Editor's note: This story has been updated to reflect five more COVID-19 deaths that were reported for Nov. 30.
Lancaster County hit a grim milestone this week, surpassing 500 coronavirus deaths as the loss of life picked up speed and spread more broadly beyond nursing homes.
The county’s 61 new COVID-19 deaths in November marked the highest monthly total since May, and raised the pandemic’s local toll to 509 as of Monday, Lancaster County Coroner Dr. Stephen Diamantoni reported.
Diamantoni said he expects the pace of deaths to continue to increase, but doesn’t believe it will rise as high as April’s record of 183 deaths in one month.
And while the death rate remains below the spring peak, the loss of life is now spread more broadly in the community, he noted.
In April, 85% of COVID-19 deaths here were residents of nursing homes and other long-term care facilities. In recent weeks, that portion was much smaller.
“In the current wave, greater than 50% are at-home deaths, not nursing home deaths,” Diamantoni said.
Statewide, residents in long-term care facilities — which include nursing homes — account for approximately 10% of all infections, but represent about 63% of fatalities.
That's changing, just as it is in Lancaster County.
“We are actually seeing more deaths outside long-term-care facilities than we were in the spring,” state Health Secretary Dr. Rachel Levine said during a press conference Monday.
While Diamantoni expects the overall number of fatalities to rise — deaths follow cases by about two weeks — he said he does not anticipate seeing as many monthly deaths as in the spring.
“I'm not sure how it will be, but certainly we could see a higher number than we’ve had over the last several months,” Diamantoni said.
He added, “The risk is much higher today that it has been at any other time of the pandemic.”
The 61 fatalities in November mark the most deaths the county has seen since May, when the local toll was 113.
Geographically, November’s COVID-19 deaths were spread across 26 of the county's 60 municipalities, an LNP | LancasterOnline analysis of county data shows.
Most of those communities had one, two or three deaths, but there were 13 in Denver Borough and four each in East Lampeter and West Donegal townships. Six local communities saw their first coronavirus deaths in November: Earl Township and East Drumore Township, and Akron, Millersville, Manheim and East Petersburg boroughs.
Only 14 of the county's municipalities have yet to record a single death from COVID-19.
Statewide, 10,383 Pennsylvanians have died since the novel coronavirus emerged in March, and the Department of Health listed 522 deaths in Lancaster County as of Monday, or 18 more than Diamantoni’s tally at that time.
'Shutdowns are not the answer'
The county’s somber milestone comes as health-care officials in Pennsylvania grapple with some of the highest daily case totals of the pandemic.
Lancaster County recorded 545 new infections on Sunday and Monday, and there were 9,797 new cases across Pennsylvania, state data show.
Pennsylvania’s seven-day COVID-19 positivity rate — the portion of tests that turn out positive for the virus — has nearly doubled since the beginning of November. The positivity rate is seen as a key indicator of the level of community spread.
According to the World Health Organization, positivity rates above 5% indicate a problematic level of community spread. In Pennsylvania, only tiny, rural Forest County has a rate below 5%.
Last week, Lancaster County’s positivity rate of 12.7% outpaced the state rate of 11.7%.
Five counties — all with significantly smaller populations than Lancaster County — have rates greater than 20%, according to Pennsylvania's COVID-19 Early Warning Monitoring System dashboard.
COVID-19 patients occupy more than half of the state’s available ICU beds, another worrisome indicator. In Lancaster County, there were 124 COVID-19 patients at Lancaster General and WellSpan Ephrata hospitals on Monday, up from 33 on Nov. 1.
But Lancaster County commissioners on Monday expressed confidence that frequent handwashing, face masks and social distancing will be sufficient to ride out this third wave of infections. They also affirmed their support for Pennsylvania remaining open for business.
“Our goal as a community is to once again flatten the curve as we did in the spring and summer,” Commissioner Ray D’Agostino said in an email.
“Shutdowns are not the answer as they will not curtail the spread, but in fact, could exacerbate it and pose a danger for other health, economic and legal related concerns,” D’Agostino wrote.