COVID-19 patients requiring critical care are increasing in Minnesota and combining with patients with other medical needs to use up intensive care beds in the Twin Cities.

The Minnesota Department of Health on Friday reported 534 COVID-19 cases in hospitals — a decline of 32 compared to Thursday — but a record 233 of those patients needing intensive care.

“We are tight,” said Dr. John Hick, a Hennepin Healthcare physician who is leading the coordination of hospitals in their pandemic response, in an e-mail. “Resuming elective surgeries plus an uptick in ICU cases has constricted things pretty quickly.”

The Health Department on Friday also reported 33 more deaths — 25 in long-term care and one in a residential behavioral health group home — from the respiratory disease, which is caused by a novel coronavirus. A total of 842 have died in the pandemic so far.

Infections confirmed by diagnostic testing increased by 813 on Friday to 19,005 overall.

The state’s pandemic preparedness website as of Friday indicated that 1,045 of 1,257 available ICU beds were occupied by patients with COVID-19 or other unrelated medical conditions — and that another 1,093 beds could be readied within 72 hours.

Nurses in the Twin Cities reported being called in for overtime shifts for the Memorial Day weekend, and doctors reported that hospitals periodically had no ICU beds open this week and had to refer or transfer patients with critical care needs to other hospitals.

Rising COVID-19 case counts caused part of the pressure, along with resumption of more surgeries that resulted in many patients needing ICU stays amid their recoveries.

While 80% of infections cause mild or no symptoms, the rapid spread of the novel coronavirus in Minnesota still means that a large number of people will suffer more severe cases and potentially need hospital care.

Health officials are particularly concerned over people with underlying health problems — including asthma, diabetes, smoking, and diseases of the heart, lungs, kidneys or immune system. Individuals with such conditions and long-term care facility residents have made up around 98% of all deaths.

The total number of long-term care deaths related to COVID-19 is now 688.

Estimates by the University of Minnesota’s Center for Infectious Disease Research and Policy are that around 5% of the total population has been infected — even if people haven’t been tested or diagnosed.

As of Friday, 12,696 Minnesotans had recovered from their confirmed cases and were no longer required to isolate themselves to prevent from spreading the disease to others.

State health officials have started to make gains in one key area — reducing the number of confirmed cases for which the source of infections can’t be identified. The rate of community-acquired infections with unidentified sources dropped from 43% on May 7 to 38% on May 13, the latest date for which data was published.

Infections with unknown sources raise concerns for public health officials, because they indicate that the virus is spreading beyond their knowledge and tracking efforts. The state wants the rate to be less than 30%.

This rate of unidentified infections sources is one of five “dial back” metrics that health officials are monitoring to determine if new strategies are needed to slow the spread of the virus.

Gov. Tim Walz had put the state under a stay-at-home order for 51 days, until it was lifted on Monday, to buy time for hospitals to prepare and add ICU beds and ventilators.

Bars and restaurants remain closed for now — though they will be allowed to provide outdoor dining service as of June 1. Gatherings are being limited to 10 or fewer people, including church services, according to the state’s latest “Stay Safe MN” strategy.

Health officials urged people to remain compliant with recommendations to wear masks, stay 6 feet apart from others and practice basic steps such as washing hands and covering coughs.

Diagnostic testing for COVID-19 increased as well, with another 7,415 tests on Thursday bringing the total so far to 180,971.

The state reported as of May 14 that 12% of all diagnostic tests were positive for COVID-19.

Universal testing of all workers and residents in long-term care facilities with confirmed COVID-19 cases is a growing part of the state’s pandemic response. State health officials on Thursday said that facility-wide testing has been completed in 39 long-term care facilities so far, amounting to 7,000 residents and staff. Another 30 facilities are scheduled.