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CHARLESTON, W.Va. — The CEO of the Morgantown nursing home that was home to a woman diagnosed with COVID–19 says it's still unknown whether she contracted the disease within the facility, from a visitor or healthcare worker, or during a visit elsewhere.

Public health investigators attempt to ascertain that information during infectious disease investigations, but Michael Hicks, CEO of Sundale Rehabilitation and Long-Term Care, said Monday afternoon he didn't know where investigators were in that process, or if they've begun.

West Virginia Gov. Jim Justice announced Monday afternoon that the nursing home case was the first in the state believed to be spread through in-state contact, not travel. He then ordered all non-essential businesses to close, as well as issue a state-at-home order for residents to begin at 8 p.m. Tuesday.

As of Monday evening, there were 20 confirmed cases statewide, according to the West Virginia Department of Health and Human Resources website.

Also during a response to an outbreak of infectious disease, public health workers inform people who may have been exposed to the disease about their risk.

Hicks said Monday he didn't know where public health workers were in that process, although he did say every resident on the first and second east wings of the nursing home, often referred to as Sundale Nursing Home in the community, had been tested. Those results weren't back as of Monday afternoon, he said.

Four people were showing some symptoms, he said.

The governor sent the National Guard to gather tests Monday morning, Hicks said, although they had to use swabs from Ruby Memorial and Mon General hospitals.

Hicks said all nursing home workers who had been in contact with the patient since 8 a.m. Saturday were also tested.

However, it's possible she may have exposed other workers, as COVID-19 can be contagious before it shows symptoms.

Hicks said the nursing home had already ceased visitation for about a week and a half, following a directive to all nursing homes. Staff had been bringing around laptops and allowing residents to FaceTime with family members, he said.

"I can't say enough about our staff so I'm very confident that our staff will once again rise to the occasion and hopefully we can keep all our residents safe," he said.

Hicks said the person was taken to Ruby Memorial Hospital at about 3 a.m. Sunday, following demonstration of mild respiratory distress and a mild fever. They admitted her and tested her for COVID-19.

WVU Medicine now has in-house testing capacity. She tested positive by 4 p.m., Hicks said. Testing results from the state lab take days, he noted.

"So kudos to them for such a quick turnaround on that," he said.

The woman is currently being treated in isolation at Ruby, he said. He said he didn't believe the situation was severe enough to require a nebulizer or respirator.

Hicks said nursing home workers are monitoring patient temperatures and had previously ended communal dining and activities.

COVID-19 has caused a global pandemic. Symptoms may include fever, cough and shortness of breath. It may be fatal to both old and young, but particularly to the elderly.

Last week, the Washington Post reported that COVID-19 had been spreading through the Life Care Center nursing home in Kirkland, Wash., for at least nine days when a sick resident was taken to a hospital on Feb. 19.

As of last week, 29 COVID-19 deaths had been associated with that nursing home. Thirty of the 43 remaining residents, and 46 of the home’s 180 employees, had tested positive.

Erin Beck is a reporter at The Register-Herald of Beckley. Email: ebeck@register-herald.com and follow on Twitter @3littleredbones.

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