BIG STONE GAP — Details emerged Wednesday of two ongoing outbreaks in nursing homes in Wise and Scott counties totaling more than 290 cases and 23 deaths.

Virginia Department of Health spokesman Robert Parker confirmed Wednesday that outbreaks had been reported at Heritage Hall in Big Stone Gap and Ridgecrest Manor in Duffield, although those outbreaks had not been included on the state’s online dashboard for outbreaks in nursing homes, assisted living and multi-care facilities. The site was introduced Nov. 2 following General Assembly legislation allowing the release of outbreak information about long-term care facilities.

According to LENOWISCO Health District Director Dr. Sue Cantrell, Heritage Hall in Big Stone Gap has seen 190 COVID-19 cases among residents and staff during the pandemic, along with eight hospitalizations and 21 deaths.

Ridgecrest Manor in Duffield has reported 104 COVID-19 cases along with seven hospitalizations and two deaths during the pandemic, Cantrell said. Information was not available Wednesday on the dates when the two outbreaks began. Residents at the facilities are considered Virginia residents for COVID-19 data purposes, Cantrell said, and facility employees who live out of state are counted for facility outbreak purposes but not in Virginia statewide data.

Since the VDH dashboard launched, only two facilities had been listed. Lee Health and Rehabilitation in Pennington Gap has had an outbreak in progress since July 4, with 129 cases and fewer than five deaths reported since that date. Nova Health and Rehabilitation in Weber City has had an outbreak pending closure that started on Sept. 11, with fewer than five cases and fewer than five deaths reported.

Heritage Hall and Ridgecrest were not listed on the VDH dashboard on Wednesday. Cantrell said that, while the VDH updates various data on its COVID-19 dashboards daily or weekly, information will lag real-time counts.

According to the VDH, an outbreak is considered in progress until 28 days — two COVID-19 incubation periods — have passed without the onset of new cases. When 28 days have passed without a new documented case, the outbreak is considered pending closure but has not yet been confirmed closed in the Virginia Outbreak Surveillance System.

Cantrell said the Big Stone Gap and Duffield outbreaks are ongoing and that additional cases may be added to that data. Community spread has been a significant factor in the two outbreaks, she said.

“Staff who work in the facilities may have no symptoms ever, and may be infecting others without ever knowing they are sick,” Cantrell said. “Or they may work and infect others for days before their symptoms appear. This is true for all of us, always and everywhere, which is why precautions are so important in limiting the spread of illness, always and everywhere.”

Cantrell said that Heritage Hall’s sister facility in Grundy, in Buchanan County, has reported 111 cases with two hospitalizations and one death. That facility was listed on the VDH website Wednesday, with the outbreak starting Nov. 9 and with only 35 cases and no deaths.

The Big Stone Gap and Grundy Heritage Hall facilities were listed on Heritage Hall Nursing and Rehabilitation Centers’ webpage ( Wednesday as not allowing any indoor or outdoor visitation. Heritage Hall’s Wise facility — not listed on the VDH outbreak webpage — was listed by the company as allowing only outdoor visitation by appointment.

“Finally, the impact on older and sicker residents is significant and hopefully is a reminder to all of us to do what we know works,” Cantrell said, “to reduce the spread to all but in particular those at risk of any age. And what we know works is wear a mask, watch your distance (6 feet) and wash your hands. That’s how you protect yourself and others.”

Wise County saw its highest one-day report of COVID-19-related deaths with six, according to Wednesday’s state data report.

The LENOWISCO Health District saw 39 cases and the six deaths for totals of 2,543 and 46 deaths during the pandemic. Wise County had 18 cases and the additional deaths for totals of 1,066 and 23 deaths. The website does not specify if those deaths occurred at a specific facility.

Lee County accounted for 16 cases for 770 and 11 deaths. Scott County added five cases for 644 and 11 deaths.

Norton’s case total was adjusted down by one in Wednesday’s report for 63 cases and no deaths.

The VDH reported that the state had 2,071 new cases and 25 additional deaths in the prior 24 hours for pandemic totals of 208,833 cases and 3,860 deaths.

The statewide testing rate for people with nasal swab and antigen tests in Wednesday’s VDH report was 3,229,178 of 8.63 million residents, or 37.42%. For nasal swab testing only, 2,983,430 people have been tested to date, or 34.57%. In the LENOWISCO district, 22,157 of the region’s 86,471 residents have been tested via nasal swab sample for COVID-19, or 25.62%.

testing rates by locality

• Lee County, 6,933 of 23,423, or 29.6%

• Norton, 2,094 of 3,981, or 52.6%

• Wise County, 8,330 of 37,383, or 22.62%

• Scott County, 4,800 of 21,566, or 22.26%

Wednesday’s announcement of the Big Stone and Duffield outbreaks coincided with a two-instance rise in overall pandemic outbreaks for the LENOWISCO district to 35. That brought the total number of long-term care facilities affected to five.

Red Onion State Prison remained at 20 inmate cases and no active staff/contractor cases, according to the Virginia Department of Corrections.

Wallens Ridge State Prison in Big Stone Gap remained at no inmate cases and one active staff/contractor case. Wise Correctional Center near Coeburn remained at 16 inmate cases and added one case for one active staff case.

The seven-day average rate of positive PCR test results in the LENOWISCO district in Wednesday’s report rose from 15.9% to 16.2%. The statewide positivity rate decreased from 7.4% to 7.1%

According to Wednesday’s VDH pandemic measures dashboard, cases in the far southwest region of Virginia — including the LENOWISCO Health District — were ranked as rising after a 58-day increase in cases. The far southwest region ranking for percent positivity of COVID-19 testing results remained increasing based on a 39-day increase in that measure.

All four school systems in the LENOWISCO district — Wise, Lee and Scott counties and Norton — were ranked as highest-risk based on the 14-day case incidence rate in the district. Scott County Schools were ranked lower-risk for percent change in seven-day case incidences. Wise and Lee counties and Norton City schools ranked lowest-risk.

Where to be tested

Do you think you might have COVID-19? Local health departments provide free testing.

The LENOWISCO Health Department, which covers Norton and Lee, Wise and Scott counties, posts regular updates on testing sites across the district and offers free COVID-19 tests at its county offices. Those seeking a test must call in advance for an appointment. Contact numbers for the county offices are:

• Lee County (Jonesville) — (276) 346-2011

• Scott County (Gate City) — (276) 386-1312

• Wise County and Norton (Wise) — (276) 328-8000

Additional testing and COVID-19 precaution information can be found at the LENOWISCO Health District’s Facebook page:

The Health Wagon will partner with the Virginia Department of Health to offer 17 sessions of free drive-thru testing at Food City in St. Paul through Dec. 31. Call (276) 328-8850 for an appointment.

In Southwest Virginia, online resources are available to help evaluate whether residents might be infected and where to get a COVID-19 test. The Virginia Department of Health’s COVIDCHECK ( can walk a user through symptoms they may be experiencing and help direct them to their local health department office or other available testing sites.