Pennsylvania reported more new COVID-19 cases Friday than on any other day during the pandemic, mirroring the same troubling trend as the nation. Meanwhile, the Keystone State’s positive test rate is so high that it may suggest a worrisome level of community spread.

Pennsylvania health officials said Friday 2,219 new cases were reported, with small gatherings a significant contributor to the surge. The increase parallels a national wave of new infections that the Washington Post reported reached more than 80,000 new cases Friday, the highest single day count of the pandemic.

Some steep increases are happening in Gloucester, Burlington, Delaware, and Chester County communities, according to an Inquirer analysis that compared case counts the two weeks prior to Oct. 20 in the region to the first two weeks of September. Though raw numbers of cases are not large in some places, it’s the rate of growth that suggests the virus is spreading more aggressively in some communities.

Though a back-to-school bump in infections among college students has eased in some places, the majority of cases in the last month in Glassboro appear to be linked to Rowan University.

The previous Pennsylvania peak came April 8, with 2,060 cases. More widely available testing partly explains the new high count, but equally important — and troubling to experts — is how many of those tests are coming back positive. Pennsylvania’s rate of positive test results over the past seven days is at 5%, the benchmark that epidemiologists say indicates a troubling level of community spread.

New Jersey has fared better. Its 1,139 cases reported Friday, is well below the high of 4,391 cases reported April 17.

Pennsylvania health officials have not said whether they would bring back restrictions to limit gatherings, though Gov. Tom Wolf said he would look at “targeted” limits. Health officials continued to emphasize social distancing, mask wearing, and hand washing, even as public health experts lamented that people aren’t consistently following those recommendations.

“I think COVID fatigue is definitely setting in,” said Shawn Quinn, President of the Pennsylvania College of Emergency Physicians. “People are sick of COVID.”

Despite rising cases, hospitalizations have not yet increased significantly Quinn said, though they are growing. Death counts, which lag behind case reports and hospitalizations, have remained stable.

Where cases are spreading

Some increases mirror the pattern seen in the spring when prisons and nursing homes cases were driving the crisis, said Jeanne Casner, Chester County’s public health director who is also managing Delaware County’s health response.

What’s different now is the steady number of cases that can be traced to small social gatherings, including family get-togethers, and group sport events. Counties are looking to the state for guidance on whether additional social restrictions are needed.

“We’re down to the families now," Casner said. "All the systems have done what they’ve been asked to do.”

Racial and ethnic disparities continue to drive some of the rise. Riverside, N.J., a community of less than 10,000, saw 57 new cases from Oct. 6 to 20. The beginning of September saw the town report only two new cases. Herb Conaway, director of Burlington County’s health department, said much of the current rise is in the area’s large Brazilian community, whose residents tend to live in multi-generational housing and work jobs that may not provide health insurance or paid sick days, never mind the ability to work from home.

“We need to be concerned about language barriers that may exist that might impede the ability of our public health messaging to reach home,” Conaway said of the Portuguese-speaking community.

A lack of cooperation with contact tracing efforts, which includes the option of anonymous reporting through an app, continues to hinder health departments' ability to track and corral the virus' spread, said Conaway, echoing a common lament by area officials.

Long term care facilities account for some of the surge in Edgemont, which saw 16 new cases in that two week period after having none in early September, and Prospect Park, which reported 31 new cases over those two weeks and just seven a month and a half ago.

Two-thirds of the 8,592 coronavirus deaths in Pennsylvania have been among long-term care residents. Cases among nursing home and assisted-living residents have been rising this month after peaking in the spring and then falling off. The seven-day average is now about 100 cases in these facilities a day, close to double the number at the end of September and near the May peak, though infections among staff have remained stable. Deaths have held steady at fewer than 14 a day since early July, likely a reflection of treatment improvements and easily available testing that is catching cases earlier in the course of the disease.

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Still, residents remain vulnerable to the off-work movements of the staff who look after them. The same is true for another kind of institutional living as well. Pocopson, in Chester County, reported 46 new cases from Oct. 6 to 20, largely due to the state prison there, Casner said.

Campus parties and COVID-19

At Rowan University, one of the few campuses where students can choose to attend class in person and not just online, some are questioning whether that option was a good idea. The university is in Glassboro, which reported 144 new cases in the two weeks in October, a 443% increase over the first two weeks of September and the third largest rate of increase in Philadelphia and its eight surrounding counties.

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“There was a little bit of a learning curve,” said Joe Cardona, a university spokesperson, who said after classes began on Sept. 1 the school had to communicate with students and campus organizations to discourage them from holding gatherings on or off university property.

The university reported 560 students and staff infected with the coronavirus since late August. The school has 15,000 undergraduates, with about 4,100 now living on campus, the school reported. It did not know how many of the rest were living off-campus in Glassboro, or taking classes from home. There are 14 students with active infections and another 40 are quarantining due to exposure to an infected person, according to the school’s COVID-19 dashboard. Classrooms frequently have only a handful of students in them. Students' social lives, though, have proven harder to regulate.

“Even last night, I saw someone I knew post something that looked like it was from a party,” said Matt Pawling, a 19-year-old sophomore from Audubon. “I saw at least a few people with drinks and music and no masks.”

Since Rowan reopened Sept. 1, 90% of Glassboro’s COVID-19 cases have been among people ages 18 to 25. Gloucester County health officials noted Rowan’s cases peaked Oct. 8 and have been declining.

The presence of students has roiled the borough. Students often don’t wear masks, say Paul Lyons, a nearly 30-year Glassboro resident. They’ve been holding parties on Thursdays and Fridays, he said, and rent homes that are shared by 10 to 12 students.

“I’m just worried now that they’re saying there’s an increase in the number of cases," he said, “we’re going to pay a price.”

But some experts, like former director of Pennsylvania’s epidemiology bureau Joel Hersh, say tougher restrictions can themselves pose serious social and economic harms that must be balanced against how quickly cases are rising.

Personal responsibility, he said, can tip the scales away from new limits.

“If I were the governor and the secretary of health that’s the kind of ping pong match I have going on in my brain right now,” Hersh said. “How do I get people to be more observant to our recommendations of wearing the masks?”

Staff writers Stacey Burling and Justine McDaniel contributed to this article.