KANSAS CITY, Kan. (AP) — A coronavirus outbreak that has killed four and sickened 33 others at a Kansas City, Kansas, rehabilitation facility has the potential to grow with another 27 tests pending.

Wyandotte County’s chief medical officer, Dr. Allen Greiner, blamed the surge of cases at the Riverbend Post Acute Rehabilitation on “a confluence of bad circumstances,” including a lag in testing results, KCUR reports. Greiner, a professor and vice chair of family medicine at the University of Kansas Medical Center, also said Tuesday that the close interactions required at a rehab facility helped fuel the spread.

Ashley Jones-Wisner, a Kansas Department of Health and Environment spokeswoman, said the outbreak was identified last week. Greiner said it appears it was caused by a staff member three weeks ago, although he stressed that officials are “not 100%” certain.

If more cases are identified, it could surpass the Life Care Center of Burlington, where 41 residents and one staff member have tested positive, as the site of the state's largest outbreak. One resident at that facility has died.

Most infected people develop mild or moderate symptoms that clear up within three weeks, such as fever and cough. But older adults and people with existing health problems are particularly susceptible to more severe illness, including pneumonia.

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