A Temple woman in her 80s was the first COVID-19-related death in Bell County, local officials said Thursday.

The Bell County Public Health District also reported it identified one new infection Thursday. Bell County has at least 20 infections, including the woman who died. So far, 18 Texans have died from the new coronavirus, according to The Texas Tribune.

The newest local infection was a Killeen woman in her 50s. It is unknown how she contracted the disease. The Bell County Public Health District recently has not been disclosing how residents have contracted the virus.

Local health officials, though, have confirmed there is community spread in Bell County.

Temple continues to be the Bell County city most affected by the coronavirus. At least 14 Temple residents have tested positive for the virus.

They include two women in their 20s; three women in their 30s; one woman in her 40s; two women and a man in their 50s; three men and one woman in their 60s; and a woman in her 80s.

Killeen has at least three known infections — a man and woman in their 40s and a woman in her 50s. Belton has at least one COVID-19 case, a man in his 20s.

Rural Bell County has at least two reported cases, a man in his 30s and a man in his 70s. The health district is categorizing small towns, such as Troy and Holland, as Bell County cases.

The state reported Thursday that there are 1,396 cases of COVID-19. The Texas Department of State Health Services reported that 21,424 people have been tested.

The health district plans to change how it reports coronavirus cases to the public once the county has more than 30 cases.

“If we reach a total of 30 cases in Bell County we will change the reporting structure to include only the number of cases, deaths and recoveries (recoveries include individuals who were confirmed and released after full resolution of symptoms),” the governmental entity states on its website.

Larger counties — including nearby Williamson County, where there are at least 27 cases — have continued to issue detailed reports on their coronavirus cases that includes age groups, gender, city of residence, hospitalizations — including how many people who are in intensive care — deaths and the number of people who have recovered.

None of Bell County’s recent coronavirus cases are people who caught the virus while working at a health care facility, Health District Director Amanda Robinson-Chadwell said.

If that does occur, she said the health district will work directly with the facility — a point Robinson-Chadwell made during a recent news conference regarding other public buildings, such as grocery stores.

In fact, the health district has done that at least twice when residents of two undisclosed assisted care facilities tested positive for COVID-19.

“If the individual is associated with a health care facility we coordinate with the facility directly to make notifications, which is part of the contact tracing protocol,” Robinson-Chadwell said. “We will coordinate with the facility to make public notifications only if significant potential for public contact with that facility is at issue. So far, any facilities with any positive cases have had a limited number of individuals involved and all have been notified, isolated and placed under monitoring as required.”

Other entities, including the Texas Department of Public Safety and local restaurant Bird Creek Burger Co., told the public about employees who tested positive for the virus.

Coryell County’s first reported COVID-19 case has a Belton connection, Coryell County officials said Wednesday. The nearby county’s newest infection was a 55-year-old Copperas Cove woman who works for a long-term health care facility in Belton. She was tested at Baylor Scott & White Medical Center-Temple, and she is currently in self isolation at her home, according to Coryell County.

“I encourage our citizens to stay within the confines of Coryell County as much as possible,” Coryell County Judge Roger Miller said in a statement. “If you must travel outside the county, I strongly discourage travel to Bell, Bexar, Brazoria, Collin, Dallas, Denton, Fort Bend, Galveston, Harris, McLennan, Tarrant, Travis and Williamson counties. These counties have the highest numbers of confirmed cases of COVID-19, and many of them have shelter-in-place orders.”

McLennan County has at least 33 cases while Milam County has at least two, according to the Texas Department of State Health Services. Falls and Burnet counties have at least one infection, according to the state agency.