Minnesota health officials ratcheted up their warnings Monday that the state is on the wrong path with COVID-19 and implored people to change their behavior or risk Minnesota sinking into struggles similar to Florida and Arizona.

Health leaders had sharpened their messages of personal responsibility the past few weeks as they pleaded with Minnesotans to wear masks in public gathering spaces, socially distance and stay home if they don’t feel well.

On Monday, they made it clear the state is heading for serious trouble if too many Minnesotans continue to do the wrong things.

"We cannot afford to have this Labor Day weekend further accelerate the community spread, because if that happens, what comes next is going to be worse," Minnesota Health Commissioner Jan Malcolm told reporters Monday. “For a while now, we feel we’ve been kind of walking on the edge of a cliff.”

The “alarming” problems right now, she said, involve people lowering their guard at family gatherings, backyard events with friends and other get-togethers.

Minnesotans’ behavior in stores, restaurants and other public places isn’t so much the problem now, but “informal gatherings have really proven to be a weak spot in our response to the pandemic,” the commissioner said.

Officials cited nine wedding outbreaks, two funeral outbreaks and 13 social gathering outbreaks, and more than 250 cases associated with college-age students, surfacing largely off campus.

Malcolm also cited Minnesotans who’ve been traveling in COVID-19 hot spots in the south and west returning to the state and bringing the disease back.

“Cases have now begun increasing at a faster rate than our testing,” she warned. “We see outbreaks occurring in many settings in our state … a really concerning high level of community transmission.”

Malcolm and Kris Ehresmann, the state’s infectious disease director, conceded that many people, fatigued by six months of hearing about the need to take precautions against the disease, may be tuning out.

“The bottom line is people have to follow them in order for them to work,” Ehresmann said of the public health safety recommendations. “We can provide lots of guidance … but that’s not what will turn this pandemic around.”

Cases climb, hospitalizations dip

Malcolm’s warning came hours after her agency released data showing one additional death but 679 more confirmed cases. Over the past week, Minnesota’s seen its number of active, confirmed cases reach a record high.

The count of people currently hospitalized (306) dipped from Sunday yet remained stubbornly consistent all through August at around 300 patients daily. The count of those needing intensive care (131) fell to its lowest level in more than a month.

The recent surge in cases hasn’t translated yet to an increase in hospitalizations. It’s been largely driven by 20-somethings, who are generally less likely to suffer symptoms severe enough to require hospitalization.

Officials, though, have warned for weeks that the waves of news cases will eventually push the hospitalization numbers higher.

Of the 75,864 confirmed cases of the disease in the pandemic, about 89 percent of those identified have recovered to the point they no longer need to be isolated.

Among the 1,817 who’ve died, about 74 percent had been living in long-term care or assisted living facilities; nearly all had underlying health problems.

Suburbs, southern MN drive new cases

Regionally, the Twin Cities and suburbs had been driving the counts of newly reported cases. Monday’s data, however, show new cases exploding everywhere except Hennepin and Ramsey counties.

Northern Minnesota cases are resuming their climb after jumping in July and then retreating a bit. Beltrami County, home to Bemidji, has seen a steady climb the past few weeks. The county reported 321 cases and one death as of Monday.

Meatpacking operations had been hot spots for big outbreaks in southwest, west-central and central Minnesota earlier in the pandemic.

New cases had slowed considerably, although the problem has resurfaced recently in McLeod County (362 cases), where more than 20 employees at a Seneca Foods plant in Glencoe were identified recently in an outbreak.

Le Sueur and Waseca counties are also seeing big, recent case increases. Le Sueur showed 378 cases and two deaths as of Monday.

College concerns grow as fall semester nears

Worries continue about the growth of COVID-19 among younger Minnesotans, including that those infected will inadvertently spread the virus to grandparents and other more vulnerable people.

People in their 20s remain the age group with the highest number of COVID-19 confirmed cases in the pandemic — more than 17,500.

State health authorities have been reiterating their concerns about college students joining end-of-summer parties and other gatherings that could feed the spread of COVID-19 and bring it onto campuses this fall.

Officials on Monday also noted a spike in Winona County they attribute to college-age people returning to schools there. Winona State University and St. Mary's University are based in Winona. The city also has a Minnesota State College Southeast campus.

Minnesota’s Sturgis cases rise; 1 in ICU

State health officials worried for weeks about Minnesotans carrying COVID-19 back from the massive Aug. 7-16 motorcycle rally in Sturgis, S.D.

The cases came rolling in shortly after the rally ended. Minnesota now has 49 cases tied to the Sturgis rally, with two people in the hospital and one in intensive care, Ehresmann said Monday.

“The lasting effects of this large event are still being seen,” she said.

Officials have urged anyone who went to self-isolate for 14 days, get tested if they don’t feel well and stay home until they get the test results.

The rally drew some 460,000 people from across the country. Most people didn't take significant precautions against COVID-19 infections. A few people wore masks and some said they were avoiding crowds, but many others packed close together at bars and rock shows.

‘Worrisome trend’

The newest numbers come after the state’s case total climbed by nearly 2,000 over the weekend.

The number of new cases reported each day has been trending upward in the past couple weeks after falling earlier in the month. The percentage of tests coming back positive has also been trending up.

That drew the attention of White House coronavirus response coordinator Dr. Deborah Birx, who was in Minnesota on Sunday.

Birx noted to reporters that there’s a “worrisome trend” here because Minnesota now has nine counties where the rate of positive cases detected in tests now tops 10 percent, up from just a couple not long ago.

Statewide, the percent of positive COVID-19 tests has been over 5 percent since Thursday.

That Birx meeting on Sunday appeared to galvanize Malcolm on Monday.

Birx, she said, made “strong and pointed warnings” about Minnesota’s current position in the COVID-19 pandemic, noting that the Twin Cities and its suburbs stood out to the federal government as one of the few urban areas in the country where case counts are surging in recent weeks.

Malcolm said that Birx emphasized that it was critical Minnesota bring down the case growth and level of community transmission before winter, when people return to more of an indoor existence, creating more close contact and accelerating the opportunity for spread.

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