2 test positive in Allegheny County
Allegheny County officials on Saturday announced the detection of the first two positive cases of COVID-19, coming a day after the first case in southwestern Pennsylvania was discovered in Washington County.
The Allegheny County cases are two adults — one in their 60s and the other in their 70s — who live in the same home in Pittsburgh, the county said, and their exposure is believed to be travel-related. Both are in isolation in their home.
Despite now having three cases in the region, neither Allegheny County’s newly appointed health department director, Dr. Debra Bogen, nor the county’s lead medical epidemiologist, Dr. Kristen Mertz, wanted to repeat a local version of the CDC’s national prediction three weeks ago that it was “not a matter of if, but when” the country would have community spread of the disease.
“So far, we don’t have any evidence of community spread,” said Dr. Mertz. “It’s not to say it’s impossible, but we have not seen clusters of unexplained pneumonia. We haven’t had any positives except for these two [in Allegheny County], and it was acquired out-of-state.”
While the two local cases are landmark moments for the county, they are not yet enough to trigger the county health department’s broad power to impose lockdown restrictions countywide, as has been done already in some parts of the county.
County Solicitor Andrew Szefi said Saturday the county does have authority to order such measures — closing schools, theaters, even places of worship — to avoid large gatherings under the Local Health Administration Act under a section on “abating of nuisances.”
But we’re not there yet, he said. “Pretty much because we’re not at the point of community spread at this point because the two cases we have are known travel-related, we’re not at the point yet where that authority would be triggered legally,” he said. “If we ever do get there, you know, we’re obviously prepared to undertake that.”
When there is a case of community spread — meaning a person is believed to have acquired the disease from someone in the community, not from out of the region or state — that would change, he said.
And when it does, he said: “What we’re going to do is consult with medical experts to determine whether we think action ... would be appropriate.”
The cases of the two Pittsburgh residents who tested positive are classified as “confirmed” cases of
COVID-19, even though their tests were only tested once and not confirmed by the federal Centers for Disease Control and Prevention’s lab in Atlanta, which has to confirm any state lab test. That’s because their tests were performed by a commercial lab initially, not the state lab.
The two people who are confirmed with COVID-19 “did exactly what we’re recommending” when someone suspects they might be infected with the disease, said Dr. Thomas Campbell, Allegheny Health Network’s chair of emergency medicine.
They did not go to a doctor’s office, an urgent care center or an emergency room.
Instead, they first called their primary care physician, who evaluated them over the phone, and then was prepared for them when they came to the office to get tested by staff, who were properly protected.
Their samples were taken at the doctor’s office earlier this week. When they came back positive Friday, the two people were directed by their doctor to call ahead to AHN’s West Penn Hospital and visit its emergency department, where staff were again prepared for them when they arrived.
They were both evaluated later Friday and discharged home, where they self-isolated, though the county also is drawing up a more formal isolation order for them, Dr. Mertz said.
The isolation order, however, will not involve any formal security presence to ensure that they stay in their home. But if they violate the order and leave their home, the county can then enforce the order, she said.
After that, the county began a “contact tracing” effort to track down anyone they may have had close contact with since they returned from the affected area where they acquired the disease.
Based on what she knows about the travels of the two people, Dr. Mertz said the tracing work should not be particularly difficult.
If the county finds anyone who came into close contact with the couple locally, those people can then formally be quarantined, even if they are not showing symptoms.
The county said it has ordered testing through the state lab of 26 people so far during the outbreak. But it does not know how many more people have been tested by commercial labs, like the two people who had positive results.
“While at this time there is no evidence of community spread in Allegheny County, the health department anticipates additional local cases in the coming days,” Dr. Bogen said.