JOHNSTON, Iowa (AP) — Iowa reported 143 nursing homes with coronavirus outbreaks, and thousands of residents have tested positive for the virus. The state Department of Public Health says more than 4,500 residents of care center are infected with the virus. State data shows 1,008 residents of long-term care facilities have died with COVID-19 in the past eight months. The deteriorating situation for nursing homes is reflective of overall virus trends in Iowa, which on Tuesday reported 18 additional deaths.

More than 500 people with COVID-19 have died in Iowa so far this month and 2,224 overall. In the past 24 hours as of Tuesday morning, there were 3,860 additional confirmed cases.