Minnesota Gov. Tim Walz cautions that moves to allow more crowds, activities will be gradual ones

Amid increasing calls to remove restrictions on more businesses, Gov. Tim Walz said changes will be made gradually, such as Friday's order to open up golf courses, shooting ranges and other outdoor activities.

Minnesota's stay-at-home order expires May 4, part of an effort to reduce social interactions by 80%, giving time for the health care system to secure more beds, ventilators, masks and other equipment, as well as staff, in hopes of containing the spread of COVID-19.

Walz said it would be impractical to maintain stay-at-home until a vaccine is developed ­— which could take at least 18 months — but said social distancing will become the norm no matter how many restrictions are lifted and when.

That means events with big crowds, such as a ballgame at Target Field, or bars and restaurants or backyard parties that draw a large number of people, are not likely to come back soon.

"The things we want probably more than anything … are going to be some of the last things we will bring back on," Walz said.

While the debate about stay-at-home continues, Minnesota on Friday reported some of the largest one-day increases in confirmed cases and deaths.

Another 159 people tested positive for COVID-19, according to the Minnesota Health Department.

Seventeen more Minnesotans have died, bringing the total number of fatalities in the state to 111.

Although the one-day total of deaths is the largest ever, it could include deaths that occurred over the past several days, as there can be a lag time in reporting and verifying the death records.

Twelve of the 17 deaths were among residents of long-term care facilities, which have been hit hard. So far, 123 nursing home or assisted living facilities have at least one case, although about half have just one.

All but two of the deaths reported Friday were in people above age 70, with the others in their 60s.

Pork plant cluster

Walz acknowledged that the JBS outbreak and future outbreaks could be prevented had there been more testing for COVID-19.

But a shortage of supplies has hampered testing efforts across the nation.

The University of Minnesota, Hennepin Healthcare and the Mayo Clinic are launching ambitious efforts to broaden testing availability, including new tests that detect antibodies, an indication that someone who has been infected with the coronavirus has recovered.

"If antibodies are detected it indicates that the person has been affected by the virus in the past and may have some protection," said Kris Ehresmann, infectious disease director at the Health Department.

But because COVID-19 is so new — it first emerged in December — researchers are unclear how long immunity protection will last and how many antibodies a person will need to fight off reinfection.

That uncertainty adds another wrinkle to the question of who should be allowed to travel in the community with few restrictions, even if they test positive for the disease antibodies.

Minnesota Senate Republicans contend that restrictions should be lifted because Minnesotans have helped the health care system prepare.

"We need to trust our citizens, churches, nonprofits and business owners to operate in a safe manner following all of the CDC guidelines," said Senate Majority Leader Paul Gazelka, R-East Gull Lake. "The stay-at-home order is achieving its goal of preparing for a surge and now it's time to save our economy and way of life."

The Senate Republican Caucus said it has received more than 1,600 suggestions two days after opening an online portal soliciting ideas about reopening the economy.

Going to snowball

North Memorial Health Hospital's intensive care units are gradually starting to fill up, said Mary Turner, a medical intensive care nurse and president of the Minnesota Nurses Association.

Patients needing ventilators to help with breathing can remain on the unit for weeks.

"Just when we think they are going to get better and we take out the tube, we have to put it back in," Turner said. "This terrible virus attacks not only the respiratory system, it is attacking the heart, it is attacking the kidneys. It is spreading throughout the whole body."

Nurses store masks and other protective equipment in bags that hang on the walls.

"We are rationing and we are being careful with it," Turner said.

"It is going to start snowballing faster and faster," Turner said. "They are all going to be full."

Dr. John Hick, an emergency physician at Hennepin Healthcare who is advising the state on health care preparedness, said progress has been made but more is needed.

"From a supply standpoint we continue to operate in a scarcity situation," he said. "We've bought time … to support building out a plan for accommodating a surge of COVID-19 patients."

The state's emergency departments have seen a sharp decline in the number of patients, which could mean that people are deferring needed medical care.

"We are very concerned that people may be too fearful to come into the emergency department," Hick said. "The emergency care system is there for you all the time."