GIRARD, Kan. — “So a few things have changed since last Friday,” Crawford County Health Officer Rebecca Adamson said as she began her coronavirus update at Tuesday’s county commission meeting, in an understatement that drew laughter from the commissioners.

“If you can’t laugh you’ll cry, right?” she said.

Although the commission last week discussed the COVID-19 outbreak at the SugarCreek bacon packing plant in Frontenac, at the time they talked about the issue the facility was not planning to test all of its employees for the novel coronavirus. That changed later in the day, and by the end of the weekend the Community Health Center of Southeast Kansas and the county health department had coordinated to test more than 600 people, Adamson said.

The results of all of those tests were still not known Tuesday morning, Adamson said. The Kansas Department of Health and Environment (KDHE) was reporting 96 Crawford County cases on Monday, but that number includes all cases going back to March, and while all of the positive results were initially being reported as Crawford County coronavirus cases because the county was coordinating the SugarCreek testing, some of them were actually Missouri residents, Adamson said.

“So we don’t have exact numbers for Crawford County yet, and we don’t even have exact numbers yet for just this cluster in general, so we’re still just going to have to wait,” Adamson said.

She added, however, that there were probably about 45 new positive cases of Crawford County residents identified on Monday.

Although Adamson said last week that not all of the new COVID-19 cases are connected to the SugarCreek plant in Frontenac, she said Tuesday that most of them were. “And, you know, we haven’t had an outbreak related to gatherings and things like that in Crawford County other than this one cluster in a workplace,” she said.

Commissioner Bruce Blair asked if Adamson had an estimate of how many of the new cases were asymptomatic, and she said she did not, but “there were many that had no symptoms.”

Adamson said she was at CHCSEK assisting with testing for several hours Friday. “No one seemed severely ill,” she said. “For the most part, most of the people, if they did have symptoms it was very mild.”

Blair said he wondered if the high number of asymptomatic positive cases could be because unlike much of the other testing that has gone on statewide, SugarCreek employees were tested regardless of any obvious sign that they were ill.

Frontenac Mayor David Fornelli said Monday that he had spoken with a SugarCreek official and there were more than 60 coronavirus cases associated with the facility, three quarters of which were asymptomatic.

At both the county and state level, COVID-19 testing for people who are not showing symptoms remains uncommon.

“Individuals who are exhibiting any two of the following symptoms: fever, chills, cough, disturbances in smell or taste, sore throat, muscle/joint aches, fatigue, nausea, vomiting, diarrhea, shortness of breath, have had an exposure to a positive COVID 19 individual, or who have questions about testing should call the Crawford County Health Department, at 620-231-5411, to be screened to determine if testing for COVID 19 is needed,” the department noted in a June 14 press release.

For testing through the KDHE laboratory, “persons must meet the person-under-investigation criteria, meaning people generally speaking must be symptomatic,” KDHE Secretary Lee Norman said last week.

“We generally don’t test asymptomatic people, and you may ask ‘Why?’ You might ask ‘Wouldn’t doing so help with tracking disease spread?’” Norman said. He said there were several reasons not to test asymptomatic people, including that there is not a reliable test for asymptomatic people that has been approved by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration.

Adamson said Tuesday that she had been in contact with area hospitals and they were not overburdened and did not have any positive cases in their intensive care units.

The county did not issue any new public health orders Tuesday or restrictions on business and public activities in response to the outbreak.

Commissioner Jeremy Johnson said he had received many questions about the increase in positive cases and asked Adamson if she would recommend new restrictions. Adamson said the county could issue an order but it would need to be able to enforce any new restrictions if it were to do so.

“To be real honest, I mean that was an issue before,” she said. “Absolutely we can do that, but if people aren’t going to follow it, how are we going to enforce it?”

“I think the whole problem with making stricter regulations is the fact that everywhere surrounding us has none,” said Blair, “and you force a population to travel that normally wouldn't travel, which is a bigger risk in my mind.”

Blair acknowledged, however, that “we have a situation,” and Adamson pointed out that the situation could quickly change.

“The hospital could call me tonight” and say it was having capacity issues, Adamson said. “Just like last Friday, I mean we didn’t think we were going to test the whole factory but then by 2:30 in the afternoon we were testing an entire factory.”

Asked by Blair how many of those who have tested positive have gone to the hospital, Adamson said she did not have an exact figure.

“With this specific cluster we’ve not seen that severity,” she said, “so it’s not been a large portion.”

Adamson added that it was important to remember, however, that Ascension Via Christi hospital receives patients from many surrounding counties as well as Missouri and Oklahoma.

“Missouri is really skyrocketing in Jasper County, so they’re having a lot of cases as well,” she said, “and a lot of that is related to our issue here.”

Although the county has not issued any new health order, Adamson reiterated that she is strongly recommending that people avoid gathering in large groups and take appropriate precautions to prevent the further spread of the virus.