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CHARLESTON — West Virginia was the last U.S. state to report a positive coronavirus case. Nine months later, the pandemic has taken a heavy toll.

The virus has contributed to more than 1,200 deaths in the rural state, left thousands of people jobless after businesses shut down and wreaked havoc on an education system forced into remote learning.

The virus dominated daily headlines and was the runaway choice as West Virginia’s No. 1 news story in 2020 in a vote of Associated Press member newspapers and broadcasters.

“The pandemic affected everyone across the entire state for months,” said Kennie Bass, a reporter with WCHS-TV and WVAH-TV. “It was a daily topic of conversation, and it may fundamentally change the way we live and interact with others, go out to eat, go to the movies and attend sporting events.”

A nursing assistant’s guilty plea to intentionally killing seven patients with fatal doses of insulin at a Clarksburg veterans hospital came in second in the voting. The firing of the state’s health officer during the pandemic response was selected as the No. 3 story statewide.

The virus has hit the elderly especially hard, with the overwhelming majority of state deaths occurring among people over age 65. Gov. Jim Justice has issued a mask mandate, closed nursing homes and then opened them back up again. The accuracy of a color-coded county virus map has been the subject of debate and speculation for months.

Deaths, hospitalizations and positive cases keep piling up in record numbers. Despite that, Justice has refused to further restrict public life and shut down businesses.

“It will likely be the big story of 2021 as well,” said Mark Curtis, a reporter with WOWK-TV and Nexstar Media.

In 2019, the suspicious deaths and a federal investigation at the Clarksburg VA hospital was voted the state’s top news story.

This past July, nursing assistant Reta Mays admitted to administering fatal doses of insulin that killed seven veterans. Tentative settlements were later reached in civil lawsuits filed on behalf of the veterans’ families. Mays is scheduled to be sentenced in February.

“The VA deaths are hauntingly tragic in that the victims died because of a nurse assistant’s sick ego,” said Eric Cravey, editor of the Times West Virginian of Fairmont.

In June, Justice forced out Dr. Cathy Slemp, the state’s public health leader, after complaining about discrepancies in the number of active cases and accusing Slemp of not doing her job.

Slemp said decades-old computer systems and cuts to staff over a period of years had made a challenging job even harder during the pandemic.

The pandemic also was responsible for another of the state’s top stories. In March, Justice ordered the state high school basketball tournament to stop. The state high school football championships in December were canceled, too, and a governing body picked the state football champions.

That story tied for fifth, along with a story about Justice’s family businesses receiving at least $11.1 million from a federal rescue package meant to keep small businesses afloat during the coronavirus pandemic.

Coming in fourth was a story about ex-Roman Catholic Bishop Michael Bransfield issuing an apology two years after resigning amid allegations of sexual and financial misconduct. The Diocese of Wheeling-Charleston said Bransfield repaid $441,000 in expenditures that were called into question, far less than the amount sought. An audit released in February shows the net assets of the diocese dropped by $4.8 million during the fiscal year that coincided with Bransfield’s resignation.