In a previous blog post I made the case that the bulk of Covid-19 cases and deaths in Chester County were the consequence of just a few “hotspots” where the infection got out of control. That post was based on data that the PA Department of Health published on May 22. That was the first time that individual data for each of Pennsylvania’s “long-term care facilities” was released to the public.

A new listing was published on June 2. It included 18 more facilities than the previous listing, for a total of 586 facilities. Of these, 42 were in Chester County. (Crosslands, which was omitted from the previous listing, was one of the new ones. Kendal appeared in both lists.)

Successful turnaround at the hotspots. I was interested in taking a close look at the new data to see how the sites of previous outbreaks had done between the two reports on May 22 and June 2. I’m glad to say the news is good. As I reported previously, just three Chester County facilities accounted for more than half of the Covid-19 deaths reported as of May 22. As of June 2, none of the three had any additional deaths, and there were only two new Covid cases among them. Clearly, the situation in those facilities has been brought under control. Their medical staffs deserve congratulations for turning around a situation which must have been a nightmare for them as well as those in their care.

In Chester County as a whole, there have been only five more deaths in extended-care settings since the May 22 report. (The county reported 21 Covid deaths during that period, which presumably included the five in extended care.) Thanks to aggressive action by the state, the county health department, and the medical teams at each location, it appears that our county is currently free of extended-care hotspots.

New hotspots emerging? Outside of Chester County, however, there are signs of new hotspots. For the state as a whole, there were 135 deaths in extended-care settings between May 22 and June 2. Of these, 50 deaths were in just 7 facilities. The 7 were scattered, but most of them were in eastern Pennsylvania. At least one of them, in Lehigh County, seems to be experiencing a serious outbreak. In the period from May 22 to June 2, it reported a dramatic increase in cases (from 153 to 173) and deaths (from 20 to 29). Several others facilities reported less severe, but still ominous, increases.

Nevertheless, the situation seems to be under control at the vast majority of Pennsylvania extended-care facilities.

The “reopening” challenge. Now, the challenge will be to protect the public at large as the state gradually reopens for business. The governor has announced that, as of today (June 5) the final 10 counties will move to “Yellow” status (from the severe restrictions of “Red”). This is concerning because it is happening at a time when Chester County in particular is experiencing a rate of Covid-19 cases that is holding steady and shows signs of rising. It is more than double the governor’s target rate of “50 new cases per 100,000 people during a two-week period”.

And more concerning still: the steady overall rate for our county hides two distinct trends. A few weeks ago, I noted that the vast majority of our cases (88%) were in extended care facilities. There has been a welcome drop in extended-care cases, which are now a small minority of the total. But given that the overall rate hasn’t changed, there must have been a corresponding, rapid increase in cases in the rest of the county. That doesn’t bode well for the future.