An outbreak of COVID-19 at the Philadelphia Macaroni Co. factory in Spokane began with one positive case and an immediate shutdown, but that didn’t stop the virus from spreading to nearly half of the facility’s employees.

Thirty-five of the factory’s 72 employees have now tested positive after being tested at various sites in the community. Some employees’ test results are still pending.

The Spokane Regional Health District estimates that more than a dozen family members have contracted the virus from a relative who works at the factory, and the outbreak has accounted for nearly 50 cases so far.

Half of the employees who tested positive were asymptomatic, said Kelli Hawkins, public information officer at SRHD.

Expanded COVID-19 testing guidelines allow any person who was in contact with a confirmed case of the virus to get tested, whether they have symptoms or not.

The pasta factory is an essential business, and Philadelphia Macaroni Co. said it was following all of the recommended safety measures.

While the outbreak occurred before Phase 2 began in the county, Hawkins cautioned it is a reminder of why physical distancing and wearing a mask inside when you cannot stay 6 feet apart from others are so important.

“It’s so highly contagious,” she said, noting the outbreak also shows why contact tracing is so important to containing the virus.

The company will work with the health district to formulate plans for reopening.

“They had all the correct processes and procedures in place, so we’ll work with them to see if there were any holes or something else they could do better the next time around,” Hawkins said.

The initial case in the facility likely came from community exposure, Hawkins said.

Spokane County added six new cases Tuesday. In the last week, the county has reported 84 cases, meaning a good majority of the recent spike in case numbers are due to the outbreak – and that the virus is still circulating in the community. There are now 503 confirmed cases of COVID-19 countywide, with no additional deaths.

Statewide, there are 68 outbreaks in settings unrelated to health care. They are mainly in commercial food settings, like factories and food processing plants. If one person tests positive in a facility, state epidemiologist Scott Lindquist said Tuesday, then an outbreak response should begin.

“An outbreak is defined as two cases in a facility in two weeks,” he told reporters Tuesday.

Right before Memorial Day weekend, Spokane County moved into Phase 2 of the governor’s reopening plan, allowing some businesses to reopen with limited capacities and safety guidelines in place. State health officials are hoping not to see dramatic jumps in case counts as counties move into Phase 2.

“We will be looking very closely,” State Health Officer Kathy Lofy said Tuesday.

Lofy said the state is looking at the Centers for Disease Control and Prevention’s definitions of “rebound” in their most recent guidance to help determine how the state will evaluate whether a county would need to go back a phase or implement stricter restrictions.

The CDC lists several types of “rebounds” a state could evaluate. When evaluating the downward trajectory of cases in a two-week period, the CDC defines rebound occurring “when the smoothed, three-day average of case counts exhibits an increase over a five consecutive day period.”

State Secretary of Health John Wiesman said that as counties move into Phase 2, community spread of the virus, without connections, would be concerning.

“As we do these outbreak or case and contact investigations, we will end up being concerned if we start interviewing folks and can’t figure out where they’re infected” from, Wiesman said.

He stressed it is possible to move through the phases safely, with community buy-in and robust public health measures like contact tracing, testing and isolation options.

“It means each of us needs to take responsibility for how we now behave differently moving forward,” he said, emphasizing some of the Phase 2 guidance.

People should continue to reduce the number of people they are in close contact with, cover their faces and physically distance, he said.

“We can successfully return without these spikes, but it means we all need to be working together on this,” Wiesman said.