Chester is the only county in the Philadelphia region that has failed to meet two important benchmarks for continuing to ease coronavirus restrictions.
Chester County’s latest 14-day count of new cases is up 20% from the previous 14-day period, according to state data. But the county’s own case counts — which overall are higher than the state’s — show a decrease of 1%. Either way, the county fails to meet the state standard calling for decreasing or stable case counts.
What’s more, the state says Chester County hasn’t had a positive test rate of less than 10% for 14 days in a row, which violates another reopening barometer. High positive rates usually correlate with high levels of virus in a community. County health officials note that testing data for the last three days are incomplete and provisional.
To be sure, some areas in the largely affluent county of almost 500,000 people have had few or no coronavirus cases. But all of the other seven Southeastern Pennsylvania counties saw their 14-day case counts decrease. Delaware County, a more urban and densely populated county, saw its two-week count fall by 59%, based on state data.
Jeanne Casner, Chester County health director, attributed the high positive rates to the department’s decision to focus testing on areas that needed the most attention.
In late May, hospitals and federally qualified health centers in the less affluent and more agricultural southern part of the county started reporting an uptick of cases. So the county targeted testing there to make sure individuals who were very sick got the care they needed, and that those with more mild symptoms were advised on how to properly self-quarantine and limit further spread. That selective testing meant a higher overall positive rate for the county, she said.
“While I understand the metrics and eagerness to get to green," Casner said of the state’s reopening phases, "we’re doing the right public-health strategy. We’re making sure they have the proper quarantine and isolation resources, to make sure we don’t have more community spread.”
Chester County added more test sites in southern towns, including West Grove, Kennett Square, and Oxford after community partners tracked an uptick in cases there. The three towns with the largest increases — Avondale, Kennett Square, and West Grove — are in the heart of the county’s mushroom farming area.
The county’s southern townships have a higher concentration of Hispanic, immigrant, and undocumented worker communities, where families face unique health challenges that have been exacerbated by the pandemic, Casner said. Social distancing is difficult in multifamily households, and many people work in jobs where they are considered essential workers and don’t have the option of working from home.
Undocumented immigrants are not eligible for unemployment benefits and are often reluctant to seek health care — pandemic or not — because they do not have health insurance and may fear their immigration status could be questioned.
Casner said the county is working with farms to make sure they are meeting guidelines and encouraging safe behavior among workers. The Health Department partnered with community organizations to create new COVID-19 guidance videos about wearing masks and social distancing in less common dialects spoken in some neighborhoods.
Safe housing and food services are available for people who test positive and do not have a stable living environment or can’t self-quarantine in their homes.
Casner said she is optimistic that if her department continues this approach, cases will decline and the county will make its way through the pandemic.
According to state rules, counties can consider moving from the “yellow” phase — which is where all Philadelphia and its collar counties are — to the more permissive “green” phase after two weeks if they meet four metrics: 14-day case rates that are stable or declining, positive tests below 10% for 14 days, available hospital beds, and contact tracing that is underway or at least in planning.
If that doesn’t happen, “then they will not be able to move to the next phase,” said Pennsylvania Department of Health spokesperson Nathan Wardle.
Across the country, the lifting of economically devastating stay-home and shutdown orders has been met with fear, political wrangling, and, now, an anticipated surge in infections spread during protests and civil unrest. Massive demonstrations began around the world days after George Floyd’s death on May 25 at the hands of Minneapolis police.
The dynamics of phased reopening have been particularly fraught in Philadelphia and its nearest suburban counties — Montgomery, Bucks, Delaware, and Chester.
Originally, Gov. Tom Wolf said counties moving into the yellow phase — limited reopening of retail, child care, and offices — had to achieve a specific low rate of new infections. But when it became clear that the Philadelphia region would not achieve that by June 5, the planned go-yellow date, the governor said the benchmark was just one of many indicators his administration was using.