The steadily widening corona­virus outbreak in Minnesota has claimed its first fatality.

State health officials Saturday announced the confirmed death of a resident due to COVID-19, the disease caused by the virus. They also disclosed more severe disease among those hospitalized for the condition, another rise in the statewide tally of known cases and hints at the much wider impact.

Nearly one third of Minnesota's 87 counties have now been affected.

Minnesota's first victim was a Ramsey County resident who was between 80 and 89 years old and related to someone exposed to COVID-19 through international travel. The individual was high-risk in terms of age but also had underlying health problems, making the case an illustration of the serious threat the outbreak poses to vulnerable Minnesotans, state Health Commissioner Jan Malcolm said during a news conference.

Total confirmed cases in Minnesota grew to 137 Saturday, but health officials said the actual tally could already exceed 10,000 cases.

"Don't think, 'Oh, there are 137 cases in the state,' " said Kris Ehresmann, the state Health Department's infectious disease director. "You can think that. … That's just the tip of the iceberg."

Minnesota is the latest of many states to report a death from COVID-19. The U.S. has reported 19,624 cases and 260 deaths, the health department says, while the worldwide counts have grown to 284,000 cases and 11,800 deaths since the outbreak started in December.

The state reported its first COVID-19 patient about two weeks ago. Since then, 12 patients have been hospitalized, including six who were still in the hospital on Saturday. Four of the patients were in intensive care units.

"We do see a shift toward more severe disease in our hospitals," Malcolm said. "The rest of the patients, those who were hospitalized and the great majority of the reported cases in total, have been recovering and are recovering at home."

The Ramsey County resident who died first showed symptoms on March 13, Ehresmann said, and was hospitalized three days later. The person died March 19. In about 80% of cases, COVID-19 patients experience mild symptoms.

Case count to rise

Public health officials Saturday stressed the confirmed case count surely understates the extent of infection across Minnesota, particularly with the state's limited supply of testing capabilities.

Asked about a New York Times/Columbia University report suggesting infection rates are at least 11 times that of diagnosed cases, Ehresmann said: "I think that's probably a conservative estimate." She emphasized that residents of Minnesota counties with no diagnosed cases should not assume they won't be exposed.

"Obviously tenfold [more cases] sounds like, 'Wow, that's a lot,' " Ehresmann said. "But it could be as high as a hundredfold. I think the bottom line is there's a lot of COVID-19 circulating in Minnesota and that's why it's so important that people take the community mitigation seriously."

Over the past week, the state has temporarily closed restaurants, bars and schools while promoting "social distancing" to cut virus transmission. Residents have been asked to stay home as much as possible, maintain a distance of 6 feet from other people, replace in-person work meetings with teleworking, and cancel gatherings of 50 people or more.

Hospitals and health care workers, meanwhile, have sounded alarms that the supply of masks and other protective gear for workers might not be sufficient as the number of infected patients grows.

Malcolm said the Walz administration is thankful that private companies and other institutions have started to come forward to try to address those needs and is working to identify more possible resources.

On Friday, Twin Cities Habitat for Humanity donated to M Health Fairview some 7,500 masks used in intensive care that filter out 95% of airborne particles. Fairview says it uses about 1,000 of these "N95 masks" per day across its health system, which includes 10 hospitals, including the University of Minnesota Medical Center in Minneapolis.

Homemade masks

In Alexandria, a doctor is following the example of an Indiana hospital by organizing quilters and sewers to make masks. The Centers for Disease Control and Prevention says homemade masks can be used "as a last resort."

Fairview is not now accepting homemade masks from the public but said in a statement that it's developing instructions on how to do so "should we need them." Allina Health on Saturday started asking for donations of factory-made N95 and ear loop masks, as well as hand-sewn ear loop masks.

Instructions on how to make hand-sewn masks can be viewed at allinahealth.org/coronavirus.

The new coronavirus was first detected in Minnesota with cases imported by travelers, but the Health Department reported six days ago the first evidence of community transmission. That means the virus passed to people who hadn't traveled outside the state or knowingly been exposed to someone else with a confirmed case.

Ehresmann said Saturday that the state is seeing "a general shift toward more and more community transmission."

The statewide count of confirmed cases jumped from 115 to 137 Saturday. The number of counties with confirmed cases grew from 21 to 26.

Health officials also reported a confirmed case in a 10-year-old, the youngest state resident caught up in the outbreak thus far. The child is home-schooled, Ehresmann said.

In recent days, speculation has grown that Gov. Tim Walz might follow the example of other states in issuing a "shelter in place" order that would confine people to their homes except for essential business. On Saturday, Ehresmann said Minnesota wasn't yet at that point.

But, she added, "We don't anticipate the number of cases slowing at all."