Most of the Twin Cities area has been downgraded to a low COVID-19 risk level as part of a new federal tracking system that assesses community threat based on hospital burden.

While Hennepin and Carver counties remain at medium risk, the rest of the seven-county metro area is listed at low risk by the Centers for Disease Control and Prevention.

The CDC does not call for mask-wearing in the general population in low-risk counties, and it instead advises them to maintain vaccination progress and improve indoor ventilation to reduce viral transmission. Masks remain considerations in medium-risk counties for people who could suffer severe COVID-19 because of existing medical conditions and are recommended in indoor public places in high-risk counties.

The improving risk levels complement Minnesota data showing a decline in the COVID-19 omicron wave in the state. The 557 COVID-19 hospitalizations in Minnesota on Friday represented a sharp decline from 1,363 on Feb. 1 and included the lowest number of patients requiring intensive care since Aug. 2. The state's reported positivity rate of COVID-19 testing declined from a peak of 23.5% on Jan. 10 to 6.6% in the week ending Feb. 18.

"We certainly are on the backside of the omicron wave here," said Dr. William Morice, chairman of Mayo Clinic's department of laboratory medicine and pathology. "All of the numbers are headed in the right direction."

Sections of central and southeast Minnesota remain at high risk under the new CDC methodology, which is no longer based solely on coronavirus infection rates. Home testing options and other factors have diminished the utility of infection rates.

The CDC now assesses risks based mostly on the rate of new COVID-19 hospital admissions in a county and the percentage of hospital beds occupied by infected patients. That aligns with Minnesota's primary goal since the start of the pandemic to preserve hospital beds.

"That has been the concern right from the start, the overwhelming of hospital systems with sick patients," Morice said. "And we have been at that threshold with hospitals in the state a couple of times."

Twin Cities health system leaders issued a public plea to reduce viral exposure two months ago, when the prevalence of two fast-spreading delta and omicron coronavirus variants resulted in a peak of 1,680 COVID-19 hospitalizations on Dec. 10, including 344 patients in intensive care.

The Minnesota Department of Health on Monday reported another 1,122 coronavirus infections and 28 COVID-19 deaths. While 80% of Minnesota's 12,109 COVID-19 deaths have been seniors, Monday's report included three people in their 40s and a Goodhue County resident in the 35-39 age range.

While 22 of the newly reported deaths occurred this month, three occurred in January and three occurred in 2021. There's a delay in the review of death records to confirm if deaths are related to the pandemic.

State health officials urge Minnesotans to seek COVID-19 vaccine and booster shots, which have been less effective against the omicron variant in preventing infection but have continued to reduce risk of severe illness, hospitalization and death. More than 3.8 million Minnesotans have been fully vaccinated with an initial series, and 2.1 million of them have received boosters. That booster shot rate of 55.8% ranks second among states.

The risk to unvaccinated people who make up 22% of Minnesota's adult population is greater when considering that vaccinated residents tend to be older and more vulnerable in the first place. The age-adjusted COVID-19 death rate was 12 times higher among the unvaccinated at the end of November and remained six times higher in mid-January.

An estimated 70% of Minnesotans have immunity right now as a result of COVID-19 vaccination and infection, according to the Institute for Health Metrics and Evaluation in Washington state.

While coronavirus immunity appears to wane over several months, the current level could at least suppress the spread of COVID-19 through the spring and summer, said Dr. Dimitri Drekonja, an infectious disease specialist with the Minneapolis VA Medical Center.

"I'm expecting/hoping for a few quiet months," he said.