SIOUX FALLS, S.D. (AP) — Gov. Kristi Noem on Monday continued to resist calls for a stay-at-home order for Sioux Falls amid the coronavirus outbreak, while announcing that the state will run a comprehensive trial for an anti-malarial drug pushed by President Donald Trump as a potential way to treat and prevent COVID-19.

The Republican governor said her push to test the drug hydroxychloroquine is a way to “go on offense” against the coronavirus. The drug has been championed by Trump but drawn skepticism from doctors who say it could have severe side effects.

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Shortly before Noem’s announcement, Sioux Falls Mayor Paul TenHaken called on the governor to issue a stay-at-home order for the city as the rate of COVID-19 infections accelerated in recent days, Many came from an outbreak at a pork processing plant operated by Smithfield Foods.

Health officials reported the largest day-to-day increase in confirmed coronavirus cases on Monday with 138 people testing positive. The state has confirmed a total of 868 cases, with the bulk of those coming from Minnehaha County, which contains Sioux Falls. So far, six people have died.

TenHaken said if the current rate of infections continue, the city’s healthcare system could be crippled. The only way to get a stay-at-home order immediately is to have the governor issue one, he said. Otherwise, it would take seven days to pass an order through the city council.

“Quite honestly, it’s crap that we have to wait that long to act,” he said.

Noem said she is evaluating the request, but resisted the notion that a more aggressive approach to get people to stay home is necessary. She said people are voluntarily taking precautions. The governor acknowledged that Sioux Falls could see a peak in infections several weeks before the rest of the state, but continued to stick to her projection that statewide infections will peak in mid-June.

For most people, the virus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

Noem said South Dakota will be the first state to run a state-wide trial to test hydroxychloroquine. There are several other trials being conducted elsewhere. She explained that the state’s three largest health care providers will conduct a trial with 2,000 people. Every participant can choose if they want to take part.

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The governor said she pushed the White House last week to provide enough hydroxychloroquine to give it to every hospitalized person, others who are vulnerable to the coronavirus and “front line” health care workers. She said state funds will be used to sponsor the trial, but did not say how much she plans to pitch in.

Allison Suttle, the chief medical officer for Sanford Health, which will be conducting the trial, said the side effects of the treatment could include nausea or fatigue, but did not list anything more severe. A press release from Sanford said there can be serious side effects from the drug, but they are rare.