REPUBLIC, Wash. (AP) — About 10% of the population of Republic, a small city in north-central Washington, has tested positive for COVID-19 in an outbreak traced to large indoor events last month at the local Fraternal Order of Eagles hall.

Ferry County Memorial Hospital officials have confirmed more than 100 cases, with one reported death, since the April 9-11 events, including a membership drive that featured dinner, live music and a 1980s-themed karaoke night. Some patients have had to be transferred to Wenatchee and Yakima because of a lack of capacity at the 25-bed hospital — the only hospital in a 50-mile radius — and other closer facilities.

“In Ferry County especially, we’re seeing really sick young people showing up in the emergency room to get care,” Northeast Tri County Health Officer Dr. Sam Artzis said, according to The Spokesman-Review.

The county previously had relatively few COVID-19 cases, and many in the conservative, rural community saw mask mandates as infringing on their liberty. Less than one-quarter of the county's residents have received a vaccine to date, according to the health district, but officials said the outbreak has increased interest in it.

The situation should serve as a warning to other communities about the danger of large indoor events with unvaccinated people, they said.

“We are deeply concerned about the rapid growth in disease in Ferry Co. & the strain this has put on their local healthcare system,” the Washington Department of Health tweeted Friday.

Health officials moved Ferry County back to Phase 2 of the governor’s reopening plan on Friday. The state Health Department said it was providing “any supplies, staff, or other supports needed to help with vaccination and outbreak response in the community.”

Ferry County Hospital has sent some positive COVID-19 samples to the state to see if they match virus variants.

Officials said patients showing up to the emergency room recently have more severe symptoms than those earlier in the pandemic, including a pattern of nausea, vomiting and pneumonia. Many young people, including some in their 20s, have displayed shortness of breath and viral pneumonia.

Darcy Dougherty, head trustee of the ladies’ auxiliary for the Eagles, called the outbreak the “perfect storm.” She said teams will deliver meals to community members again starting next week, as they have been throughout the pandemic, and they are planning to host a drive-through vaccination clinic.

Dougherty, who already is vaccinated, said the Eagles have “taken a lot of heat” for their events.

“It’s sad, but we’ll get beyond it, and we’ll hope for the best with everybody that got really sick,” she added.