The omicron variant is shifting how many Minnesotans think about COVID-19, as the growing risk of infection creates a weary resignation even among those who've conscientiously tried to avoid the virus.

The variant is quickly creating a spike in overall cases and breakthrough infections among the vaccinated. Noting the change, more doctors and people are talking about what feels like the inevitability of becoming exposed and hope that the virus soon might enter a more tame "endemic" phase.

Health officials caution, however, that infection is not inevitable and people shouldn't give up on prevention strategies that can still make a critical difference in coming weeks. Limiting transmission is more important now than ever, they argue, to protect vulnerable people and curb the number of workers being sidelined in hospitals, schools and other essential services.

"We very much hope that in this next year that we do get to the stage where it's endemic — which means it's not an overwhelming threat to most people and to society and that it's in the background," said state Health Commissioner Jan Malcolm. "This is very much still in the foreground. I think the mindset and the goal is the same; it's just the length of the marathon keeps stretching out in front of us."

'Just waiting for it to come'

Heather McLean who lives in Stillwater with her husband, two children and her elderly parents, sums up the moment this way: "It's a weird time."

For two years, McLean and her family did everything possible to keep the virus at bay. Her husband has chronic health problems, and her mom battled cancer last year.

The family was locked down until everyone in the house was vaccinated.

Although the family still takes precautions, the two kids are back in school after more than a year and half of remote learning. While it surely increases the family's infection risk, the children are much better off with teachers and peers in the classroom, McLean said.

With omicron cases spiking, e-mails pop up regularly on McLean's phone about new COVID infections in the schools.

"It's spreading like wildfire," she said.

Teachers, bus drivers, custodians and many others who make schools work are getting sick.

"Everything is a hot mess," McLean said.

"We're trying as a family to be careful," she said. "It feels useless, because we're all going to get it. … We're just waiting for it to come. And that's a really uncomfortable feeling."

Still, vaccinations combined with a less-dangerous variant for those who are immunized have allowed McLean to feel safer than she did in 2020 and early 2021.

"I personally feel [the virus] is something we have to live with, like the flu," McLean said.

Cat Ulrich, a 28-year-old lawyer who lives in St. Louis Park, and many of her friends also are trying to strike a balance, staying connected to friends and family while safeguarding themselves.

Once Ulrich was vaccinated, the summer of 2021 felt more normal as she and friends returned to restaurants, breweries and even a concert. When the delta variant emerged, booster shots relieved her anxiety about it. When omicron hit, her concerns were quelled because evidence began to show vaccinated people were less likely to get a severe illness.

"I have friends who have gotten sick, and it's been like a cold," Ulrich said. "I'm more confident that if I get sick, I'll be fine."

Still with the variant sweeping the country, Ulrich and her friends wear masks more often in public, eat in restaurants less often and keep social gatherings small and limited to those who are vaccinated and boosted.

When a family gathering included her unvaccinated 2-year-old godson, everyone took a rapid COVID test in hopes they could avoid infecting him.

"We're learning to live with this," Ulrich said. "It's been exhausting. At this point, I almost feel indifferent. I've exhausted all my energy with it. We care about it, but at the same time, we're so tired of it."

But for Gail Harless of Linwood Township in Chisago County, the risks of COVID are still too high to accept that getting the virus is inevitable. The 67-year-old retired data analyst is diabetic.

"I'm barely old. I'm barely obese, but I fear if I got it, I might have a bad outcome," Harless said. She's vaccinated and remains vigilant.

"With omicron, there's no end in sight," she said. "I'm an outgoing person, and this is just killing my soul. But I can't let up. How can I take a chance? I'm too young to die."

For Ashley Olthoff of Minneapolis, her two sons keep her steadfast in her vigilance. Four-and-half year-old Keith isn't yet old enough to be vaccinated, and 7-year-old Oliver has Down syndrome and is a cancer survivor who finished chemotherapy last year for leukemia.

During the rise of delta last summer, Oliver fell down the stairs and was taken to the emergency room. Soon after, he was back in the hospital, fighting COVID for five days.

"It's been hard to watch other people go back to regular life," Olthoff said. "For many people, the pandemic is over. But for us, that just doesn't seem like an option. We'll do anything to not end up in the hospital again. He's already spent too much of his life in the hospital."

So Olthoff calculates every decision, every risk.

"It's exhausting," she said.

She understands the weariness pushing some people to say they're done battling the virus.

"But we have to protect the most vulnerable in the community." Olthoff said. "Right now all the hospital beds are full, and for me, knowing with delta that my son needed a hospital bed, [it's] so terrifying to know that one might not be available now for him if he needed it."

From pandemic to endemic

Unprecedented numbers of people are getting infected amid this month's "viral blizzard," yet trying to slow transmission remains key, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Among other things, he said, prevention can buy time to manufacture powerful new medications.

"Would you call it a lockdown when the weather service announces we're going to get 26 inches of snow ... and you don't go driving around town?" Osterholm said. "That's not a lockdown. That's a prudent decision you make to not put yourself in harm's way."

No one knows whether a more dangerous variant might emerge after omicron. But the emergence of "hyper-infectious" variants likely signals a shift toward the coronavirus becoming endemic, meaning COVID-19 will persist around the globe rather than be eradicated, said Dr. Andrew Badley, an infectious disease specialist at Mayo Clinic.

The endemic shift won't mean the end of serious illness and death from COVID-19, but the virus will become more controlled like influenza with regular vaccinations, said Dr. Gregory Poland, a vaccine immunologist at Mayo.

"The virus wants to infect you but not to the point where you're sick in bed," Poland said. "That's how we generally see [viruses] moving from pandemic or epidemic into endemic, that there will be enough eventual herd immunity that variations will occur less often."

The state Health Department's director for infectious diseases, Kris Ehresmann, came down with COVID-19 right after New Year's along with her 89-year-old father.

Infections are spiking, Ehresmann said, but that doesn't mean people should just throw up their hands. Those who've boosted their vaccinations will be glad, she added, because their cases are more likely to resemble the relatively mild symptoms she and her father experienced.

"I'm very healthy and my dad has been very fortunate to be very healthy, even though he's elder," Ehresmann said. "But there are still people — they're in a high-risk situation, and I still feel a sense of responsibility to do everything I can to make sure I'm limiting spread on their behalf."