A statewide stay-at-home order will remain in place for at least another two weeks in Minnesota, as health officials try to thread the needle between protecting the public from COVID-19 and allowing businesses to resume.

Gov. Tim Walz on Thursday announced the extension until May 18 of the stay-at-home order, which otherwise expired Monday, but with new flexibility allowing retailers to reopen with curbside pickup or delivery for customers.

The decision will put 30,000 Minnesotans in retail businesses back to work, and the governor said he was open to further efforts to dial back restrictions as long as it doesn’t result in flare-ups like the outbreak among JBS pork plant workers in Worthington that exploded in one week.

“We are on a very fine line with this virus that can come very, very quickly,” Walz said. “It won’t be a slow burn. It will be exponential growth.”

Walz said the extension is needed to continue preparations for a peak of COVID-19 cases that is unlikely to be prevented without a breakthrough treatment or vaccine. Minnesota’s COVID-19 response strategy, when fully in place with adequate testing and health care investigators to trace the sources of outbreaks, will put the state in a strong position given its hospital resources, he said.

The governor’s announcement came as the Minnesota Department of Health reported another 492 lab-confirmed COVID-19 cases, bringing the total of known Minnesota cases to 5,136. Twenty-four more deaths were reported, with 343 fatalities total so far.

The move also mirrors those in other states such as Arizona, where Republican Gov. Doug Ducey extended a stay-at-home order until May 15 but made similar allowances for retailers to reopen with curbside pickup or appointment-based customer visits.

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said the stay-at-home extension is “absolutely supported by the data.”

Minnesota is at a “critical point,” he said, and any other action would have risked greater spread of the virus. “The governor is looking at the data very carefully, and he’s conferring with public health [experts] as well as the business community,” he said.

But partisan divides in Minnesota continued over the strategy by Walz, a Democrat, and a shutdown that has resulted in more than 560,000 Minnesotans seeking unemployment insurance benefits.

“The governor is asking the right questions and looking at the right data, but I’m disappointed he’s not turning the dial further today,” said Senate Majority Leader Paul Gazelka, R-East Gull Lake. “I think he should move further, and faster, opening businesses up again.”

Most people who died from COVID-19 had underlying health conditions, according to a Star Tribune review of 206 death records.

Among 147 long-term care residents who died, one-third had heart conditions, with 20% of them affected by high blood pressure. About 13% were diabetic and 12% had kidney disease. For 59 deaths of people who were not in long-term care, one-third were affected by kidney disease, followed by hypertension, diabetes, heart problems and lung diseases.

Of the 343 deaths so far, 271 involved residents in nursing homes or assisted living facilities. Sen. Karin Housley, R-St. Marys Point, advocated for more tailored restrictions that focus on residents of long-term care facilities and others at highest risk.

“I don’t know why the whole state has to be on stay-at-home when we should be quarantining and testing those people in long-term care facilities if that’s where the hot spots are,” she said. “To make the rest of us stay home and not be able to go to the local retail shop and try on jeans there, but we can go to Target or Walmart or Costco, [means] it’s our Main Street businesses that are dying.”

The governor’s announcement Thursday is a “really important step” for as many as 15,000 retailers that could reopen Monday, said Bruce Nustad of the Minnesota Retailers Association. The order applies to retailers, dry cleaners and even pet groomers, and allows hair salons to sell products but not cut hair.

The extension was frustrating for Ashley Potter, owner of Escape Spa in Marshall, who had appointments booked out for weeks starting Monday, and had a client who said “she felt like a woolly mammoth this morning.

“We’re disappointed that we, once again, have to reschedule appointments,” said Potter, who will now start promoting spa gift certificates for Mother’s Day instead.

While 82% of businesses in the state are able to be open, Walz lamented the frustrations for those that are closed, and also for Minnesotans looking forward to weddings and graduations. He said he is struggling with questions about permitting religious services, but he wondered whether he would then be obliged to open theaters and concert venues with similar crowds.

Walz on Monday allowed for the return of as many as 100,000 workers in manufacturing and warehousing businesses that completed social distancing plans.

Doug Loon, president of the Minnesota Chamber of Commerce, said easing Minnesota’s stay-at-home order for retailers “is a step in the right direction” but he particularly worried about summer resort owners who are wondering if they can keep their bookings and retain staff.

Walz on Thursday also encouraged Minnesotans to wear manufactured or homemade masks outside their homes when social distancing is difficult, and to continue efforts that have given the state one of the lowest rates of COVID-19 in the nation.

He lamented that a productive visit to Mayo Clinic by Vice President Mike Pence Tuesday became “a story of the mask” because Pence declined to wear one. However, he said mask-wearing will build unity in response to COVID-19, and that there is evidence that mask-wearers who are infected, but don’t know it, protect others.

Buying time

The governor originally issued the stay-at-home order to reduce face-to-face contact and disease transmission by 80% and to buy time for hospitals to prepare with more beds, ventilators and personal protective equipment.

On Thursday, he said he was optimistic that hospitals will have enough resources to serve all patients when COVID-19 cases peak — perhaps in late May or June. And while the state signed a lease Wednesday to use a shuttered long-term care facility in Roseville as an overflow hospital for stable, non-COVID patients, Walz said it might not be needed along with six other alternate sites that could be readied within 72 hours.

Hospitals might be in position to allow some elective surgeries to resume, Walz said, as long as their supplies of personal protective equipment such as masks are stable.

Supplies have been bolstered with the help of Minnesota business leaders negotiating purchases from international locations, though one large supply of masks was halted this weekend when the Chinese government nationalized a plant, said Dr. John Hick, a Hennepin Healthcare doctor who is managing the statewide healthcare coordination center.

Domestic supplies are arriving, too, including N95 masks that offer the best protection to doctors and nurses when working with COVID-19 patients, Hick said. “It’s a trickle, not a flood, but at least it’s a trickle.”

Minnesota might not be conducting 5,000 diagnostic tests per day by Monday, but Walz said that was only his goal and that the state is on track with its partnership with Mayo Clinic and the University of Minnesota to soon reach 20,000 tests per day.

Walz encouraged people to think creatively, and he said leaders of youth sports organizations should come up with strategies to safely allow play to resume — such as baseball teams using their own balls when they are on the field.

“This is just the worst of all things,” Walz said, “that the things we like to do most are the exact things the virus wants us to do to be able to spread.”

Staff writers Ryan Faircloth, Glenn Howatt, Torey Van Oot and Dee DePass contributed to this report.