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MINNEAPOLIS (AP) — The vast majority of Minnesota’s COVID-19 deaths are cases associated with long-term care facilities, health officials said Tuesday as they focused attention on how the state is trying to protect some of its most vulnerable residents.

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As of Tuesday, 113 of the 160 Minnesota residents confirmed to have died from the coronavirus were connected one way or another with long-term care facilities such as nursing homes, said Kris Ehresmann, the infectious disease director at the Minnesota Department of Health. Fourteen of the 17 new deaths reported Tuesday were among residents of those facilities.

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The department also reported 97 new confirmed cases Tuesday to boost the state’s total to 2,576. It was the first time since last Tuesday that it recorded fewer than 100 new cases. It also said 237 Minnesotans were hospitalized with the disease Tuesday, a total unchanged from Monday. Those patients included 117 in intensive care, down nine from Monday.

“It’s not that the epidemic isn’t growing, it’s that it’s growing so far in a measured way that is not exceeding our capacity to respond,” Health Commissioner Jan Malcolm said at the department’s daily briefing.

Ehresmann said it may seem like Minnesota is in a lull as Gov. Tim Walz decides on extending his stay-at-home order, which expires May 4. But she said that’s provided an opportunity to apply lessons learned from protecting congregate living facilities to other kinds of places so the state can better respond when new cases result from reopening society.

Health officials advised Minnesota’s care facilities early on to limit visitors. But Ehresmann said health care workers and other staff still need to be present to serve residents. Given that infected people may not show symptoms for 48 hours, if ever, it’s “entirely possible” for staff members or caregivers who are “working in good faith” to expose residents. The virus can then spread quickly in those close quarters, “so we need to make sure that we’re intervening as quickly as possible.”

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While the health department immediately assigns a nurse case manager to work with every facility when even one resident or one staff person tests positive, sometimes measures like isolating residents and stepping up sanitation aren’t enough to stop the spread from getting out of control.

“That can happen pretty quickly,” said Michelle Larson, the department’s health regulation division director, who said the state’s Emergency Operations Center can step in when a facility gets overwhelmed. The center can help line up staffers from elsewhere or help draw on resources from state and local agencies, she said.

An example was when state and local authorities evacuated residents from three nursing homes earlier this month after so many staffers got sick that they couldn’t properly care for the residents.

“It’s our goal to get in front of these vulnerable facilities proactively, so that we have a better idea of who can help, where, with fast-moving outbreaks in long-term care facilities,” Larson said.

Also Tuesday, Democrats called on the Minnesota Senate’s Republican majority on Tuesday to allow a major switch to voting by mail for the upcoming primary and general elections. They noted that health officials in neighboring Wisconsin reported this week that they have identified at least seven people who appear to have contracted the coronavirus from participating in that state’s April 7 election. But key GOP lawmakers have resisted that, saying the state’s existing laws allowing all citizens to vote by absentee ballot are sufficient.

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