The Women’s Eastern Reception, Diagnostic and Correctional Center in Vandalia is facing a major outbreak of COVID-19 after 161 cases were confirmed there Wednesday by the Audrain County Health Department.

While the Missouri Department of Corrections was reporting case increases since Friday, the health department had not received the associated reports to confirm the cases until Wednesday, Health Administrator Sandra Hewlett said.

“You cannot report unless you get an official laboratory confirmation through the state,” she said. “You have nothing but a number that they post on the [Missouri] Department of Corrections website. You don’t have demographics, date of birth, clinical information, or a patient name. You can’t contact trace, therefore, you can’t report.”

Because the numbers were being reported through the Department of Corrections, but the county health department was not receiving the reports, Hewlett made phone calls to the department Tuesday evening and the correctional center’s warden Wednesday morning.

With the outbreak at the Vandalia prison and the outbreak associated with Tri-County Care Center, also in Vandalia, the county’s total case number is 531, with 215 cases active. There are now four deaths associated with COVID-19 in the county. One of the recent deaths was connected to the Tri-County outbreak. The first death was reported in June.

“We have to hold [death reports] according to state guidelines,” Hewlett said. “We have to hold them until we have a cause of death, whether it is COVID or some underlying disease. We have to wait until the attending physician signs off on the cause of death before we can report the death officially. I don’t want to report a death incorrectly.”

Of the 161 active cases at the prison, 160 are among offenders, while one is a staff member.

“When you have congregate facilities like prisons and nursing homes, they have to report to us within 24 hours,” Hewlett said.

Because the confirmed offender numbers are so high, the outbreak likely is connected to offender transfers into the facility, she said.

“It wasn’t like they have 20 staff positive and they were spreading it. This was more like probably offenders coming in that were positive and spreading it,” Hewlett said. “It is hard to believe one person would have been around everybody to to do that.”

Congregate living facilities always will have the potential for rapid transmission, she said.

“When you are moving inmates in and out of a facility, it is going to increase the risk of transmission,” Hewlett said.

As of Wednesday afternoon, the health department had 132 of the 161 case reports. They received the rest of them throughout the afternoon and evening so health department staff could conduct contact tracing before they released their daily COVID update.

“I have already entered them [the case reports] myself to give my staff some reprieve,” Hewlett said Wednesday afternoon. "We know the state has been backlogged lately and they are having a staffing crisis there at the prison. They have about two-thirds to us and they are working very hard to get the rest.“

Health department staff are processing reports in real time so that daily reports are accurate. This means that county-level reporting may not match state-level reporting. Residents should defer to county reporting, rather than the state’s for now, Hewlett said.

“You always go with our numbers at the health department because we are on them every day and we don’t leave until they are done,” she said about Audrain County’s process. “We finish our cases in real time. When you get that kind of number, yeah, we do them same day, but it’s busy.”

TRI-COUNTY CARE CENTER UPDATE

An outbreak of COVID-19 was first reported Sept. 3 among staff and residents of Tri-County Care Center. Initial reporting had 18 active cases among staff and 24 residents.

The total number of cases increased to 75 as of Wednesday, with five employees and 26 residents still active. The total breakdown, so far, was that 24 staff and 51 residents were affected.

Through the efforts of the health department, the facility has enough personal protective equipment, Tri-County Director Megan Elledge said as part of a weekly teleconference with area health, business, school and government leaders.

“We have staff returning who have recovered. We have lots of residents who have recovered returning to their normal rooms as well,” she said. “We are testing weekly, as well. On the positive side, things are looking up for us.”