Local data shapes response: Zip codes reflect virus impact around state

U.S. Army Sgt. 1st Class Keith Benson, a noncommissioned medical officer with the 31st Civil Support Team, analyzes a specimen for COVID-19 aboard an Analytical Laboratory System vehicle on the grounds of the Delaware Public Health Laboratory in Smyrna on June 10. U.S. Army Capt. Brendan Mackie

DOVER — Look near and far as you gauge the coronavirus risks.

“I think that people should be very aware of their surroundings and of their risks,” said Jennifer Horney, director of the epidemiology program at the University of Delaware.

She was asked about the sense of security people may have now as restrictions loosen.

Should we worry about sending our child to daycare or going to a restaurant?

“These are decisions that need to be made locally and are dependent on what community transmission looks like in your community,” Dr. Horney said. “So by all means, be aware of the data for your community, but remember that we live in an incredibly mobile and connected world — particularly here in the small state of Delaware — so also be aware of the situation in the larger area, especially in Maryland, Pennsylvania, and New Jersey.”

The coronavirus seems to just creep and linger in the state.

In a review of statistics Friday, there were 112 new cases.

Small increases were scattered across zip codes in all three counties.

The largest was 11 in the 19963 zip code — the greater Milford area.

Page 10 of the Delaware State News Sunday edition features a chart that shows Delaware Division of Public Health statistics for each of the state’s zip codes. It ranks each zip code by postive cases per 10,000 residents.

The data, including reports since early March, was drawn Friday morning from the state’s “My Healthy Community” website.

More than a dozen zip codes list no cases, or have so few that the state does not release the numbers.

The state indicates totals of 10 or fewer are not shown to protect privacy.

So, if you live in Marydel or Bethany Beach, you may not be too worried when you look at the numbers.

But, if you live in Central Sussex County, you may have a different perspective.

The Georgetown area — the 19947 zip code — has been hit the hardest.

A key metric in the data is a percentage of positive cases per population. That number converts to 595 per 10,000 residents.

In 19947, there are 1,088 reported cases among 19,625 residents.

Of those testing positive, 68 percent were Hispanic/Latino.

About 22 percent of the Georgetown area zip code is Hispanic, according to the state data.

The next closest is tiny Ellendale to the north.

It has 79 cases that equate to 422 positive cases per 10,000.

Sussex County has the top 11 zip codes for the per 10,000 ratio. You can follow the severity down U.S. 113 through the heart of the county and the swing to the west to Seaford and Laurel.

Three weeks into April, the state saw the big increase in cases in the Georgetown area.

It was identified as a “hot spot” and the state swooped in and tested, informed and educated residents and armed them with masks, cleaning supplies and more.

The focus was on workers in the Sussex County poultry plants and their families, those with whom they shared homes and people in their communities.

On April 26, Delaware had its greatest spike in new cases – 458.

U.S. Army Sgt. 1st Class Keith Benson, a noncommissioned medical officer with the 31st Civil Support Team, handles a specimen being analyzed for COVID-19.

In reaction, Gov. John Carney mandated the use of face coverings two days later when the state had another 400-plus cases.
From April 15 to May 15, the count in the Georgetown area went from 136 cases to 1,006.

Since then, it has essentially flattened out.

“That early outbreak we saw with the poultry workers is similar to what other states saw,” said Gov. Carney. “Vice President Pence and (White House coronavirus response coordinator) Dr. Deborah Birx were commenting (Monday) on the need to focus on the county specific numbers and we’ve been doing that, of course, over the last two months given what we saw in Sussex County.

“Now as we’ve moved into the reopening of sectors of our economy, we need to identify those outbreaks early with intensive testing and to isolate those who test positive and contact folks that they encountered and to test and isolate them.”

On April 19, Delaware’s peak in percentage of people testing positive was 43.2 percent. For the week leading up to that date, Delaware had 3,002 tests from April 13-19.

Testing is much more extensive now.

In the past week, Delaware administered more than 10,000 tests — many of which to people who have had no symptoms.

It has contributed to much lower numbers of percent positive tests. On Thursday, it was 2 percent of 1,758 tests.

Delaware is in the second phase of its economic recovery plan and the stay-at-home order has been lifted. Most businesses and restaurants were allowed to open at 60 percent capacity.

It has increased interaction throughout communities that bears close watch, Gov. Carney said.

He said Dr. Birx advised governors “to make sure we’re testing asymptomatic folks — the workers in restaurants, government agencies, law enforcement, nursing homes.”

The intensive testing, he said, should help identify and get ahead of potential outbreaks so there will not be another repeat of what happened in the Georgetown area.

Gov. Carney said Tuesday that he has been studying the 20 states across the country that are seeing upward trends.

“The advice that we got from Dr. Birx was to try to get ahead of it and identify on a county-wide or sub state level where you’re seeing outbreaks,” said Gov. Carney. “That requires extensive broad based testing and we’re attempting to do that at a time when folks are not feeling as threatened by the virus and not as focused on getting tested.”

According to Johns Hopkins University, Delaware ranks 13th among states in number of tests per 100,000 population.

“There are a few metrics that are important to watch,” Dr. Horney said. “These include the rate of positive tests (positive tests per 100,000 people) and the percentage of tests that are positive. Both these numbers should be decreasing.

“This allows us to understand what is happening with the spread of the virus even as the number of tests increases and some people may be getting tested multiple times.”

It is worth noting here that the Delaware Division of Public Health total does not include multiple results for individuals. Only one result is counted.

If someone tests negative but later tests positive, they are changed from a negative to a positive case, according to the state.

“Going forward there are so many things to prepare for,” said Dr. Horney. “These are a few that I am most concerned about:

“What role will children and younger people, who tend to have mild or asymptotic cases, play in community transmission once schools and universities reopen? Will Delawareans continue to follow social distancing guidelines, using masks, keeping their 6 feet of distance, and leaving home for relatively low-risk activities like outdoor play if our numbers continue to trend in the right direction or will we become complacent?”

DPH officials late Friday cited the repercussions of close-contact gatherings among younger people, reporting that at least three teenagers tested positive for COVID-19 following senior week activities. The teens were among a dozen living in a rental unit in Dewey Beach. During that time, DPH said, the teens attended several crowded gatherings in Rehoboth, potentially exposing as many as a hundred or more to the virus.

Looking ahead, Dr. Horney said we may see some areas where cases rise.

“As restrictions loosen, I believe we will see more clusters or outbreaks locally, the extent of which will vary based on the state’s ability to meet benchmarks (such as percent positivity) and their willingness to reinstate stay-at-home orders and other restrictive measures when case counts go up,” she said.

Much of that may come from local behaviors.

“We understand more every day about the highest risk situations for COVID infection — close contact in poorly ventilated indoor spaces or at crowded events,” Dr. Horney said. “People need to constantly be reminded to stay physically distant and governments and businesses will need to continue to be innovative to avoid outbreaks of COVID that risk stressing hospital systems and returning us to stricter public health emergency guidelines.”

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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