Forty-two residents of a Virginia nursing home near Richmond have died from the Covid-19 disease pandemic in one of the worst clusters of the new coronavirus in the US, and officials expect more deaths to come.

At least 127 elderly people out of the 163 residents of the Canterbury Rehabilitation & Healthcare Center in Henrico county have tested positive for the new coronavirus in recent weeks, said its medical director Dr James Wright. News reports say the latest two people died in the last three days.

“It’s been tough,” Wright, 56, said in an interview with Reuters. “We were surprised by how quickly this went through,” he said.

Wright told media at a recent news conference: “It’s a battle that at times we feel like we're losing. It’s a battle that we have to fight every day and night, seven days a week.”

At least 35 members of Canterbury's staff have tested positive for the coronavirus as of Monday, but Wright said he did not know how many have fallen ill. But he said the virus has exacerbated an existing staffing shortage, with some staffers refusing to come to work for fear of getting ill.

“We did the best we could,” he said.

The situation was made even worse by a severe shortage of personal protective equipment such as medical masks and gowns, he said.

“We were prepared as we could be,” he said, “What this virus tends to do is find a susceptible population and spread rapidly without being detected.”

Of the 97 known coronavirus outbreaks in Virginia, 53 are in long-term care facilities such as Canterbury, state health officials said during a press briefing Monday with Virginia governor Ralph Northam.

Nationally, more than 23,000 people have died from Covid-19 disease and more than 577,000 US residents have tested positive. One thing Wright blamed was the underfunding of publicly supported nursing homes, which tend to have few private rooms, chronic staff shortages and residents in living in tighter quarters.