Five people have died from COVID-19, and 94 others have tested positive for the novel coronavirus in an outbreak among residents and staff members of Josephine Caring Community in Stanwood, health officials said Tuesday.

The 99 total cases — split about evenly between residents of the long-term care facility and staff — is an increase from 94 reported over the weekend. Seven people have been hospitalized, including the five who died, Dr. Chris Spitters, Snohomish County’s health officer, said in a Tuesday briefing.

The cause, according to Spitters, is widespread coronavirus activity in Snohomish County, where infections are rising and putting increasing stress on emergency medical services and hospitals. Health officials believe a staff member or visitor who was ill came into the building, despite the facility’s limits on visits and activities.

“It’s very difficult, we’re seeing this with many long-term care facilities, that even with good infection-control precautions, it’s hard to interrupt the spread of this virus in close congregate settings like long-term care facilities,” Spitters said.

On Sunday, Josephine Caring Community posted on its website that most residents showed mild or no symptoms, and very few were significantly ill. The facility said it worked to test every resident and member each week since cases started increasing in the community in late October. The first positive case at the facility was reported Oct. 26.

Most of the residents and staff who tested positive are in Josephine’s nursing home, but two residents and one staff member in its assisted-living units tested positive as of Sunday, the facility posted. No one in Josephine’s home-health care has symptoms or has tested positive.

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This is the second significant outbreak at the facility, and the largest outbreak connected to a long-term care facility in Snohomish County.

Throughout the county, providers and hospitals are seeing increases in 911 calls for emergency medical services related to COVID-19 cases, positivity rates in tests and hospitalizations. The Community Health Center of Snohomish County clinics have seen a dramatic surge, particularly at its Everett walk-in site, said Chief Medical Officer Dr. Tom Tocher. The organization’s clinics usually conduct about 200 tests per week, with a 4% positivity rate, but in the past week, the organization has conducted 500 tests with an 8% rate.

In Snohomish County hospitals as of Tuesday, 52 patients have confirmed cases of COVID-19 and three others have suspected cases, Spitters said. Ten people are on ventilators in intensive care units. Over the last two weeks, the number of hospitalizations has more than doubled, Spitters said.

“If we don’t turn this around beginning immediately, then that 50 will become 100, and then that’s definitely where the hospital system is going to be in big trouble, and that means we’re all in big trouble, too,” he said. “This is real and it’s happening before our very eyes, and it’s preventable.”