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Nursing home residents tested positive and then died without showing COVID-19 symptoms

Records show a handful of residents at The Citadel at Salisbury and North Carolina State Veterans Home died in the midst of COVID-19 outbreaks without symptoms.

ROWAN COUNTY, N.C. — Some of the people who died amid COVID-19 outbreaks at Rowan County nursing homes showed no symptoms, including two at The Citadel at Salisbury and two at the North Carolina State Veterans Home, according to public records.

"I think that's part of the challenge. We don't have any precursors to know that something's wrong with them," Rowan County spokesperson TJ Brown said. "The virus kind of shows up (with) sudden symptoms and it doesn't take long, unfortunately, in some cases."

The Citadel remains home to the largest congregate living facility outbreak in North Carolina. As of Friday afternoon, state records show 44 employees and 113 residents have tested positive. To date, 18 Citadel residents have passed away.

Brown said the majority of residents "continue to improve." However, county records show some battled the virus since March, while the virus snuck up quietly on other residents who never had a fighting chance. Among the two at The Citadel that didn't show symptoms, both had underlying health conditions and were in advanced stages of life, including one in hospice care, according to records.

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"This just kind of came at a bad time when these people were already close," Brown said.

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Rowan County records indicate a resident first showed symptoms, a low grade fever, on March 25, which came two days after Gov. Roy Cooper announced mandatory statewide visitor restrictions. That resident, with underlying health conditions, died on April 17, according to records. The resident's passing marked a stretch of at least one death a day for six days straight in mid-April, according to records. Three of the people who died during that stretch included a resident who died the same day as the onset of symptoms, another who died a day after first showing symptoms and a another who died two days after first showing symptoms.

In addition, the audit shows two other residents with no underlying health conditions tested positive and died at the hospital.

"It was toward the end (of the) first week of April when our first case was identified; by the next day we moved into full PPE, called all family members whose contact information we had, talked with residents and staff and worked out a plan with the Health Department to test everyone," Accordius Health spokesperson Kim Morrow previously told us. "The results were devastating; the numbers were high. I promise you that our entire team has not stopped working 24/7 on the monitoring and caring for all of our residents. The heroic work of our direct caregivers and the love they have for each and every resident at this center leaves me speechless. We are all heartbroken over the impact this virus has had on our residents and the emotional toll it is having on their family members."

Brown said both health officials and The Citadel management have unsuccessfully tried to find the original source of the outbreak.

"That's not something that we've been able to really hone in on," Rowan County spokesperson Brown said. "Together we weren't able to make a real positive ID. I think there were some guesses as to well, maybe it was this and maybe it was that, but I think it's really hard to tell and I don't think we ever will be able to figure out exactly where that first case was at that got brought in."

A North Carolina States Veterans Home audit shows an 89-year-old veteran without symptoms died on April 15, while a 79-year-old veteran without symptoms died on April 19. Both tested positive for COVID-19 on April 11, according to records. To date, the state reports nine staff members and 34 residents have tested positive, with seven of those residents passing away.