Minnesota could see more COVID-19 restrictions this week, including a pause on youth and varsity athletics, to stem a surge in the pandemic that threatens to overwhelm hospitals and leave patients without care when needed.

College students are also being advised to stay on campus over the Thanksgiving holiday or take precautions to prevent spread of the virus.

COVID-19 hospitalizations have increased 93% since Nov. 1 — with Minnesota hospitals reporting on Monday a record 1,558 patients who were admitted to inpatient beds with the infectious disease. Nearly 30% of intensive care patients statewide now have COVID-19 — a rate that has nearly doubled over the past month.

"As we peak right now, I think it is obvious we are going to have to do more mitigation measures," Gov. Tim Walz said on Monday.

One change urged by state health officials is a suspension of amateur athletics. The latest social outbreak data from the Minnesota Department of Health showed that 780 people were likely infected at 192 sports-related outbreaks. And 51 of those outbreaks were identified in November — with hockey, volleyball and football having some of the highest numbers.

State infectious disease director Kris Ehresmann said sports are responsible for 10% of all COVID-19 cases in schools, and for a southern Minnesota school and a central Minnesota school district reverting to online instruction.

"Here in Minnesota we are going to be targeted," Minnesota Gov. Tim Walz said at a Monday, Nov. 16 news briefing. He announced dial-back restrictions last week that included earlier closing times for bars.

While dial-back measures pertaining to sports and other social activities could come Wednesday, Ehresmann on Monday offered new advice to college students regarding the holidays.

She said the Minnesota Department of Health "strongly discouraged" students from traveling home for a few days for Thanksgiving if they plan to return right away to campus — potentially bringing the virus to or from home in the process.

Ehresmann said students going home for holiday breaks should first get tested for COVID-19 and then "lay low" for several days to make sure symptoms don't emerge. Alternatives include staying on campus and having virtual Thanksgivings or celebrating with roommates only.

"We know Thanksgiving is traditionally a time to reunite with friends from your high school and hometown, but it's very risky right now to get together with friends," she said. "Crowds and drinking have been associated with outbreaks of COVID-19."

The underlying concern is that hospitals could be swamped by the rising number of patients needing treatment for COVID-19 and other unrelated medical issues.

The 7,444 diagnosed infections reported on Monday brought the state's total in the pandemic to 231,018 — putting it on pace for more than 300,000 by Thanksgiving.

Intensive care nurse Kelley Anaas said she worked 32 hours this weekend at Abbott Northwestern Hospital in Minneapolis, where ICU beds were jammed with COVID-19 patients and transfers were coming from Stacy, Brainerd and Bemidji.

"We intubated more patients than we transferred out to the medical floors," she said, "and we said goodbye to patients we were caring for for weeks."

Twelve new COVID-19 deaths were reported Monday, bringing the state's toll to 2,917.

The state's pandemic response dashboard shows that 1,121 of 1,429 immediately available ICU beds are occupied by patients with COVID-19 or unrelated medical or surgical issues. Another 408 ICU surge beds could be readied within 72 hours if needed and if staffing were available.

Hospitals have seen a 500% increase in COVID-19 patients since mid-September and a 5% daily increase in overall inpatient activity in recent days, said Dr. Cameron Berg, medical director of the emergency department at North Memorial Health Hospital in Robbinsdale.

Berg said current numbers are akin to a severe influenza season, but that the current rate of growth cannot continue. "If we extrapolate that out for another six weeks, we would be in a very challenging situation," he said.

One positive is that doctors have improved and accelerated hospital care of COVID-19 patients, said Dr. Greg Beilman, incident commander of the COVID-19 response at M Health Fairview. The average length of stay for COVID-19 patients requiring intensive care has declined from 16 days to 11 days, and the average for other COVID-19 patients has dropped from eight days to five days.

"We're all looking at the models and we're planning for an increase in COVID patients over the next three weeks," he said. "I'm hoping that it starts to flatten out at that point as public health measures come into effect."

Walz urged Minnesotans to continue to wear masks, practice social distancing, stay home when sick and avoid large group gatherings in order to slow the spread of the novel coronavirus that causes COVID-19. He lamented that these protective measures have become so politicized, but he urged his Republican opponents to stick with the guidance if for no other reason than to stay healthy enough "to vote against me in two years."

Last week Walz announced restrictions designed to limit spread, including a 10 p.m. closing time for bars and restaurants, a limit of 10 people at social gatherings and a phased-in cap at receptions for weddings and funerals.

Health officials hoped that positive news on the vaccine development front would give people hope of an end point for the pandemic and the resolve to stick with preventive measures. Moderna on Monday joined Pfizer in reporting more than 90% effectiveness in interim results of its vaccine clinical trials.

"There is light at the end of the tunnel," Walz said.

However, vaccine availability won't be immediate. State Health Commissioner Jan Malcolm said that front-line health care providers could at best receive vaccines in the next couple of months, followed by people at greater risk of severe COVID-19 due to their age or underlying health problems. Broad vaccine availability might not come until late winter or early spring of 2021, she said.

Planning is underway if prevention measures fail and infection growth pushes patient volumes beyond hospital capacities. The Minnesota Hospital Association last week sent a letter to Walz asking for a variety of temporary changes to state rules and laws that could increase staffing. One example included allowing graduating nursing students to begin clinical care if they have completed coursework but not final exams.

Hospitals already are asking retired nurses to return to work and are deferring elective or non-urgent surgeries. Allina Health announced delays in procedures requiring hospital admissions from Nov. 16 through at least Nov. 27 at its Abbott Northwestern, Mercy and United hospitals.

"This crisis around staff," Walz said, "is one we're going to have to be creative" about.

Staff writer Chris Snowbeck contributed to this report.