Editor’s Note: We are standardizing the format for daily COVID-19 case data updates. These articles may feel repetitious but we want each one to stand alone in terms of providing maximum context around the data. This is the update for Tuesday, June 22.
As of Friday, June 26, Lebanon County will be the only of Pennsylvania’s 67 counties to remain in the ‘yellow’ phase.
The number of new COVID-19 cases over the last 14 days per 100,000 residents is currently at 131 for Lebanon County.
Gov. Tom Wolf had said originally that a county would need to show 50 or fewer new cases per 100,000 residents over a two week period to advance to the ‘yellow’ stage in his tiered reopening plan. After that point, according to the Governor’s plan, if overall risk remains mitigated for fourteen days, counties would be transitioned to the green phase.
Although this plan has been deemphasized by the state, with a number of counties having been advanced to yellow ahead of meeting this metric, it remains at present the primary metric of comparison for LebTown.
LebTown is developing a new version of this metric weighted by test volume that we hope to introduce next week. This test volume weighted metric is intended to provide a clearer signal for the extent to which increased testing has driven increased case counts.
Daily new cases over last 14 days per 100,000 residents
In terms of relative comparisons, the current figure of 131 new COVID-19 cases over the last 14 days per 100,000 residents represents an increase of 96% compared to one month ago and an increase of 13% compared to 14 days ago. This figure is 49% of the all-time high of 268 on April 21.
For additional context, the southcentral region is at 65 new cases over the last 14 days per 100,000 residents, Philadelphia County is at 91, Lehigh County is at 59, Berks County is at 49, and the state overall is at 49.
The southcentral region includes Adams, Bedford, Blair, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lebanon, Mifflin, Perry, and York counties. At present, Lebanon County is the only southcentral region county not designated as ‘green’, with Dauphin, Franklin, Huntingdon, and Perry counties moved as of midnight Thursday, June 18. All remaining ‘yellow’ counties, including Philadelphia County, will be advanced to the ‘yellow’ stage on Friday, June 26, although additional restrictions are expected to remain in place in Philadelphia through the following week.
In a press release on Friday, June 19, Pennsylvania Department of Health Secretary Dr. Rachel Levine provided an interpretation of Lebanon County’s rising case count that focused on the actions taken by local elected leaders last month to move the county to ‘yellow’ in advance of the state’s timeline.
“Lebanon County’s partisan, politically driven decision to ignore public health experts and reopen prematurely is having severe consequences for the health and safety of county residents,” said Sec. Levine. “Case counts have escalated and the county is not yet ready to be reopened. Lebanon County has hindered its progress by reopening too early. Because of this irresponsible decision, Lebanon County residents are at greater risk of contracting COVID-19.”
LebTown addressed these claims in a weekend editorial, noting that there was no apparent scientific basis for her comments pinning the increase on political actions. Lebanon County legislators also responded in an open letter on Friday, calling Levine’s comments “highly political” and “an absolute insults to equality and fair treatment.”
The Lebanon Valley Chamber of Commerce also addressed the decision in a letter sent to Gov. Wolf and distributed to the media on Tuesday, June 22. “We would like to understand the data analysis behind the continued yellow phase for Lebanon County as it compares to other counties with similar data patterns,” said Chamber president Karen Groh in the letter which can be read in full here (PDF). “Our Chamber members and the business community are frustrated in the continued delay in getting back to business as the majority have followed the guidance from the state and the CDC.”
Nonetheless, Lebanon County’s cases were on the rise in recent weeks.
The biggest driver of increased new case counts has been an expansion in test volume. Lebanon County saw more tests reported in recent weeks than any time earlier in the pandemic, but the positive rate remains lower than it did in those previous periods. Population testing at local nursing homes appears to be the main reason for the increase in daily test figures.
Earlier this month the county also received a sharp increase in cases due to a commercial lab submitting a large number of processed tests in a batch, although those tests are no longer counted towards the main 14-day/100k residents metric that LebTown uses in its daily tracker. A health department spokesperson said the data came from Quest and that the data dump was not limited to Lebanon County. According to the DOH, these dumps occur about once or twice a month when a large file of test results is received from commercial labs.
Test volume is trending back down towards historical average levels, with 781 tests conducted over the last seven days, compared to 1,326 tests in the seven days prior. In May, an average of approximately 540 tests were conducted every seven days.
Daily new cases and negative results as 7-day trailing average
Positive test rate as 7-day trailing average
The share of cases linked to nursing homes has steadily climbed through the pandemic, currently registering at approximately 1 out of every 6 cases being a nursing home resident or staff member. According to DOH data from 2017, Lebanon County is among the Pennsylvania counties with the highest number of nursing home beds per capita and the highest nursing home occupancy rates.
