COVID-19 expert: Many ‘are worried about Centre County’ as pandemic worsens. Here’s why
Centre County’s significant rise in COVID-19 cases hasn’t yet directly impacted the lives of most residents: The local hospital isn’t full. A majority of schools remain open. Non-essential work continues.
But, if current trends continue, that might not last through the fall
Dr. David Rubin, director of PolicyLab at the Children’s Hospital of Philadelphia, helped develop a COVID-19 model that, he said, shows both Penn State and the county must take “bold action” now before the virus overwhelms the area. That doesn’t mean the county is on an inevitable collision course with disaster — with the right mitigation strategies, the county should still be OK — but it does mean there is serious cause for concern, if the county’s 439 new cases this month (925 overall) don’t already make that evident.
“There are a lot of people that are worried about Centre County,” Rubin told the CDT on Thursday morning. “To me, it’s a perfect storm. It’s a rural area with limited health care capacity, and you just welcomed how many students — 35,000? — and, to me, that’s really hard. Without that health care capacity, the likelihood they’re going to (place) patients down outside of Centre County is pretty high.”
Added Nate Wardle, a spokesperson for the state Department of Health: “We work closely with Dr. Rubin, share his concerns and recognize the risks he outlines.”
That concern starts with community spread. Because the college-age population is typically able to weather the pandemic better than the older population, one of the keys is keeping COVID-19 contained to the immediate area of State College and University Park.
The problem, Rubin said, is that data suggests that community spread is already happening.
Although the county has not yet seen large case increases in ZIP codes outside the immediate vicinity of State College or University Park and, although it’s virtually impossible to differentiate students from non-students in the data, Rubin said there’s another way — “a poor man’s way” — to spot widespread transmission: Testing positivity rates in surrounding counties.
And, based on those, Centre County could be acting as a catalyst for other counties. Clinton County was down to 1% in late August and, as of Sunday, it’s now up to 7.5%, according to seven-day averages. Clearfield County saw a downward trend but then went from under 3.5% to above 4.7% in two weeks. Mifflin County has also seen a steady rise since Aug. 12, before the rate reached a peak of 5.4% and then fell back some to 3.9%.
“You just have to be really careful right now; this is a really tenuous time,” Rubin added. “And I would not ignore these trends in these areas around University Park and State College because I do think there’s clear, consistent information here in multiple counties that the center of the state has heated up a bit.”
Hospital concerns
Penn State’s reopening caused a domino effect of sorts on central Pennsylvania. When students converged in Happy Valley, COVID-19 cases went up. Then community spread hastened
And, if it continues, Rubin said, what comes next will be an overwhelmed Mount Nittany Medical Center.
According to the state’s hospital preparedness dashboard, the local hospital currently has seven available ICU beds. It also currently has just a single COVID-19 patient — but Rubin said hospitalizations typically lag about three weeks behind a rise in cases, meaning the hospital hasn’t yet felt the full impact of the community spike.
The local hospital’s chief medical officer, Dr. Nirmal Joshi, told the CDT before Penn State students arrived that it was “well-equipped” to weather the fall semester. If there would be a problem, Joshi said, the hospital would see it coming because the case numbers would be hard to ignore.
From March 20 to Aug. 16, the county experienced 392 cases of the coronavirus. From Aug. 17 — the first day of student move-in — until Thursday, there were an additional 533 cases, per the state Department of Health.
When told of Rubin’s statement, explaining the odds were “pretty high” Centre County’s lone hospital would have to eventually refer patients to out-of-county care, Joshi did not directly address the issue in a written response. Instead, he cautioned that this COVID-19 projection model was just one of many models.
“At Mount Nittany Health, we continue to closely monitor activity in the community and within the health system,” Joshi wrote. “To date, despite recent increases in positive test results in Centre County, we have not seen an increase in patient hospitalization and are, in fact, seeing a drop in the average length of stay of those who have been hospitalized in the past two months.”
