WARREN — The number of inmates at the Trumbull Correctional Institution in Leavittsburg testing positive for COVID-19 has spiked in recent weeks — at about the same time Trumbull County was placed in a new state “red” designation.

But those TCI cases are not the only reason Trumbull is at high risk, a county health official said.

The “red” designation means Trumbull residents are at high risk of contracting the virus and must wear a mask in all indoor areas and all outdoor areas where a 6-foot distance cannot be maintained.

Fifty-four TCI inmates currently are testing positive for the virus, a sizeable increase over the 17 who tested positive June 17.

TCI’s 54 inmates testing positive is the highest number in all of the states’s 28 prisons. The next-highest number is in the Correctional Reception Center in Orient, which has 26.

TCI has more than a third of the current virus cases in the state’s prison system — 54 of 141.

But Sandy Swann, director of nursing for the Trumbull County Combined Health District, said new data the Ohio Department of Health will release this week shows that two Trumbull County nursing homes also have seen sizeable increases in cases — one having 43 cases and the other having 41.

The listing from last week showed that the Addison Healthcare Center in Masury had 21 patient cases and 17 staff cases. But no other nursing home at that time had more than nine.

Swann said nursing homes and the prison are two reasons Trumbull County is at high risk, but the county also has a lot of virus transmissions happening in the general population — in families, at events and in settings such as bars.

She said about a third of the virus cases that have occurred in the county since the beginning — 336 of 1,083 — have happened in “congregate” settings such as prisons and nursing homes. That means about two-thirds are happening in the general population. She said one outbreak took place in an apartment complex.

Asked if she’s surprised that TCI has the highest number of COVID-19 cases right now, Swann said she was not — because the spikes tend to move around the prison system, just as they do in nursing homes.

She said when the virus comes into either type of facility, it tends to “burn through” the population, making those people less likely to spread it any more.

“If you have the same employees coming in and out and they’ve already had it … they’re probably not spreading it any more,” she said. But when new employees travel into a facility such as a nursing home or prison, that can trigger more cases.

One of the best things people can do is wear masks, she said.

“Even if you are at a venue with a lot of people, if you have masks on, you’re not spreading it,” Swann said.

Swann said she believes part of what is causing more cases is people setting aside advice about social distancing and reverting to old ways of doing things.

“It’s summer,” she said. “People were cooped up, and everything was closed down. There’s a lot of mental health issues. People need to get out — socialize. That’s all part of good mental health. When that’s all closed down, sometimes that affects people.”

So the goal should be to maintain 6 feet of distance and wear a mask, she said.

“That will help decrease the spread of it,” she said.

TCI has had 33 staff members with the virus since the pandemic began. No TCI staff members have died, and 20 have recovered. No TCI prisoners have died either.

Many of the 27 other Ohio prisons have had more infected staff members than TCI since the virus began. For example, 178 staff members at the Marion Correctional Institution were diagnosed with the virus since the virus began, and one staff member died. And, 101 staff members at the Franklin Medical Center in Columbus have had the virus; 110 staff members have had the virus at the Pickaway Correctional Institution in Orient, and one died. And 98 staff members have had the virus at the Belmont Correctional Institution in St. Clairsville.

The Service Employees International Union, which represents Ohio prison employees, meanwhile, issued a news release this week stating that the lives of prison inmates and staff are at an “unacceptable level of risk.”

The news release focuses on employees not all being provided with N-95 masks.

“These workers do not know who is positive in these facilities and who is not,” said Anthony Caldwell, director of public affairs for SEIU District 1199.

erunyan@tribtoday.com