One New Jersey resident at a Cape May County house party on Memorial Day weekend may have been the source of at least a dozen new coronavirus cases in Bucks County.
“This is exactly why we can’t let our guard down now, even if it feels ‘safe’ to be at the beach,” David Damsker, director of the Bucks County Health Department, said in a statement.
But there’s an upside. Because Bucks County health officials have been “contact tracing” — interviewing people with the infection to find out where they’ve been — it was possible to figure out this epidemiological puzzle. The episode illustrates the crucial role contact tracing will play in limiting the potential for a resurgence of the virus.
“We want to make sure single cases don’t turn into multiple cases, don’t turn into outbreaks, don’t turn into a public health crisis in the community,” said Carolyn Cannuscio, who leads contact tracing efforts for Penn Medicine.
How to track an invisible virus
Contact tracing involves identifying everyone who has recently interacted with someone who has tested positive, and warning those people to self-quarantine for two weeks — the known incubation period for the virus.
Bucks County has been a leader in the Philadelphia region, tracking about 95% of its COVID-19 cases with a team of about a dozen health department employees who were reassigned from other jobs during the pandemic.
Larry King, a spokesperson for Bucks County, noted that the effort won’t work without cooperation.
“If people within that [Shore] group had not been honest or upfront,” he added, “we wouldn’t have found out about this.”
Rather than hiring its own contact tracers, Montgomery County is paying four nonprofit health organizations to train 20 of their employees as tracers. The idea is that they can use their existing connections in the community to reach people who might not trust government authorities, said Val Arkoosh, a physician and chair of the Montgomery County Board of Commissioners.
The 10 county employees and 10 Medical Reserve Corps volunteers who have already been tracking cases have found that people fear they will be blamed for spreading the virus — even after tracers explain that they do not reveal their identities.
“If people don’t feel safe sharing this information, we’re doing it with one hand tied behind our back,” Arkoosh said.
Such cultural competency, explained Resa Jones, chair of the department of epidemiology and biostatistics at Temple University, is essential to helping people follow quarantine orders.
“We need to make sure we’re thinking about vulnerable populations and what they might need in terms of resources,” she said.
Jones led the creation of a contact tracing training that will add 200 Temple students to the ranks of tracers in the state over the next several weeks.
Contact tracing in the Philadelphia area is being led by county health departments, something most Pennsylvania counties don’t have. Health systems are taking the lead in such counties; the state is also expanding its contact tracing efforts.
Chester County is leading COVID-19 response, including tracing efforts, for Delaware County, which does not have a health department. Chester wants to recruit nursing and public health student volunteers and hire temporary workers to scale up its 10-person tracing team to 30.
Meanwhile, Philadelphia officials have said their tracing efforts won’t be able to keep pace with the rate of new cases until the number — still over 100 a day — falls precipitously.
The Public Health Department believes it will need many more tracers than other counties because in the urban environment, each patient likely comes into contact with more people, said James Garrow, a spokesperson for the department.
“We couldn’t do widespread contact tracing with the numbers where they are now, but the hope is that as the cases go down and the number of people we hire increases, we’ll find that balance,” Garrow said.
Protests and the next potential wave of cases
Philadelphia officials are nervously waiting to see how nine days of civil unrest over the killing of George Floyd by a Minneapolis police officer might affect infection rates.
Last Tuesday, the health department advised those who were “at or near a protest,” even if they wore masks, to stay home for 14 days, or get a coronavirus test seven days after being in a crowd.
But most of the scores of testing sites listed on the department’s website still restrict testing to people with symptoms of infection, a doctor’s order, or both, based on an informal survey by The Inquirer. City health clinics and hospitals generally offer testing only to existing patients.
Vybe Urgent Care, with nine centers in the city and Delaware County, is among the exceptions, and it had “a busy day” on Monday, said CEO Peter Hotz.
“If they don’t have symptoms but they were exposed, we are testing,” Hotz said. “Monday is always busy, but it seems like a lot of people are heeding [the health department’s] advice. I think we’ll see even more as the week goes on.”
Sayre Health Center, at 59th and Locust Streets, also saw signs that some protesters are worried about exposure, said medical director Kent Bream, a family physician. Not only did Sayre see an uptick in asymptomatic people seeking testing on Monday, but many were not from the Cobbs Creek neighborhood that Sayre serves.
Respiratory samples were collected from about 30 people per hour, a rate that he expects will grow over the next week. The city’s largest demonstration was on Saturday, when thousands crowded between the Philadelphia Museum of Art and the Cathedral Basilica of SS. Peter and Paul.
Nursing homes and lives saved
On Monday, Gov. Tom Wolf’s administration turned what had been a request into an order, telling nursing homes to test all residents and staff at least once by July 24.
New data released Monday by the Pennsylvania Department of Health shows the outbreaks in nursing and personal care homes are well past their peak. These facilities have been hot spots because the virus spreads quickly among vulnerable residents living in close quarters and needing hands-on care. They have accounted for 20% of the nearly 80,000 people who have tested positive for the virus, but 69% of the state 5,953 deaths.
Wolf also launched a new online dashboard that includes demographic details of cases and deaths, and updates on the reopening status of each county.
States such as Texas and Florida that reopened weeks ago are already seeing a surge in infections. But two new analyses, published on Monday in the journal Nature, conclude that the shutdowns around the world tamped down the pandemic dramatically.
About 285 million infections in China and 60 million in the United States were averted, according to an analysis led by researchers at the University of California, Berkeley. The other study, by Imperial College London epidemiologists, estimated 3.1 million lives were saved in 11 European countries.
Garden State officials on Monday reported 356 additional confirmed coronavirus cases and 40 deaths. For the fifth straight day, less than 2,000 people in the state were hospitalized with the virus.
Pennsylvania, meanwhile, reported 351 additional confirmed cases and 10 new deaths. Philadelphia reported 162 confirmed cases since Saturday and one additional death. Across the region, 629 people were hospitalized.
The city announced it will hold neighborhood day camps beginning July 6 on a modified weekday schedule for children ages 6 through 12. Campers will be encouraged to wear masks, while staff will be required to do so, and parents must submit children’s temperatures each day.
Also starting July 6, Philadelphia’s spraygrounds, as well as other spray features to cool off kids, will reopen on a rolling basis. In New Jersey, Gov. Phil Murphy said municipal and private-club swimming pools can reopen on June 22.
Staff writer Stacey Burling contributed to this article.