Minnesota's COVID-19 cases continue to decline but high rates of infection are still being caused by the highly contagious omicron variant.

"Omicron hit with a vengeance and really swept through the state," said Dan Huff, an assistant commissioner with the Minnesota Department of Health. "The good news is it appears that we have peaked and are coming back down."

"We still have very, very high case counts in Minnesota," Huff told the Minnesota House Health Finance and Policy Committee on Wednesday. "A few regions in the state are still on the increase."

Another 5,480 new COVID-19 cases were announced Thursday by the Health Department along with 45 more deaths, bringing the pandemic totals to 1.35 million infections and 11,561 fatalities.

The Health Department had been working through a backlog of cases caused by the flood of positive test results during January. Thursday's case count includes more than 1,000 that were more than one week old. But by adding staff and streamlining case processing, the backlog has been cleared, according to a statement issued by the department.

In mid-January, Minnesota had a daily average of about 13,000 cases, based on the date tests were sampled. The average fell to 4,100 last Friday.

Minnesota's pandemic indicators also continue to slide, with the test positivity rate falling to 20%, from a high of 23.6%. The per capita daily case rate is 161.7 per 100,000 people, more than a 30% decrease from the high of 239.6.

Hospitals and clinics are beginning to see some relief from the crush of people seeking testing or treatment.

"This is the first week where things have felt more steady again for our community and for our staff, but there is always this sense of what is next," said Dr. Lauren Graber, vice president of population health at Minnesota Community Care, which has three medical clinics, partners with organizations that serve the homeless and also provides health care to St. Paul Public Schools students.

"This past month has been unbelievably hard for our community, with by far the highest rates of COVID infection that we have seen," she said.

As the pandemic drags on, some patients are ready to move on while others have developed a "heightened sense of anxiety."

"This anxiety about interacting, this anxiety about needing to look after others or assuming adult responsibilities at younger ages," Graber said. "Trying to figure out what will normal look like. That is a question for all of us."

The first signs of a downward slope in omicron came as research on Minnesota's wastewater began showing a decline in COVID-19 genetic material in the second week of January. Because people often delay testing until they get symptoms, or don't get tested at all, wastewater has been one of the most reliable indicators of how much coronavirus is circulating in the state.

"In the metro areas, you are seeing the measures in wastewater coming down," said Dr. Tim Schacker, vice dean for research at the University of Minnesota Medical School. "There are still parts of the state where we are not seeing that, where it is either going up or it has plateaued."

University researchers have been working with 44 treatment plants that process wastewater for about 67% of the state population.

"In southwest and southeast Minnesota, we are not seeing much of a decline in general," he said. "There are places in the northern part of the state or the western part of the state where it looks like it is coming down."

Schacker said comparison of results by region can be complicated because of the varying amounts of wastewater analyzed.

"You tend to see a bigger decrease in wastewater plants that have a larger population," Schacker said.

As COVID-19 cases continue to recede, fewer test reports are coming into the Health Department, either because fewer people have symptoms or because fewer people are being exposed to infected people.

The average daily number of tests has fallen to about 42,000, from a high of 65,000 in mid-January.

Hospitalizations have remained steady, with 1,350 getting treatment from Minnesota hospitals Wednesday. The number needing intensive care continues to trend down, with 193 in ICUs compared with 371 in mid-December.

Seasonal influenza also is putting less pressure on hospitals, with 16 people admitted to hospitals for flu last week, less than half of the 34 flu patients the previous week. There have been 535 hospitalizations this flu season, which began in the fall. That's the lowest number in the past five seasons, except for last year when the flu barely made an appearance.

However, three more people have died from flu-related complications, raising the seasonal total to 30.