The Minnesota Department of Health reported the state’s first COVID-19 death Saturday morning as confirmed cases increased by at least 23 statewide and by two in south-central Minnesota.

The death occurred Thursday and involved a Ramsey County resident in his or her 80s who recently tested positive for COVID-19, the illness caused by the novel coronavirus. The person had been in contact with a family member who was a frequent international traveler and had previously been confirmed to have the disease, according to state health officials.

Minnesota Commissioner of Health Jan Malcolm said everyone has been watching the number of cases and the number of deaths rising across the world: “But this strikes closer to home and closer to heart.”

Malcolm said the death underscores the importance of protecting the most vulnerable Minnesotans during the outbreak and “reminds us how important it is to continue working to protect each other during this outbreak.”

She emphasized the need to slow the spread of the virus to protect those at higher risk of severe illness or death, particularly those over 65 and those with underlying health conditions. Minnesota’s first victim fell into both of those categories and quickly succumbed to the virus, first showing symptoms on March 14 before being hospitalized two days later and dying three days after that.

The number of confirmed cases statewide rose to at least 138 by Saturday morning — 137 on the latest Department of Health update released at 11 a.m. and at least one additional cases in Nicollet County that won’t be added to the statewide list until Sunday. Of the 138, six are hospitalized, including four in intensive care. The new statewide cases included Minnesotans ranging in age from 10 to 84, with a median age of 44. The 10-year-old was a home-schooled student.

There were 115 confirmed cases Friday, up from 89 on Thursday. Due to testing shortages, the actual number of cases in Minnesota is certainly higher, according to health officials.

During a press briefing Saturday, Malcolm and Kris Ehresmann, the department’s infectious disease director, said the actual number of cases in Minnesota is certainly higher due to testing shortages. Asked about a Columbia University study that estimated that the number of cases nationwide might be 11 times the number of lab-confirmed cases, Ehresmann said that’s likely a conservative estimate.

“It could be as high as 100-fold,” Ehresmann said. “... There is a lot of COVID-19 circulating in Minnesota.”

The department is now reporting 11 cases in south-central Minnesota, up from nine on Friday. The number in Martin County, the hardest hit among the counties adjacent to Blue Earth County, rose from four to five. Blue Earth County cases are now at three with one additional case reported Saturday.

The Waseca school district reported Saturday evening a new confirmed case involving one of its teachers but didn’t list the teacher’s county of residence. Nicollet County also reported an increase in cases from two to three late Saturday morning.

“The case is a 26-year-old who was exposed to an individual who previously tested positive for COVID-19,” said Nicollet County Health and Human Services Director Cassandra Sassenberg. “This individual is at home and has been asked to quarantine themselves for 14 days from their exposure and will be monitored for fever and respiratory symptoms. MDH is working with the infected person to identify and contact all potentially exposed individuals.”

Although the case was not included in the updated statewide list of COVID-19 cases by county, Nicollet County received word of the case from the state health department, Sassenberg said.

Noting that the new case involved exposure to someone who had previously been confirmed to have the virus, Sassenberg said it reinforces the importance of area residents taking protective measures like staying home and avoiding social gatherings.

“The goal is to slow the spread of COVID-19 so we don’t overwhelm the healthcare system,” she said. “It’s important for all of us to do our part to protect the people in our lives who are at higher risk for serious illness.”

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. Older adults and people with existing health problems are at risk of more severe illness, including pneumonia. The vast majority of people recover.

Strategies for slowing the spread of COVID-19 and other information about the disease can be found at www.health.state.mn.us/diseases/coronavirus. A Minnesota Department of Health hotline for the public is open seven days a week, 7 a.m. to 7 p.m., at 651-201-3920.

Since the outbreak started in December, more than 304,000 cases and nearly 13,000 deaths have been reported worldwide as of early Saturday evening. Nearly 92,000 have recovered. In the United States, 25,493 cases have resulted in 307 deaths, according to Johns Hopkins University. With the virus spreading more recently here than in Asia and Europe, only 171 Americans are listed as recovered at this point.

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