Indiana's first COVID-19 outbreak in a nursing home began in late March, according to an announcement during Indiana Gov. Eric Holcomb's daily press conference on Monday.
Indiana State Health Administrator Kris Box said it was always her greatest fear "that we would have an outbreak in a nursing home."
That has now happened at Bethany Pointe Health Campus in Anderson, Indiana.
"Unfortunately, three employees are hospitalized, two of which are critically ill," Box said, noting the outbreak has taken the lives of 11 residents already. "This is a heartbreaking situation. ... This will not be the last outbreak of this time.
"If you have ill employees or residents, take immediate steps. ... We will come out, and we will test all of your symptomatic individuals."
The nursing home reached out to the ISDH on March 26, and the next day a strike team from the state was sent to Madison County to test residents and employees.
Box pleaded for those who have personal protective equipment to donate items to hospitals and health-care providers. She asked companies who can to "fire up their lines" to start producing PPE equipment as well.
It's not clear whether or not Indiana will receive any further supplies from the national stockpile, Box said.
"Until I have those supplies in my hand I cannot promise," Box said. "This is just another reason why we need every Hoosier to hunker down."
New executive order to limit retail businesses
The governor announced a new executive order that would come into effect at 11:59 p.m. tonight, though some specific clauses will start to apply at 11:59 p.m. Tuesday.
New restrictions limit retail businesses that aren't selling the "necessities of life" as outlined by Holcomb's order to remain open "only for online or call-in ordering with delivery or curbside pickup."
These new restrictions are meant to reduce foot traffic in businesses and increase physical distancing measures, the term the Centers for Disease Control and Prevention now uses instead of social distancing.
Businesses that provide necessities of life include grocery stores, supermarkets, certified farmers markets, farm and produce stands, convenience stores, gas stations, pharmacies, auto sales, bicycle shops, hardware and supply stores, pet supply stores and others, according to the order.
Large church services are not essential
Holcomb thanked pastors for live-streaming services and understanding that this week is a holy one for many in the Christian faith, and was clear in his message that he wouldn't be considering changing religious entities abilities to hold large gatherings.
"This coronavirus does not discriminate," he said. "It does not care what crowd you're in.
"This disease does not care. This disease will prey on the vulnerable. This disease will prey on large gatherings."
Holcomb acknowledged there are many weeks considered important for different religions, but the possibility of transmitting the disease means people need to physical distance and prevent transmission from occurring.
Box said that she wouldn't be having a traditional Easter dinner with her extended family this weekend, as several members of her family are health-care workers and her parents are at a higher risk due to their age.
Demographic data is limited
The ISDH does not receive information pertaining to a person's race after they've just been tested for the coronavirus, Box said, so it's hard for the state to know how the virus is affecting people of color in proportion to others, and if a disproportion exists.
"We've been working very hard on that," Box said. "We don't get any other demographic information. ... We still have about a 30% gap in our information."
She noted that a person being hospitalized makes it easier for further information to be released.
Looking toward the future
A wider range of people may be tested in the future, as Box said that people with higher BMI would qualify for testing. Being obese to a certain point puts additional pressure on a person's chest, which could leave them compromised and with a higher chance of getting sick, something Indiana residents might be at a higher risk for.
"We are a fat state," Box said. "We are the 12th most obese state in the nation."
If nursing homes in the future think their residents are becoming sick as well, Box said they should put out a call to the ISDH for help.
"I can't empathize enough that we are here to help you," she said. "We will come again, and again, and again because we know that you want to protect this population.
"These are our grandparents, and our parents."
For now, hunker down
Holcomb recounted a few hopeful stories of young people across the state trying to make do in the uncertain times many Hoosiers are finding themselves in.
He told the story of a kindergartner in Munster, Indiana, named Sofia who was painting pictures to be put in intensive care unit rooms. A high school student named Dylan in Center Grove built a website so he could help his neighbors get groceries and items from local businesses delivered to their homes. A young girl from Boonville, Indiana, told off adults for going to stores for nonessential items during a pandemic.
"'Browsing the dollar section (at Target) is not essential business,'" Holcomb quoted of the 5-year-old Nora, eliciting a few laughs from others during the press conference.
Holcomb said in the long run, we're all in this together.
"We've got a Hoosier hike ahead of us for two weeks," Holcomb said.