Spokane County health officials confirmed 23 more cases of COVID-19 on Wednesday, the highest daily count of cases reported since the pandemic began.

County Health Officer Dr. Bob Lutz attributed the jump in cases to increased testing with expanded eligibility as well as an outbreak at a pasta production facility that has affected at least 50 people so far.

“This will be what we’re going to be seeing for the foreseeable future,” Lutz said. “We will have these upticks, then maybe a little bit of flattening or relaxation.”

He expressed concerns following “some overexuberance” over the long holiday weekend, noting the potential for more cases in the coming weeks.

“I may be seeing numbers similar in the next week or two weeks, given that people may start having symptoms about five days after being exposed or up to two weeks after,” he said.

Nationwide, the death toll for COVID-19 hit 100,000 Wednesday, and 1,095 deaths have been recorded due to COVID-19 in Washington state.

“We’ve lost lives. Every life matters,” Lutz told reporters Wednesday.

There are now 526 confirmed cases of COVID-19 in Spokane County, and the majority of new cases reported on Wednesday indicate that the virus is still spreading in the community outside of contained outbreak situations.

A person who suspects they were exposed to the virus can get tested regardless of symptoms, a dramatic change from just a couple months ago when only the sickest residents could be tested.

So far the outbreak at the Philadelphia Macaroni Co. factory has led to 36 employees testing positive, along with about 15 close contacts of those employees, Kelli Hawkins, public information officer with the health district, said. Not all test results are back yet, but 28 employees have tested negative for the virus.

Despite the pasta factory following safety guidance and protocols, people still became infected, which reveals, Lutz said, that there is still a lot about the virus we don’t know.

“What I’ve heard is that the plant was doing everything they were supposed to do, and yet people still got infected,” he said. “I don’t have an answer for that, and neither do they.”

The virus can be highly contagious and spreads without people even knowing it. Half of the employees that got the virus were asymptomatic. Lutz said the likelihood of getting infected is a function of time and space.

“The more time spent in a smaller amount of space, the greater the likelihood of you being infected,” he said.

Cases of widespread transmission in one environment, as at the choir practice in Skagit County, show that respiratory droplets and particles expelled when singing as well as coughing and sneezing can spread the virus easily. Even speaking can emit droplets that spread the virus.

A recent study of droplets emitted when a person speaks found that “there is a substantial probability that normal speaking causes airborne virus transmission in confined environments,” and that droplets can last up to 14 minutes in the air.

Wearing a mask, as is required in a few counties in Washington, including Spokane County, can help reduce the transmission of respiratory droplets, Lutz said.

So far 24 counties have moved to Phase 2 of Gov. Jay Inslee’s Safe Start plan. The virus has a higher reproductive number – the number of new cases expected to directly result from each infection – in Eastern Washington than in Western Washington, even when modelers excluded Yakima County, which continues to have high positivity rates and increased case counts.

Residents of the Spokane Veterans Home being treated at the Mann-Grandstaff VA Medical Center will begin to return to the home this week. They will first go to a COVID-19 recovery wing for two weeks. Once they test negative for the virus twice, they can return to their rooms.

So far eight residents have returned home after testing negative twice, but many residents who contracted the virus continue to test positive for several weeks.

The VA Medical Center will begin discharging residents based on time, not testing. If a resident wants to return to the home, is symptom-free for two weeks, has waited 30 days since the first positive test and is not anticipated to need aerosolizing procedures, the resident will be cleared to return to the COVID-19 recovery wing at the Spokane Veterans Home.

The VA hospital and the veterans home have consulted with the regional and state departments of health before beginning the transition process, according to a news release.