The state has also begun using a “risk-based decision support tool” to inform its response, with the tool described as one of many inputs used in the decision-making process. In the state’s county dashboard, Lebanon County is indicated as meeting two of four metrics, with the two unmet metrics being increasing case counts and a positive test rate higher than 10%.
In terms of raw numbers, Lebanon County is now tracking at 1,272 cases of the novel coronavirus, according to current Pennsylvania Department of Health data, with 7,467 negative tests. (All figures in this article are based on DOH data unless otherwise noted.)
47 of those cases are probable cases, a designation made by healthcare providers based on symptoms and known exposures.
The Department of Health is reporting 40 deaths as of today, while Lebanon County is reporting 34. According to the county’s COVID-19 dashboard, the 35 deaths are linked to residents from Lebanon County municipalities as follows:
- City of Lebanon (2)
- Cleona Borough (1)
- Cornwall Borough (3)
- Myerstown Borough (16)
- North Cornwall Township (6)
- South Lebanon Township (5)
- Swatara Township (2)
Calculated as a percentage of confirmed cases, coronavirus currently has a mortality rate of 3.2% in Lebanon County – although due to still-limited testing as well as the occurrence of asymptomatic/undetected cases, the actual mortality rate may be lower than that. The mortality rate is however much higher in nursing homes and in general the virus should still be considered as extremely dangerous.
The Department of Health has recently begun reporting a total “recovered” percentage as part of its daily updates. A person is considered recovered if a case has not been reported as a death after more than 30 days past the date of the first positive test or the onset of symptoms. At present, the state says 78% of cases are considered recovered.
Daily new cases as 7-day trailing average
In late May, it was reported that the state is including positive antibody tests in its overall counts. Antibody tests are not broken out to date by the state in its county-level reporting. Negative antibody tests are not counted towards the state’s overall negative case count.
Neither WellSpan Health, Lebanon Veterans Affairs Medical Center, nor UPMC Pinnacle are actively conducting antibody testing in Lebanon County at this time, with Quest Diagnostics being the only firm known to offer this type of testing at present. However, tests could be performed on Lebanon County residents at facilities outside of the county and show up on state data, which is based on county of residence.
The state began breaking cases out by ZIP code in mid-April. Find the full dashboard here or see below for how cases looked across Lebanon County ZIP codes as of the last time the data was updated.
- 17003 (Annville) – 43 positive, 371 negative, seven probable
- 17010 (Campbelltown) – zero positive, 11 negative, zero probable
- 17016 (Cornwall) – 12 positive, 91 negative, zero probable
- 17026 (Fredericksburg) – 18 positive, 121 negative, 1-4 probable (redacted)
- 17028 (Grantville) – five positive, 101 negative, zero probable
- 17038 (Jonestown) – 44 positive, 302 negative, 1-4 probable (redacted)
- 17039 (Kleinfeltersville) zero positive, 1-4 negative (redacted), zero probable
- 17041 (Lawn) – zero positive, 1-4 negative (redacted), zero probable
- 17042 (Lebanon) – 396 positive, 2,362 negative, six probable
- 17046 (Lebanon) – 450 positive, 1,838 negative, 16 probable
- 17064 (Mount Gretna) 1-4 positive (redacted), 41 negative, zero probable
- 17067 (Myerstown) – 176 positive, 741 negative, 1-4 probable (redacted)
- 17073 (Newmanstown) – 33 positive, 210 negative, 1-4 probable (redacted)
- 17078 (Palmyra) – 50 positive, 907 negative, nine probable
- 17087 (Richland) – 15 positive, 108 negative, zero probable
- 17545 (Manheim) – 121 positive, 868 negative, 1-4 probable
- 17963 (Pine Grove) – 32 positive, 299 negative, zero probable
- 19551 (Robesonia) – 13 positive, 174 negative, 1-4 probable (redacted)
- 19567 (Womelsdorf) – 56 positive, 177 negative, zero probable
Deaths from COVID-19 occur at a far higher rate in nursing home residents than among the general population.
Percentage of COVID-19 cases linked to nursing homes
Percentage of COVID-19 deaths linked to nursing homes
As of Tuesday, June 23, the state was reporting COVID-19 cases at seven nursing homes or personal care facility in the county, with 199 cases among residents and 35 cases among employees. According to DOH data, there have been 29 coronavirus-linked deaths at Lebanon County nursing homes or personal care facilities to date.
