Imagine refusing to buy homeowners’ insurance because you’d rather not spend the money. Then your roof rips off in the middle of a hurricane. Then, it rains for another five weeks straight.
This is the coronavirus situation in Delaware County, where decades of Republican control prior to historic elections in November have left Delco as possibly the most populous county in the United States without its own health department and now, quite urgently, as coronavirus has emerged in suburban Philadelphia, with no local control over suspected cases as they emerge.
Every other nearby county and city together have scores of dedicated professional staff working cases as they arise. Delco, however, does not. It is at the mercy of the state Department of Health, whose staff in an emergency operations center two hours away in Harrisburg are running response and investigations of reported cases in the county of more than a half million people.
Republicans who controlled this county for over a century are to blame. They repeatedly resisted calls to create a health department. Democrats who won in November said coronavirus hit before they could fix what Republicans had effectively broken.
What we have: A potentially dangerous situation as the trajectory of infection by this fast-spreading virus remains unclear but is rising with each day.
The state is not just responsible for helping Delco. It must assist the other counties in Pennsylvania without departments if and when cases emerge there — less developed counties that, like Delco, also chose to subsist off the state balance sheet instead of paying to protect their own people.
One question I heard repeatedly from people close to the situation: What will happen to Delco coronavirus cases if and when cases pop up in many more counties?
“The problem is with something like a coronavirus, which is a complicated response, the Pennsylvania Department of Health is severely underfunded and understaffed. They will be doing similar responses in all of the [other] counties without county health departments in Pennsylvania and their resources will be very stretched,” said Rosemarie Halt, who heads a public health committee with the county League of Women Voters, which has pressed for a Delaware County health department for years.
So far, the most frustrating thing locally has been the state’s refusal to share anything but bare-bones information about the single known case so far of COVID-19 in Delaware County.
“Delaware County is so densely populated. We’re right on top of each other,” said State Sen. Tim Kearney, a Democrat who two years ago won the seat held by Republican Tom McGarrigle. “So it’s frustrating when there’s no mechanism in place for this kind of information.”
The state is releasing only the information required under the law. Meanwhile, all its epidemiologists continue handling things out of an operations center in the capital city.
“Our infectious disease specialists are here in Harrisburg,” said Health Department spokesperson Nate Wardle. “There’s no need to have our state epidemiological team out of the counties.”
This is little comfort in Delco considering how things are being handled right next door in Montgomery County, where a Children’s Hospital of Philadelphia cardiologist working out of a King of Prussia medical building has emerged as a possible source of coronavirus contagion.
In Montgomery County, a former National Institutes of Health employee runs a sprawling Office of Public Health. It’s a big department, and in recent days its staff have been chasing down and then disclosing to the public detailed information about an escalating number of confirmed cases. Even its food-safety licensing agents have been visiting grocers and restaurants to urge preventive deep cleanings if they believed someone there may have had contact with a coronavirus-exposed person.
Montgomery County has about 100 staffers on the ground — 80 of them Health Department workers -- now deployed to coronavirus. They’re performing investigations and reaching out to businesses where presumptively infected people may have gone, OPH administrator Brenda Weis told me Tuesday.
"We’re in an all-hands-on-deck mode,” Weis said. “
None of this is happening in Delaware County, where Weis, incidentally, said she had been working with officials in recent months to help get a health department off the ground.
The frustration in Delaware County is evident.
A few days ago, one Republican and one Democratic state senator asked state Health Secretary Rachel Levine to release more than the exceptionally scant information her office has issued about the reports from Delco.
“We’re the largest county by population that doesn’t have a health department in the entire country,” said newly elected Democrat Monica Taylor, vice chair of the Delaware County Council.
What that means: If someone believes they contracted coronavirus, county officials are prohibited from handling it. They can’t initiate testing or even call anyone who may have contacted that person.
“As it is right now,” Taylor told me, “we don’t have the jurisdiction to do the contact tracing. We’re just not allowed to."
“We’ve been trying to be very proactive with this because of the fact when we came into office we didn’t have a health department," Taylor added. "That’s why we started immediately with the process of trying to create one. But it takes 18 to 24 months.”