MINNEAPOLIS (AP) — Minnesotans who qualify to be designated as “essential caregivers” will be allowed to visit family members in senior living centers under new guidance Friday from the state health department, which loosens restrictions that have kept loved ones under a near-lockdown for four months due to the coronavirus pandemic.

Long-term care facilities such as nursing homes will be able to designate family members or others as essential caregivers so they can resume visits with precautions, Health Commissioner Jan Malcolm said.

The tight restrictions imposed in mid-March were “difficult but very essential” to protect residents and staff, but they came with their own costs in loneliness, quality of life and health risks resulting from that social isolation, Malcolm said in a briefing for reporters.

“People are suffering and they’re dying from COVID-19, but also from loneliness,” said Cheryl Hennan, the state ombudsman at the Office of Long-Term Care at the Minnesota Department of Health.

Limited to phone, video or window visits, Hennan said, families are seeing their loved ones slip into psychological and physical decline. Some residents stop eating, sleeping or bathing and lose the will to live, she said.

COVID-19 has been most devastating to Minnesota’s senior residents, with almost 78 percent of the state’s 1,495 deaths coming in residents of long-term care or assisted living facilities.

An essential caregiver could be a family member, an outside caregiver, or a friend or volunteer who provided regular care and support to the resident before or during the pandemic. Residents can have more than one.

The state’s guidelines call for facilities to establish procedures no later than July 25 to determine who counts. Those who are approved will be able to spend up to three hours per day with their loved one. But Malcolm stressed that the guidelines aren’t meant to allow everyone in who wants to visit. More casual visitors should instead follow guidance issued earlier for limited window and outdoor visits, she said.

Approved caregivers must sign in and be screened prior to entering the building, just as employees are currently. They must comply with infection control procedures. Those include frequent hand washing, using hand sanitizer and wearing. face masks, eye protection and potentially other personal protective equipment. Coronavirus testing will not be required but will be encouraged.

The department issued the new guidance on a day when it reported 609 new confirmed cases and five new deaths from the coronavirus, including one death in a long term care facility resident. The state’s positivity rate, an important measure of how fast the virus is spreading in the community, has risen to 4.5% from 3.8% a week ago, Malcolm said.

The commissioner acknowledged that the decision carries risks and that facilities may have to suspend visits if they experience outbreaks.

“But we believe that we’ve got, certainly, much better tools in place today than we did four months ago,” she said.