Here is nursing home data from the Department of Health as of Wednesday, June 10:
- Cedar Haven – 1-4 cases among residents, 1-4 cases among staff, zero deaths
- Cornwall Manor – 11 cases among residents, five cases among staff, 1-4 deaths
- Coutryside Christian Community – Zero cases among residents, zero cases among staff, zero deaths
- Kadima at Campbelltown – No data available
- Kadima at Palmyra – Zero cases among residents, zero cases among staff, zero deaths
- Lebanon Valley Brethren Home – Zero cases among residents, zero cases among staff, zero deaths
- Lebanon Valley Home – Zero cases among residents, zero cases among staff, zero deaths
- ManorCare Health Services Lebanon – 32 cases among residents, eight cases among staff, eight deaths
- Spang Crest Manor – Zero cases among residents, zero cases among staff, zero deaths
- StoneRidge Poplar Run – 18 cases among residents, 6 cases among staff, zero deaths
- StoneRidge Town Centre – 65 cases among residents, 19 cases among staff, 18 deaths
DOH data and self-reported data do not always line up. The state has previously received criticism from nursing homes about its reporting methodology. The state has not updated its facility-specific dataset since June 10.
According to data released by StoneRidge, 17 deaths have occurred to date among residents at StoneRidge Town Centre in Myerstown. This figure has remained constant since May 29 with no new deaths or resident cases reported since that date.
Cedar Haven has also reported that it is dealing with an outbreak. Cedar Haven said on Sunday, June 14, that it had confirmation of 30 cases, 13 of which were said to be currently asymptomatic, and that 23 staff members have tested positive, 11 of which were asymptomatic at the time of testing. Cedar Haven said eight more residents “may also have been impacted.” Cedar Haven reported its first COVID-19 case, a staff member, on June 3, showing how quickly the virus can spread through a facility.
In an update on Monday, June 22, Cedar Haven reported that it had not seen any new confirmed cases of COVID-19 in the previous ten days. Cedar Haven also said in the release that it has seen four deaths from the virus. “All of us at Cedar Haven offer our sincere and heartfelt condolences to their families and loved ones during this difficult time,” said the facility in the statement. Cedar Haven noted that 26 staff members have tested positive to date, with all impacted staff said to be following strict quarantine requirements.
Regarding online discussion that a Cedar Haven staff member may have withheld information of a potential COVID-19 exposure and brought the virus into the facility, Cedar Haven would not provide a specific comment. “We aren’t comfortable making specific comments about individuals on our team because of HIPAA-related and safety concerns,” said Meg Farrington, a spokesperson for Cedar Haven owner Stone Barn. Farrington noted that the facility has been following a strict mitigation protocol since mid-March that includes a twice daily survey and temperature screening for staff members, as well as a full telehealth program and restrictions on visitors in favor of video call visits.
“Unfortunately, even these strict measures do not prevent any and all opportunities for exposure,” said Farrington. “Healthcare facilities cannot control exposure staff-members may face outside of the building or the manner in which they answer the survey questions.”
“However, we can terminate the employment of any staff member who does not comply with the policies and procedures that align with our commitment to care for and protect our residents.”
Farrington emphasized that the team has worked very hard to limit further spread of the virus throughout the facility. In its release Monday, Cedar Haven noted that all but one of the impacted residents lived on the same floor.
“We want to thank our team for their rigorous efforts and commitment to our residents and also thank our community for the ongoing support during this truly unprecedented time,” said Cedar Haven in its release.
As of mid-April, WellSpan Health has made available a dashboard showing hospital-specific data. According to this dashboard, to date there have been 5,257 tests performed by WellSpan Health in Lebanon County, with 5,123 of those finalized and 134 pending. 853 tests (16.7%) were positive.
Currently there are 13 confirmed positive COVID-19 patients at WellSpan Good Samaritan Hospital and three patients under investigation for presumed COVID-19.
WellSpan Good Sam in-patient census
According to WellSpan data, 12 deaths have occurred at WellSpan Good Samaritan Hospital as a result of coronavirus. WellSpan notes that this information is not based on patient residency and therefore may differ from DOH statistics.
The Department of Veterans Affairs also makes some information available regarding treatment of coronavirus at its facilities. As of today, the Lebanon VA Medical Center is providing care to 17 active cases – 16 veterans who tested positive for COVID-19, as well as one employee. Active cases are defined as patients tested or treated at a VA facility for known or probable COVID-19 who have neither died nor reached convalescent status, which is itself defined as patients who are “either post-hospital discharge, or 14 days after their last positive test, whichever comes later.” 129 additional people (110 veterans and 19 employees) are considered convalescent cases at present. The facility has recorded 18 known deaths from the virus. These figures include residents of the VA’s long-term care Community Living Centers.
