if it weren't for COVID-19."

The stories behind the death counts are heartbreaking, Lyons added. Those who have been lost include sons and daughters, parents and grandparents, partners and neighbors.

"Their deaths leave a hole a mile wide through the lives of their loved ones, and it's a particular tragedy that their personal grief is being subsumed into a national and international tragedy," he wrote. "Families cannot grieve and process in the normal ways. I've had more end-of-life conversations via telephone the last several months than the rest of my career combined."

On Saturday, the Minnesota Department of Health announced 4,447 new coronavirus cases, a figure that pushed down the seven-day rolling average for new infections to its lowest point in more than a month, according to the Star Tribune's coronavirus tracker.

At its peak on Nov. 20, the state was averaging more than 7,000 new cases per day. Even so, it might still see an increase from Thanksgiving travel and gatherings, said Kris Ehresmann, the state's director of infectious diseases. She added that while case numbers show signs of stabilizing, they're doing so "at unacceptably high levels."

"The continuing high number of deaths is very concerning," Ehresmann wrote in an e-mail. "The impact of deaths lags behind cases, and so even as cases stabilize we are continuing to see the devastating impact of the mid-late November cases."

The latest Health Department data show the number of new COVID-19 hospital admissions continues to trend downward. The percentage of ICU and general hospital beds occupied by those patients is "slowly sliding down," said Dr. Rahul Koranne, president of the Minnesota Hospital Association. That's still "a lot of patients," Koranne said.

In November, hospital capacity tightened due in part to more health care workers being sidelined by the virus. Koranne said the percentage of all hospital workers surveyed who can't work following a virus exposure has dropped from 5.7% on Nov. 11 to 3.8% last week.

Hospitals hope recent numbers "could be the beginning of an encouraging trend," he said, adding: "We have to remain watchful and on high alert."

The stress on hospital workers remains high.

"They're exhausted and they're in desperate need of our help," Dr. Kevin Croston, chief executive of Robbinsdale-based North Memorial Health, said Friday. Of the case trends, he said: "In all honesty, we're watching right now with wary eyes."

Residents of long-term care and assisted-living facilities accounted for 37 deaths announced Saturday and 2,856 fatalities since the pandemic's start. Since March, the state has reported 375,398 cases and 19,428 hospitalizations. Most of the deaths announced Saturday were in people 65 or older.

The Upper Midwest saw a surge in cases following a two-week cold snap in October, said Dr. Jonathan Temte, associate dean for public health and community engagement at the University of Wisconsin.

"We have had an unusually warm November and start of December," Temte said via e-mail. "There is a delicate interplay between environment and behavior out there."

Gov. Tim Walz said Friday he wants to see more data before deciding whether to extend restrictions closing bars and restaurants to in-person service, and limiting gatherings to just those who live in a household. Last week, the state also announced plans for distributing later this month the thousands of doses of the first COVID-19 vaccine. The promise of the vaccine is significant, but it won't have a measurable impact in Minnesota until early next year, Osterholm said.

"This is the week where people really are finalizing Christmas plans," he said. "I know this is a very unpopular statement, but this is our COVID Christmas. We must, in the strongest terms, let people know that if you get together at Christmas, and someone ... bring[s] that virus home, there very well could not be people sitting around the Christmas table next year."

Christopher Snowbeck • 612-673-4744