Joanne N. Borders, a registered nurse, has stared at the coronavirus statistics on her computer screen and hoped the cases in Yeadon, the small borough where she has lived for about three decades, would have finally dropped off.

They have not.

The Delaware County town of fewer than 12,000 people has seen the highest rate of coronavirus cases of any suburban municipality or Philadelphia zip code with at least 10,000 residents, according to an Inquirer analysis as of July 17. It has held that unfortunate distinction since before June 15, when its case rate was 360 cases per 10,000 residents. That’s now up to 388.

Lately, the situation shows tentative signs of improvement. But now, with people across the country growing increasingly impatient with staying at home and wearing masks, those gains could be lost, public-health experts say.

An outsized number of cases in one area frequently means that the community includes numerous nursing homes with many virus-vulnerable residents. High rates also are seen in areas that are mostly low income and minority, as the virus is striking hard at people who are more likely to have underlying health conditions, who can’t work at home, may live in closer quarters, and have less access to testing and health care.

Yeadon has both.

“The simple reality is that this pandemic has highlighted the gross inequities that exist with medical care for African American communities,” Borough Council President LaToya Monroe and Mayor Rohan Hepkins said in a statement to The Inquirer. “We continue to provide information and supplies to residents and firmly believe that together we can beat COVID-19 and extinguish the disparate medical care often provided to African American communities.”

Volunteers provide coronavirus testing for any Delaware County resident over the age 18, during a walk-in at the parking lot adjacent to Providence Rehabilitation & Healthcare Center on Mercy Fitzgerald Campus in Yeadon on July 9, 2020.
JOSE F. MORENO / Staff Photographer
Volunteers provide coronavirus testing for any Delaware County resident over the age 18, during a walk-in at the parking lot adjacent to Providence Rehabilitation & Healthcare Center on Mercy Fitzgerald Campus in Yeadon on July 9, 2020.

Yeadon also sits in the only suburban Philadelphia county that does not have its own health department. Early in the pandemic, local officials frustrated at the response of state health officials contracted with the Chester County Health Department, which has helped Yeadon with better access to testing and outreach. Yet unlike other hot spots in the region that got the virus under control weeks ago when the area was still in the most restrictive lockdown status, the crisis persists in Yeadon.

“Yes, we are concerned,” Chester County Health Director Jeanne Casner, who is overseeing Delaware County’s virus response, said earlier this month in a phone interview. “The solutions are not necessarily foolproof, and, honestly, fatigue has set in with our public.”

Borders, 65, said she sees that fatigue. She has noticed graduation parties in the borough where young adults aren’t social distancing and aren’t wearing masks. She worries about what happens when those teenagers go home to their grandmothers.

“When I see that, when I see the rest of the area going green and we’re still struggling, those are the times I think more education is needed,” Borders said. “Those are the times I try to send out more emails, or another tip or reach out to people and say, ‘How are you doing? How is your family doing? Are you remembering the precautions?‘”

Yeadon, which borders southwest Philadelphia, is almost 90% Black. More than one in four households earns less than $35,000 a year. And about 30% of working people have health-care jobs — which these days often means direct contact with the virus.

Residents of Yeadon’s long-term care facilities have been especially vulnerable. ManorCare Health Services-Yeadon and Providence Rehabilitation and Healthcare Center at Mercy Fitzgerald had a combined 175 resident cases, both nursing homes confirmed this week. That is almost 40% of the borough’s 446 cases.

At least 41 Yeadon residents have died of complications from COVID-19 as of July 15, according to Chester County’s health department, though the nursing homes report 46 resident deaths. This discrepancy may be due to Yeadon nursing home residents who died while still maintaining their primary address in another town, a Pennsylvania health department spokesperson said.

Early in the pandemic, health officials could see who was most vulnerable. Yet, in Yeadon, there was no first line of defense.

By mid-April, the peak of Pennsylvania’s coronavirus outbreak, Yeadon was already reeling from 15 deaths and more than 100 cases. A few weeks later, the case count nearly tripled and deaths approached three dozen.

“When the first wave came and hit us, we didn’t have a health department in place,” said Monica Taylor, one of three Democrats elected to the County Council last fall, marking the first time in generations that Republicans lost the majority. Taylor and her colleagues Elaine Schafer and Christine Reuther made forming a health department a priority in their successful campaigns. But that will take time.

Taylor says the Chester Health Department “has started to come on board and understand our county more.”

Initial testing in Delaware County, and across the region, was limited. People could not be tested unless they met certain criteria, such as being elderly, an essential worker, or symptomatic — though it’s now well-accepted that people without symptoms are spreading the virus. The Delaware County Council recently set up a testing site in Yeadon for residents over age 18 or with preexisting conditions.

Casner hopes this effort, along with more testing next week, will provide a clearer picture of why it has been so difficult to bring down Yeadon’s numbers. With data from the testing site, officials will know whether Yeadon’s high numbers could be because so many residents already have been exposed due to living in long-term care, being essential workers, or just living with essential workers.

That’s what the health department found when it conducted similar testing in Chester’s hot spots.

Volunteers provide coronavirus testing for any Delaware County resident over age 18, during a walk-in at the parking lot adjacent to Providence Rehabilitation & Healthcare Center on Mercy Fitzgerald Campus in Yeadon on July 9, 2020.
JOSE F. MORENO / Staff Photographer
Volunteers provide coronavirus testing for any Delaware County resident over age 18, during a walk-in at the parking lot adjacent to Providence Rehabilitation & Healthcare Center on Mercy Fitzgerald Campus in Yeadon on July 9, 2020.

For now, there are signs of improvement. In the last week, new cases in Yeadon were up just 1% — slower than Delaware County as a whole. The entire region is seeing a gradual uptick in cases, especially among young adults who may not be following safety practices as diligently as they should.

“In general, the county is doing much better, and Yeadon is doing much better than they have been a few months ago,” Taylor said. “We want to make sure we continue to keep that trend and don’t see a backslide.”

Borders is also nervous about a backslide. She has warned Father Jordan Casson at St. Michael’s Episcopal Church in Yeadon, where she is a junior warden, that reopening the church may be further off than they hoped.

Casson said the church has remained closed, avoiding large gatherings, hugging outside, and singing together, because of Borders’ warnings.

“We have someone saying, ‘Listen, we’re still in a yellow, red zone, even though the county is green.’”

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