SALISBURY — With dozens of inmates testing positive, the Rowan County Jail is in the midst of its largest COVID-19 outbreak.

Sheriff Kevin Auten said there are about 49 cases at the jail and that there’s no way to determine if the outbreak started with inmates or staff. Positive tests started three weeks ago and most of the cases are inmates — 13 of which have been admitted to the jail in the previous two weeks.

No positive inmates have required hospitalization, he said.

Auten said housing units within the facility have been quarantined and inmate court cases will be handled remotely when possible. Masks are mandatory for workers in the jail. Inmates have been offered COVID-19 vaccinations, but Auten said a small portion accepted the shot. Previously during the pandemic, controlling the size of jail outbreaks meant citing and releasing people charged with crimes instead of booking them into jail, but whether that occurs now depends on the seriousness of the crime, Auten said.

“There are a lot of moving parts in trying to slow COVID down,” Auten said.

The only nearby jail with an outbreak is Davidson County, where 31 inmates have tested positive.

Another large outbreak at the Rowan County Detention Center occurred in April, when 12 staff members and 27 inmates tested positive for COVID-19.

Elsewhere in Rowan County, the number and size of COVID-19 outbreaks are growing, too.

At Compass Healthcare and Rehab, a nursing home in Spencer, state data show 22 cases among residents, three among staff and one resident death, but facility administrator Georgie Moore said 93% of her residents are vaccinated and most of the cases are asymptomatic. It’s an odd situation, particularly because the nursing home was COVID-free for 16 months.

“I feel prepared but caught off guard,” Moore said.

Moore, who said she’s fighting a “COVID war,” said aggressive testing practices are one reason the facility found asymptomatic people who otherwise wouldn’t be tested. The test positivity rate across Rowan County was 16.8% on Wednesday, which means in-facility testing is required twice per week. Staff also are tested for COVID-19 at the door, which produced multiple positive tests, Moore said. She said staff are 47% vaccinated.

Moore said the general public should return to practicing the three Ws as cases continue rising in North Carolina: washing hands regularly, waiting 6 feet apart and wearing a mask.

Other active congregate living outbreaks in Rowan County include:

• Big Elm nursing home in Kannapolis, where there’s been one staff case and one resident who died.

• Accordius Health at Salisbury, a nursing home on Statesville Boulevard, where there are three staff cases.

• Compass Assisted Living Rowan, where there have been two staff cases.

• The N.C. State Veterans Home on the campus of the Salisbury VA, where there’s been two staff cases.

• An unspecified congregate living setting on North Long Street in Salisbury where two resident cases have been identified. State data list the location in the “other” category — meaning it’s not a nursing home, residential care facility or jail.

In the previous two weeks, Rowan County has seen 944 new COVID-19 positives, including 73 on Wednesday. There have been 322 deaths in the county since the start of the pandemic, a number that was unchanged on Wednesday. Hospitalizations in Rowan County’s region — 18 counties named the Triad Health Care Preparedness Coalition — were at 478 on Wednesday, which was an increase of 449 from the day prior.