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Pike County has lost more than 20 residents to COVID-19.

The county reached 21 confirmed COVID deaths with the Thursday morning update from the Alabama Department of Public Health, a nearly 24 percent increase in more than a week.

Pike County also added 13 additional cases of the virus, bringing the 14-day positive rate to 31.87 percent.

“We’ve said all along that this has to become very, very real to people before they’ll take It seriously,” said Rick Smith, CEO of Troy Regional Medical Center. “With the number of unfortunate deaths in rapid succession, I hope people will take note that this happens in Troy and Pike County, Alabama, just like it does in big cities.”

Alabama added 4,695 new cases on Thursday, for a total of more than 310,330 cases and 4,254 confirmed deaths. More than 2,310 Alabama residents are hospitalized due to the virus and the state’s 14-day positive rate is 36.23 percent.

The increasing spread of the virus is putting a strain on medical resources throughout the state. The University of Alabama at Birmingham said Wednesday it will bring in more than 120 nursing students to help fill the gaps at the hospital. In Dothan, Southeast Alabama Medical Center announced it was suspending elective surgeries due to the demands of treating COVID patients.

At TRMC, Smith said the hospital continues to adjust to try and stay ahead of the increasing spread. “We just added three more negative pressure rooms,” he said on Wednesday. “We’ve gone from three rooms when the pandemic started to 14 now.”

Vaccine distribution began this week at 15 hospitals across the state, and private pharmacies are expected to begin providing vaccines to nursing home patients within the next two weeks.

The initial rounds of vaccines are earmarked for front line healthcare workers and first responders, the elderly in nursing homes and other designated groups. The general public could see available vaccines in summer 2021.