Two COVID-19 cases have been confirmed in Lee County, the first two in far Southwest Virginia, the Virginia Department of Health reported Saturday.

These are the first confirmed cases of COVID-19 in residents of the LENOWISCO district. The people have been described as a man and woman in their 50s. The second person is a household contact of the first. The department did not say how the first case contracted the virus.

The pair has made no contacts with the community since prior to the onset of symptoms in the first case and have maintained strict isolation, following public health guidance, since symptom onset, the health department said Saturday.

No at-risk community contacts have occurred.

“As we see new cases of COVID-19 throughout the commonwealth, and going forward in our communities, it is critical that people follow the public health guidelines on social distancing and good hygiene,” said Sue Cantrell, M.D., director of the LENOWISCO and Cumberland Plateau Health Districts. “Social distancing is one of the most effective strategies in lessening the impact of this pandemic.”

A total of 152 cases of COVID-19 had been reported in Virginia as of Saturday afternoon, but that did not include the two cases in Lee County, as they had not yet been confirmed until later in the day, officials said. Two people have died in the state.

The Cumberland Plateau Health District of Southwest Virginia said Saturday it is also investigating potential contacts of a confirmed case in a resident of the Henrico Health District who also spent time in the Cumberland Plateau Health District. The patient is a female in her 20s. She is self-isolating, the district said.

“To protect privacy, VDH does not disclose details of individual cases or investigations,” Cantrell said. “Public health staff are investigating any potential exposures associated with this case, identifying potential contacts, assessing their risk of exposure and recommending appropriate public health and medical measures, as needed.”

Cantrell said officials believe the virus spreads mainly from person to person, through respiratory droplets from coughs and sneezes.

“So the best way to prevent illness is to avoid close contact with other people,” Cantrell said. “Keep at least six feet away from others. Wash your hands with soap and water well and often, and disinfect surfaces frequently.”

Bluefield College in Tazewell County confirmed late Friday that a student there had tested positive for the virus. However, the person was not in Southwest Virginia.

Sunday also saw a large increase of cases in Tennessee. The Tennessee Department of Health reported 505 confirmed cases of COVID-19. The number includes two in Sullivan County, two in Washington County and three in Greene County.

The new case in Sullivan County is a Ballad employee, but exposure did not occur in a Ballad health care facility, according to the statement.

“An additional new case was confirmed in Sullivan County on March 22,” according to statement. “This case was a team member serving at one of our hospitals.

Investigators have determined that the positive case is linked to personal travel, not hospital exposure and has also confirmed that this case did not have any contact with patients.”

Ballad Health CEOC is working with the appropriate officials to notify anyone who may have been in close contact with this case, according to the statement.

The only previous Sullivan case was a man who self-quarantined after personal travel.

There are two new confirmed cases in Greene County, according to Ballad officials.

“Ballad Health continues to take additional steps to protect its patients, team members and communities,” according to the statement.

The vast majority of cases are in the greater Nashville area — 167 in Davidson County and 48 in Williamson — but there are now confirmed cases in more than 40 counties.

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