Coronavirus infections have risen back above Minnesota’s high-risk threshold, but health officials hope COVID-19 immunity levels will limit the number of cases that result in hospitalization or death.

Minnesota for the first time in two months has identified more than 1,000 infections in a day, despite the rising popularity of at-home rapid antigen COVID-19 tests that aren’t included in state tallies. The 1,003 infections among samples collected April 13 drove Minnesota’s COVID-19 case rate to 12 per 100,000 residents, above the threshold of 10 indicating substantial viral spread.

People are eager to move on from the pandemic but should still take precautions such as staying up to date with vaccinations and wearing masks on public transportation — whether it is mandated or not, said Dr. Dimitri Drekonja, an infectious disease specialist with the Minneapolis VA Medical Center.

“[The] message needs to shift from ‘we’re moving on’ to ‘we’re better off but still at risk and can be better,'” he said in a social media posting.

Hospitalizations already increased in response to the turnaround in infection numbers from 183 on April 10 to 215 on Wednesday. However, only 24 of the COVID-19 hospitalizations required intensive care, and that daily number has been declining since mid-December.

Minnesota reported three more COVID-19 deaths on Thursday, but death numbers have not increased in response to the latest uptick in infections. Vaccinations and unprecedented infections during the January omicron COVID-19 wave have left many Minnesotans with at least temporary immunity, which reduces the risk of severe illness.

Reinfections also have increased over the past two weeks, indicating that immunity might be waning. There were 119 reinfections identified from samples collected April 13 — more than 1 in 10 of the COVID-19 cases identified on that date. Overall, Minnesota’s more than 1.4 million known infections include 64,260 reinfections. The state’s COVID-19 death toll is 12,482.

A BA.2 coronavirus subvariant remains responsible for the small but steady increase in COVID-19 activity in Minnesota over the past month. BA.2 was found in 84% of positive COVID-19 specimens that were analyzed through genomic sequencing in the week ending April 9, according to Minnesota Department of Health data released Wednesday. That is an increase from 61% a week earlier.

Wastewater sampling in the Twin Cities has found an increasing amount of viral material as well, and that more of it is made up of BA.2. Updated results from the Metropolitan Wastewater Treatment Plant are due Friday.

COVID-19 vaccination activity has increased in Minnesota, where 71,962 doses were administered in the week beginning April 10 — an increase from 17,511 in the week beginning March 20.

However, the state remains stuck at 49% in its rate of Minnesotans 5 and older who are up to date with COVID-19 vaccination — meaning they have recently completed the initial series or received scheduled boosters to maintain immunity.

The increase in vaccine administration is largely among people receiving second boosters, which were OK’d by federal authorities late last month. Second boosters are permitted for people who are 50 and older, have weakened immune systems or have received only the less-effective Johnson & Johnson vaccine.

All Minnesota counties are listed at low COVID-19 risk by the Centers for Disease Control and Prevention, meaning none have recommendations for broad, public indoor mask-wearing to reduce viral transmission. The CDC risk determination is based on a combination of local infection and hospitalization levels.

Only 27% of Minnesotans wear masks in public most or all the time, according to COVIDcast survey data, down from 63% at the peak of the omicron pandemic wave in mid-January.