In her daily press briefing on Monday, Iowa Gov. Kim Reynolds confirmed an outbreak of the novel coronavirus in a Cedar Rapids long-term care facility.

Twenty-one of Linn County’s 71 COVID-19 cases are directly related to the outbreak, a designation Reynolds said is characterized by three or more members testing positive for the virus.

The total number of Linn County residents who’ve tested positive for COVID-19 surpassed Johnson County’s on Monday, the first time a county other than Johnson has led in case count. Linn County has 71, Johnson County has 70, and Polk County has 61, according to numbers updated Monday from the Iowa Department of Public Health.

Heritage Specialty Care in Cedar Rapids released a statement March 26 notifying the public that four of its residents had tested positive for the coronavirus after two of its staffers tested positive.

The facility began screening residents screened two times daily for fever and respiratory illness the release said, and for the previous two weeks employees had been screened for fever and respiratory illness upon entering the building with no visitors allowed. The center discontinued communal dining and activities last week.

Reynolds said early in the state’s preparation for potential COVID-19 outbreaks, she instructed long-term care facilities to screen staffers at the beginning of their shift, including a temperature check, to mitigate the risk of exposing residents to the virus. Now, she said she’s ordered that screening procedure for workers at all public health care facilities in Iowa.

As testing ramps up in the state, 88 additional Iowans tested positive for COVID-19 Monday, the largest single-day spike in cases. Before, Iowa’s biggest case spike was March 27 and Sunday, a signal, according to Reynolds, that the state is able to conduct more testing.

She added that the state is waiting on at least 15 recently FDA-approved testing machines that would conduct tests more quickly.