VANCOUVER, Wash. (AP) — A long-term care facility in southwest Washington has recorded 40 COVID-19 cases.

The outbreak at Avamere Rehabilitation of Cascade Park in east Vancouver is Clark County’s largest at a long-term care facility since the county’s first COVID-19 case was discovered in March, The Columbian reported.

Clark County Public Health confirmed the outbreak Thursday afternoon. A COVID-19 dashboard on Avamere’s website said 18 residents and 22 staff at the skilled-nursing facility had tested positive for the virus as of Thursday afternoon. So far, no deaths have been linked to the outbreak.

Avamere did not respond to a request for comment from the newspaper.

In late April, Highgate Senior Living in Hazel Dell, Washington, recorded the county’s largest care facility outbreak at that time. There were 26 confirmed cases and seven deaths linked to Highgate.

Clark County Public Health Officer Dr. Alan Melnick said Public Health and the state Department of Health are working with the facility, and that the first case was identified in July. Testing has been conducted for residents and staff, Melnick said.

“Long-term care facilities are not on an island. They are part of the community,” Melnick said. “When you have more activity in the community, you are going to see more activity in long-term care facilities. I’m urging and begging people of any age to physically distance and wear masks.”

Washington state reported 800 additional COVID-19 cases on Friday and 19 more deaths. The state has had more than 66,100 confirmed cases since the start of the pandemic and at least 1,755 deaths.