Minnesota’s death toll from COVID-19 rose to five Saturday, with the latest case spotlighting concerns about the spread of the virus in long-term care facilities.

The state’s fifth death was that of a Hennepin County resident in his or her 70s who lived in one of those facilities, according to the Minnesota Department of Health. That means four of the state’s five deaths were residents of such centers.

In addition, there are now 20 outbreaks in congregate-care settings, although the term doesn’t necessarily mean there are multiple cases at a location, said Kris Ehresmann, the Health Department’s infectious disease director. The department defines a positive test for either a resident or staff member as an outbreak.

“That is our focus and our concern right now, because congregate-living settings represent our highest-risk populations,” Ehresmann said in a call with reporters. “We have teams in place to reach out to the facilities … and we are in daily contact with them.”

All five deaths involved people with underlying health problems who were in their 70s or 80s, Ehresmann said. That’s consistent with the groups who are at highest risk for severe illness, according to the Health Department.

Meanwhile, the tally of people who have tested positive for the virus in Minnesota now stands at 441, up from 398 cases Friday. The number includes one of the youngest Minnesota victims so far, a 2-year-old described as doing well so far.

Public health officials have stressed that the case count understates the number of Minnesotans who have been infected and sickened. The virus is thought to be circulating across much of the state, but limited testing makes it impossible to precisely document.

“We’ll continue to see increases in cases,” Ehresmann said. “I won’t predict when a spike might happen.”

Congregate-care settings include not just long-term care facilities, but also shelters, prisons and jails (although no cases have been reported in the last three settings). Ten of the cases involve only health care workers.

When there’s an outbreak, the Health Department works with the facility to review infection control practices, including isolating those who are sick. The department would like health care workers in group settings to wear surgical masks in order to minimize the chance of transmission, but that’s not always possible due to the limited supply of protective equipment, said Ehresmann.

“We have put guidance on our website about alternate face masks and some of the options there,” she said.

The agency has a statewide network of “sentinel” health care providers who report weekly the proportion of patients with fever and respiratory symptoms — the symptoms that come with COVID-19, Ehresmann said.

As the flu season started winding down, the providers started reporting fewer people with flu-like illness, she said. But the numbers are picking up again, likely because of COVID-19.

“We’re adding some additional syndromic surveillance elements so that we can have a better picture,” she said. “We recognize that with limited testing … we’re going to have to have other ways of identifying what’s happening in Minnesota.”

Since Minnesota’s first coronavirus case was reported March 6, a total of 57 patients have required hospitalization, according to the Health Department.

On Saturday, 30 patients were hospitalized for COVID-19, down from 34 Friday. Thirteen remained in intensive care.

Many cases result in mild or moderate illness. Most cases don’t require hospitalization, but some of those who get infected will require sophisticated medical care.

At 11:59 p.m. Friday, Minnesota implemented a “stay-at-home” order meant to slow the virus’ spread. Slowing the pace of patients who require intensive care is one goal, Gov. Tim Walz said.

Hospitals continued Saturday to prepare. Abbott Northwestern Hospital in Minneapolis was reconfiguring about 60 hospital beds with special air handling equipment so they can be dedicated to patients with COVID-19.

Patients with severe respiratory problems related to the illness could require ventilators or machines that provide positive airway pressure. The airway treatments, as well as the process of inserting or removing a breathing tube, could cause COVID to become aerosolized — a big risk that’s significantly reduced by the new equipment, according to Dr. Sarah Prebil, a physician on the hospital’s incident command team.

Shortages of personal protective equipment and uncertainty about how many COVID-19 patients will need care mean there is “a healthy amount” of anxiety among health care workers, Prebil said.

Saturday’s newly declared patients included a 2-year-old, whom Ehresmann said “is doing well.” So far, state patients have ranged in age from 6 months to 104 years.

Clearwater County became the 41st of Minnesota’s 87 counties to see a confirmed case. Hennepin County continues to have the highest tally of known cases, 152.

On Saturday, the data release showed the number of cumulative tests completed since Jan. 20 increased from about 14,003 on Friday to 16,129. The number of COVID-19 patients who no longer need to be isolated now stands at 221, up from 180 patients Friday.