As the number of cases of the new coronavirus continues to climb -- though a little more slowly -- in Pennsylvania, New Jersey and Delaware, some counties say they wants the state to start thinking about the crisis differently.
Delaware County Council issued a statement Monday saying the state should consider the crisis that is happening in its nursing homes to be separate from the spread of the virus in the larger community.
Seventy percent of the county's cases are in long-term care facilities. Only 30% of the cases have been contracted outside those homes.
Council called on Pennsylvania Gov. Tom Wolf to "separate out" the number of new cases in nursing homes from those in the community as he decides when counties can reopen their economies.
The state rejected that request. "We are not going to separate nursing home cases from other cases in counties," said Health Secretary Dr. Rachel Levine.
"The staff go back and forth," she said. "It really is an example of how we are all connected."
But the issue isn't likely to go away. Bucks County has made a similar request of the state. Philadelphia said it did not support that request, but more than half of all cases are connected to long-term care.
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In Montgomery County, about 80% of COVID-19 cases are connected to long-term care, and on Tuesday County Commissioners Chair Dr. Valerie Arkoosh showed a graph that broke out nursing home cases. It indicated the community rate of new cases had been stable or falling for some time, while long-term-care cases peaked sharply in late April, driving up the total number.
How the cases are counted could have enormous impact for the counties. One of the criteria the state is considering when deciding when to reopen a county is an average number of new cases each day below 50 per 1,000 people.
Delaware County would need to have no more than 20 new cases reported per day. With nursing homes counted, it's seeing 139 per day, council's statement read.
"Council views our current situation as two separate challenges that require separate approaches – infections in our nursing homes and other congregate care facilities, and the outbreak level in the broader community at-large," it said.