DULUTH – Linda Shank's last Facebook post was on Nov. 10.

"I had two weeks of gastrointestinal trouble, nausea, diarrhea. I still have those symptoms and we are on day 12 of fever, chills, terrible body aches, fatigue, cough," she wrote. "I just wanted to share our symptoms and tell you all to be extra careful right now. We must have let our guard down once and that is all it took to get the virus."

Her husband took over her account on Nov. 21 to give an update.

"She is not doing well. She is in very critical condition," Gene Shank wrote. "Doctor says she has a 50-50 chance of survival. ... I am so afraid of a phone call in the middle of the night saying she's not going to make it."

She died on Dec. 5 at age 69.

Long spared the high level of death and grief that has accompanied the spread of the coronavirus across the globe, northeastern Minnesota and northwest Wisconsin have seen a stunning increase in COVID-19 deaths in the past month.

In Carlton County, where Linda Shank lived, deaths have nearly quadrupled, from 8 to 31, since mid-November.

In Douglas County, Wisconsin, home to Superior and 43,000 people, only one person had died from the virus through Nov. 8. As of Thursday there have been 29 confirmed and probable deaths, according to state data.

And in St. Louis County, home to 200,000 people, 65 have died from COVID-19 just in December, the Minnesota Department of Health reports. That's more than a third of all coronavirus deaths in the county, which now total 177.

The spike in deaths follows an unprecedented rate of new infections in the region in November. Reported infections grew 160% over the month in St. Louis County and 138% across the border in Douglas County.

"It makes sense from a disease transmission perspective that we're seeing a higher number of deaths because of our high community transmission rate," said Amy Westbrook, St. Louis County's director of public health. "As we see community transmission go unchecked then everyone in our community becomes susceptible."

State health officials expect the COVID-19 death rate to begin to decline, following drops in the infection rate since mid-November and in the hospitalization rate since the beginning of December. That doesn't change the record-setting surge in November, when the virus increasingly killed people outside of long-term care facilities, where deaths were initially concentrated.

At the end of October, 75 people had died from COVID-19 in St. Louis County, and all but six of them were residents of long-term care facilities or group homes. Since the start of November, a third of the area's 102 coronavirus victims were living in their own homes — many of them in northern parts of the county outside of the Duluth area.

"It is expected that we would see an increase in deaths in both long-term care and other settings based on the amount of disease circulation going through communities right now," Westbrook said.

The more the disease spreads around the community, the more likely it will reach someone who could die from it.

Some of this fall's spread can be attributed to students in off-campus housing, Westbrook said. The county has reported 741 cases associated with colleges, with just a handful traced to dorms or other campus settings.

"We saw transmission with a lot of off-campus housing settings — I think that was a big driver in the early fall," she said. "The colleges did a great job with on-campus buildings and housing. It was really in the off-campus housing that we were seeing the impact."

The University of Minnesota Duluth expects spring semester to operate much the same as fall — a mix of in-class, online-only or hybrid classes, with similar approaches to housing and residence life.

Last week the region's two largest hospitals said that with the recent vaccine approval, the pandemic's end is just over the horizon, though as the rise in deaths continue — another five were reported Friday in St. Louis County — it could get worse before it gets better.

"Unfortunately, there's more dark days ahead," said Dr. Jon Pryor, president of Essentia Health's east market. "We're not over this yet."

Essentia administered the first vaccines in Duluth on Thursday to 120 front-line staffers after receiving 975 doses earlier this week. On Friday an ICU nurse named Sam Moder received the first vaccine at St. Luke's Hospital, which received enough initial doses to inoculate 850 people.

Applause followed the shot as officials marked the historic occasion.

"Today is a day of remembrance," said Dr. Nick Van Deelen, co-CEO of the health system.

Westbrook said not to take too much solace in the vaccine just yet, since early doses will be given only to those at high risk of infection and death and it will be some time before the general population is inoculated.

"I think the biggest risk right now is people letting down their guard — thinking because we're starting a vaccine distribution process that they can let down their guard," she said. "But that isn't the case. We need to make sure we're still doing what we know works at preventing disease."