The Shelby County Health Department began its investigation over the weekend at Carriage Court, 1645 W. Massey, after a second case of COVID-19 was identified, a red flag the virus could be spreading.

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Its strike team tested 22 people with likely contact, including residents and staff. It also reinforced infection-control procedures and further limited movement of people inside.

In cases involving assisted-living or nursing homes, like the outbreak at Carriage Court, the Centers for Disease Control says all residents who have tested positive should be moved to an isolated area, said health department director Alisa Haushalter.

On Tuesday, she said Carriage Court had not been allowing visitors for several weeks and was strictly complying with protocol and testing.

 Wanda Wages is the health and wellness director at Carriage Court. She did not return a phone call.

The health department released the name of the facility and test results on Wednesday because Carriage Court refused to.

“So, I made a decision with input from the mayor and others that it was in the best interest of the public to to release that information,” Haushalter told reporters Wednesday afternoon.

The health department, she said, tried throughout the day Tuesday “to encourage them (Carriage Court) to be transparent and release that information.”

Carriage Court did begin notifying families, employees and residents, starting on Tuesday.

But there was no public notification earlier, even though the facility serves a fragile population, because with only one case, it would be hard to show transmission was happening, Haushalter said.

“It may be linked to a family member coming to visit. So, there’s no indication that it’s an outbreak. It’s an indication that there is a case.”

In the best-case scenario, Haushalter said notifications would happen in 24-48 hours after the second case was identified.

On Sunday, Gov. Bill Lee’s COVID-19 Unified Command took action to deal with an outbreak affecting dozens of patients and staff at the Gallatin Center for Rehabilitation and Healing in Middle Tennessee.

Nearly 60 residents and more than 30 staff tested positive.

“Unified Command has worked in partnership with the Gallatin Center for Rehabilitation and Healing and local partners in testing residents, transporting the sick and further evaluating those at risk,” said Unified Command Director Stuart McWhorter. “This situation has escalated quickly and we urge nursing homes and assisted care facilities to reach out to us as soon as cases are identified within their populations.”

Assisted-living facilities and nursing homes in Shelby County have been on high alert for weeks, instituting new protocols, including bans on visitors.

“It’s unsettling to think about an outbreak in these facilities,” said Julia Allen, a resident at Trezevant on Highland Avenue. “I’m sure the families of the people there are wanting to bring them home. It certainly makes every home more anxious to do the right thing, but it’s almost impossible to build a shield around everyone,” she said, noting that a handful at Trezevant are still meeting for bridge games around small tables.

Trezevant is taking the temperature of staff, couriers and others who have business there.

“We have our meals served in our rooms now,” Allen said. “No outsiders are allowed to come in. When my daughter-in-law brings groceries, she has to leave them in the entry area.”