State officials say outbreaks of COVID-19 in long term care facilities have caused more than 40% of the deaths in Iowa that are linked to the virus.

Public health officials confirmed an outbreak at a nursing home in Cedar Rapids last week, but declined to name other facilities.

The latest report from the state indicates 91 people were hospitalized for treatment of COVID-19 on Saturday night and the deaths of 22 Iowans are linked to the virus.

On Friday, Governor Kim Reynolds tweeted the message to “Stay Home As Much As Possible” to stop the spread of the disease.

“One of the things that I have asked Iowans since the start is to remain calm and to be informed,” Reynolds said during a news conference Friday afternoon. “The term shelter-in-place does not mean that any state’s orders are different from or stronger than what we are doing in Iowa. What matters is the substance of the order, not its name.”

More than 10% of all the 868 positive cases identified in Iowa by Sunday are among staff and residents of long-term care facilities.