Georgia has a new COVID-19 hot spot: Hancock County, 100 miles or more from the outbreaks at Albany and Gainesville.

With just 8,500 people, Hancock has 170 reported cases of COVID-19, the fourth highest number per capita in the state, higher than any county outside the Albany region. On Tuesday a Hancock nursing home reported 14 deaths to the state Department of Public Health, making the county’s total of coronavirus-related deaths at least 18.

Hancock is a microcosm of where the disease hunts: The county is lower-income and overwhelmingly African-American; it contains two nursing homes with poor ratings, and one prison. Health officials have confirmed the virus also has a solid foothold in the community outside those facilities, with a third of the cases and at least three deaths.

“It’s a matter of life and death is what it is,” said Robert Ingram, a Hancock County retiree who knows several of the 14 people who died in the Sparta Health and Rehabilitation nursing home. His own aunt, 95, caught COVID-19 there but survived, he said. Those who died were “regular, decent good people,” including a neighbor who lived next door to his parents.

» COMPLETE COVERAGE: Coronavirus in Georgia

That nursing home has reported 52 infections of patients and 20 of employees. The other nursing home in the county, Providence of Sparta Health and Rehabilitation, reported 38 infected patients, 11 infected staff, and one death. Both homes have troubled inspection histories. The Providence home has a federal rating of one star, or much below average. Sparta Health is rated two stars, or below average.

Ingram pointed to the closure of the Hancock County Hospital in 2001 and residents’ patchy access to doctors ever since as other signs of the county’s vulnerability in a pandemic.

“I think it’s more than serious at this point,” he said. “We’re dealing with something that even the country’s not prepared to handle. And if the country’s not prepared to handle it, then how are we going to handle it in Hancock County?”

A spokesman for the state Department of Public Health, which is leading Georgia’s response to the pandemic, acknowledged that Hancock County faces risk factors associated with harsher COVID-19 outcomes: It’s a rural area, over 70% African American, and with an average household income well below the state average.

Ingram and health officials also complain that many residents are not taking social distancing seriously, holding parties and spurning masks.

“It’s obviously a — not exactly ideal situation out there,” said Michael Hokanson, with DPH’s North Central District, which covers 13 counties including Hancock. “This illness is still something that’s severely impacting our community.”

What’s more, some health care facilities with a legal duty to report cases to DPH aren’t returning the department’s calls. The district’s two epidemiologists tracking disease, planning response, fielding community inquiries and supervising contact tracing over 13 counties are instead left to learn of some cases on the news. The district hired two part-time epidemiologists to help. They started Monday.

» RELATED: Infection control lapses, short staffing put senior care homes at risk

» MORE: State actions seen as too little, too late to spare senior care residents

Sparta Health at first did not report its 14 deaths to DPH as required by law, but did report them as required to another state agency, the Department of Community Health, which holds its license. District DPH officials said they don’t have access to the other state agency’s database and learned of the 14 deaths by watching local TV news on Monday night.

“That was a surprise, to say the least,” Hokanson said. “It’s something that we’ve struggled with, getting the most accurate information from facilities.”

Following a call from a reporter Tuesday afternoon about the deaths, Sparta Health sent an e-mail to DPH confirming the deaths.

DPH also has a data discrepancy with the Department of Corrections, Hokanson said. Corrections reported a total of two infections at the Hancock prison on its website. But the prison’s warden told Hokanson’s office there were seven.

“So it’s one of those things where we don’t know where the error is, because we spoke with the warden,” he said.

There are discrepancies in general community results, too. A profusion of organizations have stepped up to help offer testing, and if they are small or temporary, they don’t always get the laboratories that they partner with to report positive results to DPH after reporting them to the patients, he said.

“That should be the case. But that’s not always the case,” he said.

DPH is glad to have more testing available, he said, but sometimes the agency doesn’t even know a church or community organization has offered testing until after it’s over and they see it on the news.

A spokeswoman for the nonprofit organization that runs Sparta Health, Ethica, confirmed the 14 dead and said in an email to the AJC that it was following CDC guidance for infection control. Providence Health and Rehabilitation did not return a call from the AJC.

Ingram said when he visited his aunt at Sparta Health, it looked well kept. The staff always looked busy, he said.

The facility is currently seeking to hire 11 workers, including someone to coordinate the care of residents, an assistant director of nursing, a nurse supervisor, a charge nurse, a social services coordinator, and someone to coordinate admissions.

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