An early riser, Willmar funeral director Nathan Streed usually begins his days around 6 a.m. and clocks out at 5:30 most evenings.

But recently his phone just keeps ringing, as COVID-19 continues to spread rapidly throughout Minnesota, claiming more than 4,400 lives and counting.

"You don't turn it off at night," said Streed, owner of Harvey Anderson and Johnson Funeral Homes, with six locations in central Minnesota. "It's always on your mind."

Since the pandemic struck last spring, much attention has focused on the nation's first responders, the medical workers on the front lines. But relatively little heed has been given to the last responders — funeral directors like Streed, who must make sense of these new and unfamiliar deaths and help guide the evolution in how we mourn them.

"We're no different from health care workers, we're all in the same boat," said Chris Robinson, a South Carolina funeral director and board member of the National Funeral Directors Association (NFDA). "We have to take a lot of precautions," whether the deaths occur at nursing homes or private residences.

"There has not been enough attention paid to the physical and mental toll that the pandemic is having on funeral directors," said Tariq Adely, project manager of a George Washington University study "Rituals in the Making," which explores how mourning has changed in the pandemic. "They are stretched to capacity in many areas across the country."

Funerals are being held in Minnesota, but in a much more constrained way than before the pandemic. Health Department rules restrict the number of people attending funerals to half a building's capacity, up to 250 people. Social distancing, hand sanitizing and masking requirements are now the norm.

At the same time, funeral directors, families and friends have been forced to reimagine end-of-life rituals. Livestreaming funerals, and archiving them digitally, have become commonplace.

NFDA estimates that nearly half its members have begun offering livestreaming options to mourners since the onset of the virus, a trend the Wisconsin-based industry group expects to continue well into the future.

But while virtual mourning may be a boon for those who can't afford to travel to a funeral or for those with disabilities, the experience can prove frustrating to those logging on, especially if there's a tenuous internet connection, said Sarah Wagner, an anthropology professor at George Washington University and a researcher on the "Rituals" study, funded through the National Science Foundation.

As Adely notes, "Many communities don't have access to the same technological resources. Access does fall along class and race lines in the United States."

The physical disconnect of a virtual funeral concerns some, as well as the inability to share a meal with fellow mourners. Gov. Tim Walz's current executive order generally prohibits social gatherings — which means lunches following funeral services, among other things, are verboten for the time being. Grieving friends and family cannot embrace or hold each others' hands in comfort.

Streed said that's a huge loss.

"People can share stories, they feel relaxed doing that over a meal or sharing a cup of coffee," he said. "They can reminisce, laugh and cry and carry on."

Adely also noted that mourners may not have the chance to touch the person who has died, or say goodbye. That's especially true for members of the Hmong community, where the funeral ritual often lasts for days and draws hundreds of mourners.

"Funerals that once were big are now more intimate," said Kou Vang, owner of Legacy Funeral Home, which has four chapels in the Twin Cities. "This has been incredibly hard for the Hmong community."

Chu Wu, owner of the Koob Moo Funeral Chapel in St. Paul, said some families have opted for shorter services.

"You do what you can to help out; it is very challenging," he said. "It's very difficult for the families. They don't know what to expect."

Vang said some Hmong families opting to bury a loved one right away have gotten pushback from the community.

"The culture is changing before our eyes," Vang said. "Humans are social. We are creatures that need to touch, to feel, hug and cry. It may also be the last time to see and touch the deceased, to say goodbye. It's a kind of closure."

Faced with restrictions on gatherings, mourners often get creative. Streed has facilitated services in farm fields, barns and lake homes. Outdoor funerals are still being held, at least until the snow flies. "It was kind of enjoyable to see that creativity," he said.

But some may skip attending funerals altogether, fearing exposure to the wily and potentially deadly virus that has sickened nearly 380,000 Minnesotans.

"There was a man out here who died last week who was very well-liked and well-known. He would have easily drawn several hundred people to the funeral before COVID," said Bill Carlin, owner of Miller-Carlin Funeral Homes, with four locations in Stearns and Morrison counties. "There were maybe 30 people there."

Other services have been delayed until the pandemic ebbs. About half the NFDA's members report that families have postponed a loved one's service because of COVID-19, with plans to hold a remembrance in the future.

But this may result in an incomplete mourning process, Wagner said, "one that's happening in bits and pieces." The second wave of COVID-19 could spark additional anxiety among those grieving: "There isn't a moment to say, 'Oh, we're past that,' " she said.

Yet some are still able to hold some semblance of a pre-COVID funeral.

A funeral mass for Jim Quinn, 91, who died last month of COVID-19, was held Thursday at Holy Cross Catholic Church in northeast Minneapolis, with the burial following at Fort Snelling National Cemetery.

"It was very, very important to us," said his son, Mark Quinn. "It would have been too much for my Mom to wait until spring."

A 3M retiree from St. Anthony, Quinn was vibrant right up until he was hospitalized with the virus, his son said. The elder Quinn told his family he wasn't ready to die, "but if the good Lord is ready for me, then I will go."