COVID-19 hospitalizations and cases declined in Minnesota, according to a data update Friday, but the state still has a high level of coronavirus transmission and little critical care capacity to treat the sickest patients.

While COVID hospitalizations dropped in one week from 1,678 to 1,554 on Thursday, the latest count included 374 patients needing intensive care because of breathing problems or complications from infections. That brought the state closer to its one-day record in November 2020 — before vaccines were available — of 399 COVID patients in ICU beds.

Health officials warned that Minnesota hospitals are swamped and that any uptick in viral transmissions and patients could overwhelm them. COVID and non-COVID patients took up all but 18 of 1,012 available adult ICU beds on Thursday.

"We're in an important moment here," said Health Commissioner Jan Malcolm, who urged Minnesotans to seek vaccines and be mindful of infection risks during the holidays that can be addressed with mask-wearing and social distancing.

Minnesota appears to have peaked in its fourth COVID wave, barring a reversal over the holidays or a rapid spread of the highly infectious omicron variant.

Minnesota had the highest rate of new infections in the United States for much of November but now ranks 14th as COVID case rates have accelerated in the Northeast, according to the Centers for Disease Control and Prevention.

State officials on Friday reported 54 more COVID deaths and 3,854 infections, raising pandemic totals to 10,111 deaths and 979,283 infections. Minnesota is on pace to surpass 1 million infections by year end — including up to 12,000 people infected more than once.

While 85% of COVID deaths have been seniors, health officials have reported more deaths among younger adults in the latest wave that is being driven by the delta variant. Friday's reported deaths included someone 25 to 29 years old from Ramsey County and three Minnesotans in the 30-39 age range.

State leaders said booster vaccines are making a difference by addressing the waning immunity that occurs six months after people receive their initial shots. More than 75% of eligible Minnesotans 5 years and older have received at least the first vaccine dose, according to the CDC. Among fully vaccinated adults in Minnesota, 45.6% have received boosters — second-highest in the nation.

While studies globally suggest the vaccine is slightly less effective at preventing omicron infections, it still appears to reduce the risk of severe illness, hospitalization and death, said Kris Ehresmann, state infectious disease director.

"The expectation is if people are boosted and we are able to raise their neutralizing antibodies through that booster dose, that that will increase protection against hospitalization and death," she said.

Genomic sequencing of a sampling of positive COVID specimens in Minnesota so far has found seven infections involving the omicron variant.

Viral transmission patterns have shifted since the start of November, according to a state weekly COVID-19 report released Thursday. Hard-hit counties with lower vaccination rates in northwestern Minnesota are seeing declines, while counties in central and southeastern Minnesota are seeing increases.

Cases involving pre-K-12 students who were infectious while in school buildings peaked at more than 3,000 per week in early November. Weekly case counts dropped to 1,700 during Thanksgiving week and the first week of December, but those totals are preliminary. Ehresmann said school infections remain a concern because of lower vaccination rates among children who then could spread the virus during the holiday break.