Missouri reported more than 5,000 new COVID-19 cases on Saturday to more than double the previous single-day record.

ST. LOUIS (AP) — Missouri reported more than 5,000 new COVID-19 cases on Saturday to more than double the previous single-day record.

The Missouri Department of Health and Senior Services said there have been a total of 144,230 confirmed cases since the outbreak started, up 5,066 cases from Friday. The previous single day high of 2,084 new cases was set on July 30, KMOV reports. 

Health department spokeswoman Lisa Cox didn't immediately respond to an email from The Associated Press seeking an explanation for the large increase. It was reported on the same day that the number of deaths increased by 27 to bring the total to 2,422.

Data from the state also shows that 1,313 people were hospitalized as of Friday, the second-most for any single day. The rise in hospitalizations is occurring largely in Missouri's rural communities.

"People aren't following the rules," Jayne Dees, administrator of the health department in New Madrid County in the Bootheel region of southeast Missouri, told the St. Louis Post-Dispatch.  "They're not social distancing. They're not wearing masks. They're gathering."

Dr. Nathan Sprengel, a doctor at the SEMO Health Network clinic in New Madrid, said some patients get upset when they are urged to wear masks in the clinic.

"That tells me they're probably not wearing one when they're out in public," he said.

Meanwhile, an outbreak at the jail in St. Louis County has grown to include 20 inmates and one employee, officials announced Friday night. Mass testing is underway as the facility seeks to control the spread of the virus.