Thirty-five new COVID-19 deaths were reported Wednesday, a grim reminder of the fatal consequences as the corona­virus pandemic continues.

State health officials linked the high number of fatalities — the most since May 28 — to accelerating infections.

"We've known that a surge in deaths was to be expected several weeks after a surge in cases," Minnesota Health Commissioner Jan Malcolm said.

Malcolm noted that the pandemic has entered a different phase, moving beyond urban areas into rural parts of the state.

"We will see more and more deaths in greater Minnesota because of the high caseload in that area," said state Infectious Disease Director Kris Ehresmann.

Wednesday's tally, which includes deaths that happened over several days, ties a one-day record set five months ago.

Department of Health Commissioner Jan Malcolm, shown in July. Malcolm noted that the pandemic has entered a new phase, moving beyond urban areas into rural parts of the state.

At that time, Minnesota was averaging 600 to 800 new COVID-19 cases each day. The rolling average has risen from 1,200 new cases 10 days ago to nearly 1,600 most recently.

Altogether, 2,281 Minnesotans have died from COVID-19 complications.

Another 1,082 new infections were reported, bringing the total case count to 126,591 since the virus was first detected in Minnesota in March.

Malcolm said more deaths are expected if some residents continue to interact without masks or social distancing.

"We need to brace ourselves for that," she said.

Of the deaths announced Wednesday, 25 were among residents of long-term care facilities. About half lived outside the seven-county metro area, and all were over the age of 59.

Cases in nursing homes and assisted-living facilities have been rising for several weeks, but not at rates seen in the community.

"It is pretty darned impossible to keep the virus out of long-term care settings with this degree of spread all over the state," Malcolm said.

New infections in care facility employees now outpace infections among residents.

"During the early months we saw more cases in residents, which likely reflected more transmission within the facility," Ehresmann said. "Now we are seeing many cases in staff."

Some people who catch the coronavirus don't experience symptoms, Ehresmann said, and they can unknowingly transmit the virus to others.

New clusters of infections have been traced back to many types of social interactions, but there have been at least 360 outbreaks between June 1 and mid-October, according to data compiled by the Health Department.

August and September have had high numbers of outbreaks, with nearly 200.

About 2,000 cases have been linked to restaurants and bars, while social gatherings have resulted in 2,181 infections.

Health investigations have identified COVID-19 spread at 62 weddings with at least 570 infections. There have been 524 cases from 32 outbreaks centered in gyms.

Complications from COVID-19 have sent 446 to the hospital over the past seven days, with 107 of them needing intensive care.

Minnesota has 1,502 intensive care beds, with about 73% of them occupied. There are a total of 160 COVID-19 patients in intensive care.

Most people who become infected with the new coronavirus have mild or no symptoms and don't need medical care. The respiratory disease is likely to be more serious among those who have underlying health conditions, including kidney disease, heart problems, diabetes and obesity.

Most deaths are among those with one or more underlying conditions, especially among those ages 60 and older, and 95% of the fatalities were in people with pre-existing conditions. Among those younger than 60, 82% had underlying conditions.

Since the pandemic began, 113,158 people are no longer considered to be infectious and do not need to be isolated. That's 89% of all known cases.

Relief in the form of a vaccine is at least a few months away, and state and local public health agencies are already making plans for distributing it. There initially won't be enough vaccine for everyone, and priority will most likely be given to health care workers, first responders and the medically vulnerable, such as long-term care residents.

"We must insure that the distribution and availability of vaccines is fair, especially in the early weeks when availability is limited," Ehresmann said. "It will likely not be a situation where people could just walk up and get vaccinated."

Federal health officials said Wednesday that one or two vaccines might be available before 2021, but so far none has completed trials and evaluation.

State health officials said they are satisfied that the proper protocols are being followed in the development of the vaccine. But they added that they would inform the public if corners are cut.

"It has been our commitment that we will fully follow those developments and pledge that we will not administer a vaccine in Minnesota that we don't feel is safe and effective," Malcolm said.

Apart from the state health agency in St. Paul, Minnesota relies on a network of county and tribal public health agencies that make contact with local residents, especially those who are uninsured, underinsured or don't have options for traveling to a clinic.

Christine Lees of Dakota County Public Health is among the dozens of local officials who have been working on plans for the vaccine rollout.

"We want to reach people where they are at," she said and arrangements are being made for mobile and drive-through clinics. Local agencies already do this work with other vaccines, including influenza.

Community pharmacies are also being enlisted.

"We can reach many people from many underserved communities in Minnesota where health disparities are already apparent," said Laura Schwartzwald, co-founder of GuidePoint Pharmacy, based in Crow Wing County.