White House coronavirus task force coordinator Dr. Deborah Birx met with state officials Sunday as part of a series of nationwide visits to asses states’ pandemic response. Health Commissioner Jan Malcolm said Birx cited the state’s case growth and community transmission as concerns, and urged action before the weather turns colder and people spend more time indoors.

“We have not improved, and that was Dr. Birx’s big concern and big message to us and big question to us,” Malcolm said on a call with reporters. “The greater metropolitan area here in Minnesota stands out to the federal government as one of the few urban areas that has not seen cases decrease in a concerning number of weeks.”

The seven-day rolling average of the positivity rate in Minnesota has risen over the past two weeks from 7.2% on Aug. 16 to 9.08% on Aug. 30, according to data from The COVID Tracking Project. Malcolm said the positivity rate showed cases are increasing faster than the testing rate for the first time, and new cases per 100,000 have climbed above the national average.

The state’s infectious diseases director, Kris Ehresmann, said state officials have seen good compliance with masks and social distancing in grocery stores and other retail settings, but informal gatherings statewide are contributing to significant community spread. Outbreaks have been linked to 29 social gatherings like parties, weddings and funerals in August, and more than 500 cases have been linked to social events since June.

“There’s a whole range of different types of activities that have been associated with cases, and some of them are outside and some of them are not but the bottom line is it’s situations in which people are not following the guidance,” Ehresmann said. “If you’re not following the guidance, that is what really leads to transmission.”

Ehresmann said more than 250 cases have been linked to colleges and universities, though transmission in most cases occurred off-campus. As K-12 and college students return to school, Malcolm said state officials are confident in the flexibility of Gov. Tim Walz’s plan and working with different school districts on their reopening plans.

The Minnesota Department of Health reported 679 new cases and one death, raising the state’s totals to 75,864 cases and 1,817 deaths. While the one death marks the lowest single-day total since April, new daily cases statewide have risen in recent days.

Hospitalized patients statewide totaled 306 on Monday, with 131 patients in intensive care. Hospitalizations have remained somewhat steady at around 300 since late last month, though reported deaths climbed into double digits twice last week.