But, prior to Joshi’s response, Rubin had already explained: “To me, what matters is where the hospital’s going to be in three weeks, not where they are today. When hospitalizations are climbing, you’re too late.”
Although Mount Nittany’s number of ICU beds remains low, it does still have 41 available medical/surgical beds, 21 airborne isolation beds and six pediatric beds. Based on the state dashboard, it also has 25 of 26 ventilators available for use.
Wardle also said the state DOH would help when, and if, it’s needed.
“The department works with our hospital partners to ensure they have the resources they need, and will work through the health care coalitions to provide regional assistance, if needed,” he said. “This has largely not been needed in the pandemic, but is available through collaboration that has been in place for several years.”
What happens next?
Rubin’s advice to those in Centre County was simple, concise and all-encompassing: Be careful. Wear a mask. Wash your hands. Social distance.
But, when asked specifically about his recommendations for Penn State, he didn’t hesitate. He lauded the response of Notre Dame and advised Penn State to follow a similar path. At Notre Dame, classes quickly moved online when cases spiked, as the university experienced a lockdown of sorts — with most public spaces closed, visitors forbidden and in-person gatherings limited to 10. Notre Dame later reopened when the rise subsided.
Locally, two faculty-based groups called last week for a temporary move to remote instruction, and Penn State President Eric Barron acknowledged last Friday that would be considered. But no action has yet been taken.
“We certainly appreciate input from other health professionals and their varying perspectives — which play into critical conversations about mitigating risk,” said Dr. Kevin Black, interim dean of Penn State’s College of Medicine and co-lead of the university’s Health Resources Task Group. “At this time, we are not seeing the indicators that might compel a reversal of our course, but we certainly are monitoring all aspects carefully. The university is in close communication with local and regional public health authorities, officials at Mount Nittany Health System and the Pennsylvania Department of Health.
“As we have said, our process includes monitoring activity in areas around our campuses, as well as statewide data. Our plans from the beginning have kept the health and safety of our community as a priority, and our approach to decision-making is to collect and monitor the data; consult infectious disease and other experts; predict potential trends and outcomes; and take action as needed to mitigate risk of the virus spreading. In fact, we look at all data collected, not only on a daily basis, but sometimes hourly, as well as trend lines to not only measure the current disease, but also to predict both increases and decreases in disease prevalence and adjust our mitigation efforts accordingly.”
Black emphasized that the university isn’t just being reactive. And he said Penn State is “prepared to use the data to predict possible trends and initiate corrective action.”
But Rubin still had some other suggestions. Namely, he said, he’d also like Penn State to step up the enforcement of its guidelines for students.
“People need to see very publicly that Penn State is serious and they’re not going to have nonsense throughout the year,” Rubin added. “This is a pretty serious situation, and you do not have the health-care capacity to meet the demand of what could happen in Centre County.”
Rubin advised not dining in restaurants. Not going to large gatherings. Maybe heading to the grocery store once a week instead of twice. Whatever might be possible.
Meanwhile, however, restaurants still remain open locally and statewide at 25% capacity. And area schools like Bald Eagle Area, Bellefonte, Penns Valley and Philipsburg are still teaching in-person.
“We are continuing to work with the Department of Education, and our postsecondary partners to ensure everyone is taking steps to protect the health of the college communities and all communities in Pennsylvania,” Wardle added.
Wardle also emphasized all Pennsylvanians need to work together to stop the spread of the virus, something that was echoed by Joshi and Rubin.
“I understand it’s natural not wanting to alarm the community,” Rubin said, “but, at the same time, the indicators are all there. You’ve got multiple counties that have rising test positivity. People need to know in the community that they should adjust their routines and protect themselves.
“That’s the period you’re in right now. Now’s the time to protect yourself a little more; you can take more chances when there’s no cases around.”
This story was originally published September 10, 2020 at 6:05 PM.
