Driven in large part by an outbreak at a South Boston nursing home, Halifax County added a record number of COVID-19 cases and deaths in November.

The caseload tally increased by 266, the largest count so far in the pandemic that’s now entering the ninth month and shows no signs of slowing.

Deaths nearly doubled from nine to 17 in November, according to the Virginia Department of Health. While a federal report notes 10 residents of South Boston Health and Rehabilitation have died of an outbreak there, it’s not clear if those deaths are reflected in the state’s total.

The federal data comes from the Centers for Disease Control and Prevention and is received on a weekly basis from nursing homes. While there’s a lag in updating to the public — for instance, the latest report available is for the week ending Nov. 15 — it offers far more details than available on the state level.

A state website — known as the Virginia Long-Term Care Task Force — is updated weekly on Mondays and only shows total cases and deaths. However, if there are fewer than five, the task force shields the exact number from public view citing patient anonymity.

At South Boston Health and Rehabilitation — previously known as Woodview before a change in ownership — 131 residents had tested positive for COVID-19 by the week ending Nov. 15. A total of 10 have died.

A total of 59 employees also have tested positive for the illness caused by the coronavirus, making the total number of cases reported by Nov. 15 to be 190. However, those figures date back to late May when nursing homes were required to submit weekly reports to the CDC.

Berry Hill Health and Rehab Center also is experiencing an outbreak in cases. Two residents have tested positive, along with two staff members since the outbreak was reported on Nov. 4, according to federal data. However, the state puts the total number of cases there at eight.

Official tally

As of Tuesday, the death toll in the county increased by one, the health department reported in a daily dashboard update.

Very little is publicly known about a person when they die of COVID-19. Only basic demographic data is available online. That info is particularly difficult to determine since Halifax is part of the Southside Health District that also includes Mecklenburg and Brunswick counties. If there’s a death in more than one county on a given day, it’s not possible to know the demographics.

However, Halifax was the only locality in the district to report a fatality Tuesday. Basic details indicate the latest death was a woman in her 80s. Deaths, along with cases, are recorded in an individual’s official place of residence.

When the health department lists a new death, it’s never clear when it actually occurred. Officials must wait for a death certificate to arrive before entering the information in an online database. Sometimes that process can take weeks.

That’s why the federal data shows more local nursing home deaths. Those figures come directly from the facility as they are reported, while the Virginia Department of Health waits for the official death certificate.

By the numbers

On Tuesday, the state had an 8% positivity rate, the highest since August. That figure — a calculation of positive results against the overall number of tests administered — has been climbing as the overall caseload in the state soars.

For the Southside Health District, that rate is at 6.9%, but the number of tests administered is on the decline. At the end of November, there were about 150 tests given a day in Halifax, Mecklenburg and Brunswick counties. That’s down from about 266 in October.

Simply put, fewer Southside residents are being tested for the illness.

After a spike in cases from nursing homes, the average daily caseload has dropped to about five in Halifax County from about 15 in mid-November.

Virginia is adding more than 2,000 cases a day.

Nationally

Already at record highs, health experts are worried Thanksgiving travel may lead to an even larger surge of virus cases across the nation.

According to the CDC, the United States is adding about 160,000 cases a day. To put that in comparison, a surge of the summer brought about 67,000 new daily cases.

Deaths are also accelerating across the country with about 1,400 new fatalities recorded each day, according to the CDC.