Nine people in Minnesota have died amid the ongoing coronavirus outbreak – a tally that looms large today but may seem small in the near future.

With predictions circulating Sunday that the nationwide death toll may eventually exceed 100,000, public health officials in Minnesota confirmed four new deaths in the state in the past day.

"There will be a time in the near future when we could have four deaths in an hour, or more – many more," said Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy.

The four recently reported deaths included three cases among residents of group-care living facilities in Hennepin County. All told, seven of the nine people who have died after getting COVID-19 in Minnesota lived in these congregate care facilities, which includes skilled-nursing facilities and assisted-living (but not jails or shelters).

Asked by a reporter Sunday whether families should start thinking about taking their loved ones out of group care homes, Minnesota Health Department Commissioner Jan Malcolm said a lot of people are probably asking themselves that same question.

"We are certainly not in a position of dictating that answer," Malcolm said. "We believe that folks in long-term care are working really hard to make those environments as safe … as they can, for their residents and their staff. And I just would have to defer that to private family decisions and consultations with individual care facilities."

The four deaths represent the largest one-day jump in Minnesota fatalities since the first confirmed case in the state on March 6. The department issued updated statistics Sunday for people who have confirmed cases of COVID-19, as Minnesotans adjusted to their second full day of living under a statewide "stay-at-home" order.

The latest numbers showed there have been 503 confirmed cases of COVID-19 in Minnesota, including 252 people who no longer need to be isolated. Health officials added 62 confirmed cases to Minnesota's tally on Sunday, one of the higher single-day jumps since the outbreak began.

Malcolm said such tallies don't reflect the large number of cases that exist in Minnesota but are not diagnosed. Osterholm agreed.

"I wouldn't be surprised if less than 1% or 2% of COVID cases in the state have been tested and counted," because of the limited supply of testing materials, Osterholm said.

Two of the newly reported Hennepin County deaths happened to people who lived in the same unidentified long-term care facility, while a third was a resident of a different group-living home.

The fourth death reported Sunday happened in Martin County in southern Minnesota and did not involve a long-term care facility.

One of the people who died most recently was in their 50s and had underlying health conditions. The other three people were in their 80s and 90s, and their full health status wasn't immediately provided Sunday. Before Sunday, the five previous deaths all involved people in their 70s and 80s who had underlying health problems.

The number of long-term living facilities with at least one confirmed COVID-19 case increased to 25, from 20. The majority of those have only one case, though three facilities have more than two cases, and none has more than four.

The 503 confirmed cases in Minnesota included at least 21 residents of long-term care facilities and another 11 health care workers who worked in those centers, Malcolm said.

Across the United States, more than 125,000 confirmed cases of COVID-19 have been reported, and more than 1,000 people in the U.S. have died after getting the illness. Globally, there are about 692,000 cases, including nearly 147,000 people who have recovered since December.

About 80% of people who develop COVID-19 after contracting the SARS-CoV-2 virus end up with only mild symptoms. Another 15% have more serious symptoms, and 5% may require critical hospital care, according to a recent peer-reviewed, evidence-based article on the medical website UpToDate.

In Minnesota on Sunday, there were 39 cases of COVID-19 requiring hospitalization, an increase of nine from the day before. Of those active cases, 16 people were in intensive-care units getting treatment for the respiratory illness, while the others required non-intensive hospital care.

Gov. Tim Walz issued a series of executive orders this month designed to delay the peak incidence of COVID-19 in Minnesota until later this summer, in the hopes of preserving worker health and maintaining supplies of personal protective gear for when the peak hits.

At the same time, researchers are investigating treatments and vaccines, and manufacturers are ramping up production of much-needed items like face-worn respirators and ventilator devices.

As of Sunday, more than half of Minnesota's counties have at least one confirmed case of COVID-19. Hennepin County remains the hardest-hit in the state, with 171 confirmed cases, an increase of 19 from the previous day. Olmsted County — home of the Mayo Clinic, which is offering drive-through testing for people who qualify — rose by 10 cases, to 47 in total.

More than 17,600 COVID-19 tests have been completed for Minnesotans, including about 7,700 tests conducted by the Minnesota Department of Health's lab. Some tests conducted by Minnesota hospitals are processed on-site in less than 24 hours, while other samples are sent to large commercial labs out of state, introducing some delays in results.

Walz issued a general stay-at-home order for all noncritical workers statewide that took effect at 11:59 p.m. on Friday, emptying many highways and sidewalks and forcing those who did venture outside in groups to stay 6 feet apart.

The order includes several notable exceptions. For example, people can still leave and find a new alternative home if their home or residence is unsafe, such as in cases of sewer problems or violence.

People can seek emergency services and medical care outside the home, including picking up prescription drugs or to donate blood, and for carryout food, groceries and supplies.

They can also leave to care for a family member, friend, or pet in another household, and can transport children pursuant to existing parenting or visitation schedules. Finally, residents can leave home for outdoor activities as long as they stay 6 feet from others.

Joe Carlson • 612-673-4779