COVID-19 hospitalizations in Minnesota increased to 1,616 on Thursday, but a fall in the number of intensive care patients remains a hopeful sign in the latest pandemic wave.

Non-ICU hospitalizations have increased 34% in January, reaching the highest total in Minnesota since Dec. 2, 2020. However, the 260 ICU cases on Thursday represented a 13% decline this month. Hospital leaders urge people to get vaccinated, wear masks and quarantine after coronavirus exposures to keep pressure off capacity.

Symptoms have been less severe among patients infected by the fast-spreading omicron variant since it replaced delta as the dominant viral strain, said Dr. George Morris, who leads the COVID-19 response for St. Cloud-based CentraCare. However, patients also are going into hospitals later in their illness, so the surge of infections could mean that demand for beds is next.

"The peak is so high, so high, that it's going to take a while to see what it does for medical needs and what it does for mortality in our community," he said.

The positive rate of COVID-19 tests in Minnesota increased to a record 21.6% in the week ending Jan. 6. The state on Friday also reported 11,560 more infections and 32 COVID-19 deaths, including three people in their 30s. That increased the state's pandemic totals to more than 1.1 million infections and 10,971 deaths.

Gov. Tim Walz said Minnesota is probably "in the worst of it," but the latest wave hasn't peaked. Modeling projections are unclear, but omicron's early arrival in other states and countries offers clues to Minnesota's future, he said.

"My hope is, and the evidence seems to support this, that once it starts to come down, it starts to come down as fast as we saw it go up," said Walz, after visiting the Mall of America's COVID-19 vaccine site Thursday. "If that happens, that's really good news."

Influenza was nonexistent last winter but is a complicating factor in the latest COVID-19 wave. Minnesota on Thursday reported 418 influenza hospitalizations so far this season, compared with 35 all last flu season.

Kelley Anaas, an intensive care nurse at Abbott Northwestern Hospital in Minneapolis, said her hospital has open beds for waiting patients that can't be staffed because so many colleagues have COVID-19 and are out sick.

"There's not a day in the last month that ... I haven't gotten a text or e-mail asking if I could be willing to come in, if only for four-hour stints, just to kind of limp us through this latest surge," she said.

The COVID-19 cases in the ICU "still continue to be the sickest patients that we've ever taken care of," she added.

The omicron wave has stretched testing supplies as well, prompting CentraCare on Friday to restrict its testing to symptomatic patients. People needing negative results to travel, go to restaurants, or return to work or school should order at-home tests or schedule appointments at free state sites, Morris said.

"We need to preserve our capacity for medical treatment, medical diagnostics and medical staff," he said.

Bloomington-based HealthPartners also has suspended testing of people who are outside its health system or asymptomatic, a spokesman said Friday.

The delta wave last fall took off in rural counties with lower vaccination rates before rising in metro areas. The omicron wave is the reverse, hitting the Twin Cities hardest over the past month and spreading outward. Health officials hope that vaccination progress and the often less-severe effects of omicron-triggered illness explain why the share of COVID-19 hospitalizations requiring intensive care has dropped from more than 25% last fall to 16%.

Minnesota ranks second among states with more than half of its fully vaccinated residents receiving boosters, according to the Centers for Disease Control and Prevention. More than 4 million Minnesotans 5 and older have received at least first doses of vaccine — or 77% of the eligible population.

Morris said he is worried that talk of a rapid peak, milder illness and shorter quarantines can make people complacent. Monoclonal antibody therapies and new COVID-19 antiviral pills also are in short supply and being reserved for people at greatest risk.

"Less severe doesn't mean mild," he said. "Less severe just means not as many people are dead from it."

Other states are tracking the severity of omicron by differentiating hospitalizations based on whether patients are primarily treated for COVID-19 or their infection is secondary to other issues. Iowa reports that COVID-19 is a secondary diagnosis for 36% of the 871 infected hospitalized patients. That is an increase from 25% on Dec. 1.

Separating out the role of COVID-19 in hospitalizations can be challenging, said Dr. Carolyn Ogland, chief medical officer for North Memorial Health, which operates hospitals in Robbinsdale and Maple Grove. She called COVID-19 the "great masquerader" because of its ability to cause illness on its own or worsen other health problems.

"People have underlying issues, so cardiac issues or COPD, that type of thing," she said. "Did COVID exacerbate them? That's the part we don't know. Were they at risk [for hospitalization] and did COVID push them over the edge? That answer is probably, yes, that it was COVID."