As the number of Minnesota deaths from COVID-19 grew to 24 on Saturday, the pandemic's financial shock became clearer for hospitals as one of the state's largest health systems asked some doctors to consider going on furlough.

Fairview Health Services said it has asked doctors, nurse practitioners and physician assistants in certain primary care clinics to volunteer to take a week of unpaid leave, starting as early as Monday.

The request is being made of caregivers in clinics that are seeing a reduced volume of patients, Fairview said, adding in a statement that "reductions are not being made on the front lines of COVID patient care."

"We've moved quickly to slow the spread and preserve necessary equipment by moving a majority of our visits to virtual and postponing all elective and nonurgent procedures," Fairview officials said in response to questions from the Star Tribune. "The result is not only a dramatic reduction in workloads … but also a dramatic reduction in revenues."

Revenue hits have prompted a number of health systems and private medical groups over the past two weeks to curtail hours or furlough workers. Hospitals, in particular, are incurring extra costs to prepare for the pandemic while also feeling financial pain from the elimination of elective procedures.

Hospitals remain strong supporters of an order from Gov. Tim Walz to halt elective and nonessential procedures in order to preserve scarce medical supplies, Mary Krinkie, vice president for government relations at the Minnesota Hospital Association, told lawmakers late last week. But they're taking a financial hit.

"Our hospitals right now in Minnesota are losing $31 million a day — $31 million a day — because of lost revenue from eliminating elective surgeries," Krinkie said. "We made that decision because we had to keep as much personal protective equipment as possible, but this is causing enormous financial hardship for hospitals."

The Minnesota Department of Health reported Saturday two more deaths linked to COVID-19, an increase that pushed the statewide death toll to 24 people in the global coronavirus emergency. The number of known COVID-19 cases increased from 789 to 865, according to the Health Department.

A total of 95 people currently require hospitalization, compared with 86 Friday, the Health Department said. Patients in intensive-care units stood at 42, compared with 40 Friday. And the number of Minnesota counties with known cases increased to 58, with the addition of McLeod and Polk counties.

COVID-19 is a viral respiratory illness caused by a new coronavirus that surfaced late last year. Since the first case was reported in Minnesota on March 6, a total of 180 people have been hospitalized.

The pandemic is putting severe stresses health care workers in hospitals, even as revenue hits are prompting temporary closures for some clinic locations and reduced staff at others.

Last week, Minneapolis-based Fairview said it expected to reduce some staff work hours in response to revenue cuts. Fairview operates 10 hospitals, including the University of Minnesota Medical Center in Minneapolis and 65 primary care clinics.

On Saturday, Fairview said reduced hours will apply to about 15% of workers across the health system, which uses the brand M Health Fairview. Word of voluntary furloughs for physicians only came by week's end and fits with changes happening in health systems across the country, Fairview said.

Furloughing now does not mean physicians won't be brought back immediately if needed, the health system said. As part of a broad restructuring where more care is being delayed or provided online, Fairview next week is temporarily stopping walk-in care at 17 clinics.

The period for requested one-week physician furloughs ends May 3. Those who take unpaid leave will still get benefits.

"We are deeply grateful to all of our employees for the heroic work they are doing during this unprecedented crisis," James Hereford, the chief executive at Fairview, said in a statement.

"The changes we're making now are needed to ensure the long-term health of our system, so it can serve the community throughout this crisis and beyond."

Two private medical groups in the past week told the Star Tribune they had furloughed more than half of their staff due to the shutdown of elective procedures.

Duluth-based Essentia Health has placed 500 nonmedical employees on unpaid leave. Mayo Clinic reduced or temporarily suspended hours or projects for supplemental or contract workers.

The primary focus now for hospitals is preparing for the pandemic, but the financial impacts are an "important sub-story," said Dr. Rahul Koranne, chief executive of the Minnesota Hospital Association.

"Hospitals are organizations like many other employers," Koranne said during an interview in late March. "We're all in this together, so the economic impacts that are being felt by all employers are being felt by hospitals and health systems as well."

On Friday, the CDC recommended that people wear cloth face coverings in places like grocery stores and pharmacies where it's difficult to stay at least 6 feet apart.

Kris Ehresmann, the state's infectious disease director, said in a conference call with reporters Saturday that Minnesotans who want to follow that guidance should take care not to use N95 masks, which are in short supply and must be conserved for health care workers.

Christopher Snowbeck • 612-673-4744