ST. PAUL -- Two more Minnesotans have died of COVID-19, the Minnesota Department of Health reported on Tuesday, March 31, bringing the total number of deaths in the state to 12. According to health officials late on Tuesday, one of the deceased was an 83-year-old resident of Hennepin County who died in a hospital, and the other was a 73-year-old resident of Hennepin County who died at home.

Also on Tuesday, the state added 53 more cases of COVID-19 to its confirmed case count, bringing the state total to 629 cases, a number widely believed to be an undercount and not reflective of much more than attention now being paid to select groups of testing-eligible persons at highest risk of overloading the capacity of the health care system.

"We had 53 new cases on a moderate volume of testing Monday," state health commissioner Jan Malcolm noted ominously in an afternoon press conference with Gov. Tim Walz and other state agency heads. Because of weekly lulls, the state health department conducted just 156 tests on Monday, with private labs contributing another 802.

Though a reflection of suppressed testing capacity specific to the U.S. -- South Korea, Germany and even Iceland have tested a far greater percentage of their citizens per capita than have the U.S. -- testing remains far too infrequent within Minnesota to shed light on the prevalence of the illness.

The result has been an inability to differentiate a hot spot needing attention, contact tracing and containment, from an artifact of added testing within a given region courtesy of access to private testing vendors, an ambiguity now on view with the elevated case count in rural Martin County.

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Despite a statewide population of 5.6 million residents, just 20,000, or 0.35% of all Minnesotans have been tested for the virus so far. It's a gaping shortfall reflective of global shortages in testing materials in a narrow sense -- swabs are made in an Italian town being decimated by the outbreak -- but there's little disputing a broader lack of preparedness within the U.S. at the outset of the illness.

With a lack of preparedness having muted surveillance of the illness and slowed mitigation efforts, at 164,000 of the 800,000 cases globally, the U.S. has now become, as the state health commissioner here noted, "by a pretty large margin, the country with the largest number of cases in the world."

The state for now has put off the ongoing failure to expand testing beyond a specialized fragment of the population in order to address the approaching wave of illness expected sometime as early as mid-April, or as late as mid-June, another monumental unknown.

Health officials articulated on Tuesday a goal of expanding the statewide ventilator-equipped ICU supply by 2,000 beds and enough general-use so-called medical-surgical beds to accommodate 2,750 others. Officials have also identified five sites from across the state suitable for emergency re-purposing, locations capable of providing over 600 beds.

With funds offered by FEMA, this distribution of pop-up medical centers would find an extra 1,000 new rooms from currently empty hospitals, nursing facilities, hotels and dormitories in the metro area, as well as another 250 rooms in each of seven regions across the state. Staffing, a considerable variable even as hospitals begin laying off employees statewide, remains to be determined.

The goal is to have enough sites and equipment in place to quickly build within a 48-hour period the emergency overflow venues, and by a date sooner than most Minnesotans realize.

"We can tell people it's not going to happen next week," Walz said. "But we don't want people to be misled. It depends on what we do with mitigation."

"It's going to be sometime in the next four weeks," he added. "We have to be prepared for that to be upon us."

"I hope we never need any of the alternate sites," said state emergency preparedness director Joe Kelly, "much less all of them at the same time. But as Governor Walz has said, hope is not a plan. We're doing our best to use the time Minnesotans are giving us with social distancing strategies to become prepared for any outcome."

Four counties reported cases for the first time on Tuesday: Carlton, Traverse, Lyon and Brown, with Winona County having doubled its case count from 5 to 10 cases in one day.

These numbers too, are but an artifact of short-handed testing, and the health department believes the virus is circulating widely throughout the state.

For the first time on Tuesday, health officials released aggregate demographic data about the outbreak in the state.

According to the MDH Coronavirus webpage, the median age of Minnesotans who have contracted the illness is 46, the median age of those have been hospitalized is 63, the median age of those placed in intensive care is 62 and the median age of those who have died from the illness is 86.

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Minnesota Department of Health COVID-19 hotline: 651-201-3920.

School and childcare hotline: 651-297-1304 or 800-657-3504.

MDH COVID-19 website: Coronavirus Disease (COVID-19) website.