COVID-19 is spreading at an increasing rate in Washington and has reached 108 long-term care facilities that house those who appear most vulnerable to the disease, State Health Officer Kathy Lofy told reporters Tuesday.

Her concerns come from the past two weeks’ worth of data.

The percentage of positive cases reported each day ticked up from between 6-7% to 8-9% by the end of March.

“The number of deaths reported per day has been increasing, which is concerning to me as well,” Lofy said Tuesday.

The increase in testing capacity statewide has led to an increase in both positive and negative test results reported to the Washington State Department of Health, overwhelming the data reporting system, which has not been updated since March 28.

Washington has 4,896 cases with 195 deaths due to COVID-19 at the most recent count, but a recent surge in cases, particularly outside of the Seattle metro area, in the last full week of March could be due to several factors, Lofy said.

“When you look at some of the communities outside the Puget Sound area, we’ve seen dramatic increases in the number of cases detected recently, and it’s a little hard to tell from that data if we’re seeing a surge of activity in that region or if we haven’t been testing enough in the previous weeks to detect it at a lower level,” Lofy said. “The testing capacity issue we’ve had over the past few weeks has made it difficult to interpret our data now.”

Several Eastern Washington communities have reported limited numbers of testing kits to offer residents, including in Spokane County, where the drive-thru screening initially had 1,000 test kits and is now down to less than 200.

There are some innovative testing methods coming, Lofy said, but they will need to be approved by the Food and Drug Administration first.

Companies are developing do-it-yourself testing that can be done at home as well as a quick-results kit for health care providers to test and diagnose on-site. Once those become available, specimens will no longer have to be mailed to a lab.

“We think these new strategies will help be game-changers in our response,” Lofy said, although it is not clear when the new testing methods will be federally approved and available.

The FDA loosened some of its testing kit material requirements last week, too, allowing health care providers to use different kinds of swabs and mediums to collect and safely ship specimens to be tested.

Testing is vital, especially in long-term care facilities with confirmed cases, because COVID-19 has disproportionately impacted people over the age of 60 in Washington, with 93% of deaths occurring in seniors.

Lofy said the virus spreading in long-term care facilities is “very concerning” due to higher risk for older people to develop severe symptoms with COVID-19. She said she has heard some facilities have high “attack rates” where more than half of a facility gets infected.

“Those high attack rates highlight the fact that nobody has immunity, and it’s easy to spread within facilities,” she said.

Models from the University of Washington Institute for Health Metrics and Evaluation, which state officials are watching closely, predict the peak capacity and resource use at hospitals will be on April 18 in Washington.

Lofy said these models’ predictions use the currently known death rate for COVID-19, which may be skewed due to insufficient testing.

While COVID-19 is increasing, Lofy did say mitigation strategies, like Gov. Jay Inslee’s “Stay Home, Stay Healthy” order, appear to have stymied an exponential spread of the virus, which occurs when each confirmed case can lead to two or three new ones.

But it is difficult to say how effective mitigation strategies are when relying only on traffic counts and other indirect data that make it difficult to see if social distancing is working in more rural areas, she said.

Spokane County added a dozen cases to its count Tuesday, bringing its total to 145 confirmed cases. No new deaths were reported, leaving the total count at four.

The county’s drive-thru COVID-19 testing center closed early Monday due to windy conditions. The site is expected to remain closed through Wednesday.

County Health Officer Dr. Bob Lutz said at a media briefing Tuesday morning that officials are working to identify a new location for COVID-19 screening.

Lutz also announced the county received five pallets of personal protective equipment, although that will not be enough to cover the shortage in the Spokane area. N95 respirators and surgical masks are used by health care providers to treat patients with respiratory symptoms and COVID-19.

The latest number of residents tested and the county’s positivity rate were not updated Tuesday morning, due to technical issues with the state database.

Lutz reiterated the importance of adhering to the governor’s “Stay Home, Stay Healthy” order, including social distancing in essential businesses.

He suggested grocery stores limit the number of people allowed in the store at a time, noting he has seen people not social distancing in stores in the community. He suggested the prohibition on gatherings of more than 50 people should apply in those settings.

For residents picking up carry out, he asked restaurants to make sure people are social distancing inside if they are waiting.

“Social distancing is imperative if we are to stay in front and keep in front of this illness,” Lutz said.

On Monday, the Centers for Disease Control and Prevention seemed to be reconsidering guidance on whether or not to recommend people wear masks or face coverings outdoors.

Lutz said he isn’t yet taking a position on the use of cloth masks for people outside medical settings.

“I wouldn’t discourage them, but I also wouldn’t advocate for them at this time,” he said.

While Inslee’s stay-home order currently set to last through April 6, it likely will be extended.

Lutz noted that while the Puget Sound region appears to be starting to flatten the curve, Eastern Washington has not done so yet.

He suggested that social distancing and stay-home policies will be encouraged through April, with some measures potentially lasting into May as well.