Here’s how Lebanon County’s confirmed case count has grown since the pandemic began.
Here’s how confirmed cases compare to overall tests in Lebanon County.
Here’s how the daily number of new cases in Lebanon County looks.
Here’s how that looks when negative tests are included.
Here’s a look at the entire southcentral region for 14-day new cases per 100,000 residents.
Here is a chart that shows an estimated mortality rate based on a thirty day recovery period from the time of the state receiving a positive test result.
Here’s how Lebanon County compares to other counties, as well as the region and state, across three main metrics.
Postive Cases as Percent of Overall Population
Overall Tests as Percent of Overall Population
Positive Cases as Percent of Overall Tests
Frequently Asked Questions
Where are COVID-19 cases occurring in Lebanon County?
The state began releasing ZIP-level date on April 20 and intends to update this dataset daily. We now include it in the main update above. Some ZIP codes are missing at this point and the DOH says they are working on including them. Previously, the DOH had declined to share ZIP code level data, citing HIPAA concerns. LebTown editorialized on this issue and questioned the applicability of HIPAA in this regard. In April the state also presented counties with an offer for specific addresses (but not names) of COVID-19 patients to be shared with 911 centers, but Lebanon County has declined so far to enter that agreement, citing concerns shared by the County Commissioners Association of Pennsylvania that the agreement exposes the county to undue liability. Lancaster Newspapers has reported that the Lancaster County Commissioners share this view as well. In any event, that agreement, if ratified, would prevent county officials from sharing the data with the public.
How does Lebanon County look compared to other counties?
This is a complicated question and there’s no one answer to it. In our primary daily update, we track a few specific ratios:
- Postive Cases as Percent of Overall Population
- Overall Tests as Percent of Overall Population
- Positive Cases as Percent of Overall Tests
In general, Lebanon County will be doing well if we can continue to increase #1 while holding steady with #2. In that scenario, #3 would necessarily go down.
How does the state define a COVID-19 case?
Initially cases were only listed by the state if a positive test had been recorded. In April, the state began including probable cases as well. Here is how the state defines probable cases:
- Appropriate symptoms of COVID-19 and exposed to a high-risk scenario
- A positive antibody test and either symptoms or a high-risk exposure
- A fatal case with no known test result, but COVID-19 named as either the primary or a contributing cause of death
Probable cases were counted in the overall death count for some time, but the DOH reversed course on that decision. Additionally, positive antibody, or serology, tests are also being counted towards the positive case count. The state does not include negative antibody tests in its negative case data.
How many tests have been done in Lebanon County?
This is a complicated question. The state does not track, at least publicly, the total number of outstanding tests at the county level. WellSpan Health began disclosing hospital-specific data related to COVID-19 testing and treatment on April 22 and we include this information in our daily update above. One complication here is that just because a test was administered in a specific county, does not mean that the person who received the test resides in that same county. However the state has recently added the number of negative tests to its county-level data. By adding the negative tests number with the total cases number, we can estimate the total number of tests taken by Lebanon County residents, although this figure should be seen as a proxy and not an absolute or highly precise measure.
How many people have recovered from COVID-19?
The state began reporting a recovery count in late May and we have begun including this figure in our daily tracker updates.
How can Lebanon County and the Department of Health have two different numbers for COVID-19 deaths?
The Department of Health has said that fatal cases which are not reported through the state’s electronic system may not be captured in the official counts. Likewise, cases reported directly to the state may not also be reported to the county coroner. Read more on this subject in our article with Lebanon County Coroner Dr. Jeffery Yocum here. Additionally, the state and county have different criteria for registering a death – the state counts a death if the deceased tested positive for COVID-19 at the time of their death, whereas the county counts a death if COVID-19 symptoms were the primary cause of death.
How did you select which ZIP codes to list?
Some local ZIP codes include land in other counties as well as in Lebanon County. To be comprehensive we have included any ZIP code that falls even partly inside county lines. Note that Ono (17077), Quentin (17083), Rexmont (17085), and Schaefferstown (17088) are still not present in the source data.
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Full Disclosure: WellSpan Health and the Lebanon Valley Chamber of Commerce are advertisers on LebTown. LebTown does not make editorial decisions based on advertising relationships and advertisers do not receive special editorial treatment. Learn more about advertising with LebTown here.