Philly COVID-19 cases trend downward as city debuts new breakthrough case dataset

After a few weeks of increased concern caused by the delta variant of the coronavirus,  COVID-19 cases are finally starting to trend downward in the city, Philadelphia public health officials say. As of Tuesday, the city is averaging 250 new cases per day, down from a recent high of 313 per day on Sept. 4.

“Only about 4% of the test results we’re receiving are positive, which is a good sign that we’re catching most of the virus that’s circulating,” Acting Health Commissioner Dr. Cheryl Bettigole said at a press conference Wednesday.

The city also is making good progress in its vaccination effort, Bettigole said: 1,025,296 Philadelphians, or 82.6% of adults, have received at least one dose of a COVID-19 vaccine. Now fully vaccinated are 841,921 Philadelphians, representing 67.8% of adults in the city.

Among children ages 12 to 17, 45,349 have received at least one dose, Bettgole said, noting that effort was showing “steady progress.”

Despite the positive news, health officials plan to keep a sharp eye on the city’s hospitalization numbers in the coming weeks. Because data on hospitalizations and deaths lags behind case numbers, making predictions can be difficult. Yet Bettigole is optimistic.

“I’m still feeling reasonably confident that we’re not going to see a sharp rise in hospitalizations, unless our case rate goes up a lot,” she said.

On Wednesday, Philadelphia debuted a new dataset with detailed information on breakthrough cases, hospitalizations, and deaths. Bettigole said the new data, offering a month-by-month breakdown, tells an important story about the efficacy of the vaccine.

“Ninety-six point five percent of people who’ve been hospitalized for COVID in Philly weren’t vaccinated, and 98.2% of the 1,184 Philadelphians who have died from COVID this year were not vaccinated — these vaccines work,” Bettigole said.

The data shows that the overall number of cases, hospitalizations, and deaths has dropped sharply as more Philadelphians get the jab, she said. Since January, less than 5% of all cases of COVID-19 in the city have been among those who were fully vaccinated.

“I believe that our high vaccine rate is why we’re not seeing all of the cases, the overfilled hospitals, and the deaths that other states with lower vaccine rates are seeing,” Bettigole said.

Preparing for pushback from vaccine opponents, Bettigole said she did not want the public to “misunderstand” the data. She proposed a thought experiment in which 80% of people in a group were vaccinated.

If the vaccine were ineffective, she said, vaccinated people would make up 80% of hospitalizations, which is not the case in the real world. Bettigole pointed to national studies that show the risk of hospitalization is about 10 times higher among people who are unvaccinated than in those who are.

“For example, here in Philly, in August, a total of 343 people were hospitalized because of COVID. Sixty-six of them had been fully vaccinated, 277 had not. So that means that about 80% of hospitalizations were among those not yet fully vaccinated, while only about 20% of the hospitalizations were among the roughly 80% of Philadelphians who were vaccinated. The math works, and so do the vaccines,” Bettigole said.

Testing issues

In recent weeks, with the delta variant surging, some say they have found it increasingly difficult to find appointments for COVID-19 tests. Philadelphia health officials have heard complaints from residents, but Bettigole said Wednesday that there still appears to be some testing capacity left.

“We are anticipating that demand to go up, which is why we were reaching out to make sure capacity is there. There should be scalability from what we’re hearing from the various testing providers around the city,” Bettigole said. She noted that the city still has its online information hub available.

Schools and COVID

Regarding efforts to keep schools safe and open, Bettigole said the city has a different threshold for each type of learning setting. The Department of Public Health looks at a variety of factors, such as school or classroom size and whether cases are isolated to single classrooms, grades, or random students.

So far, she said, one Philadelphia public school and two charter schools have had to be put on pause this academic year.

“We are looking at our criteria almost daily, just trying to make sure that what we do is consistent with the CDC, makes sense for the situation here in Philly, is both safe and designed to keep kids learning. It’s something we’re discussing constantly, so there may be changes in the guidelines going forward,” Bettigole said.

School has only been in session for a short period, so transmission data within schools is not complete. However, Bettigole said that most transmission appears to be happening at home.

There has been a “small amount” of in-school spread, Bettigole said, but she believes the path to keeping kids safe starts at home. If that doesn’t happen, expect more school closures, she said.

“The best way to avoid that situation is to layer on as many protections as we can. With everyone who’s eligible to be vaccinated, masks on throughout the school day, and hygiene, and contact tracing, and parents cooperating with isolation and quarantine, we can slow down the spread of the virus and we can keep our schools open, but that takes a partnership across the city,” Bettigole said.