INDIANAPOLIS — Indiana’s first coronavirus infections occurred at least a couple weeks before the first illness was confirmed in early March, the state health commissioner said Wednesday.

That would indicate the virus could have been spreading around Indiana for perhaps six weeks before the statewide stay-at-home order took effect March 25.

“We tracked cases that we thought probably went back to at least mid-February,” said the health commissioner, Dr. Kristina Box.

Indiana’s coronavirus death toll reached 661 as the state health department added 31 newly reported deaths on Wednesday. That total will jump up later this week as the official count starts including deaths that doctors blame on COVID-19 without confirmation of the illness from test results.

In Elkhart County, the number of cases rose by six to 185, the state reported Wednesday.

The earlier Indiana infections are in line with the determination of two coronavirus deaths in California in early and mid-February, showing that the virus was spreading in the U.S. well before health officials realized it.

Box said Indiana’s number of presumptive deaths will add less than 100 fatalities to the state total. She said some respiratory illnesses before the state’s first confirmed COVID-19 infection on March 6 were undoubtedly from the coronavirus.

“There will be individuals that never hit the hospital system that may very well have had COVID-19 and they won’t know that until we have that good antibody test out there to show that they are immune,” Box said.

The Indiana State Department of Health said 394 more residents have been diagnosed with coronavirus infection, bringing the state’s total to nearly 12,500. But the agency said Wednesday’s new test results were lower than expected because of a technology issue and shouldn’t be regarded as a decline in new infections.

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