'Scared to death': Looking back at the first COVID-19 cases in the Philly suburbs
COVID: Then and Now
PHILADELPHIA (KYW Newsradio) — It's hard to recall a time before social distancing and mask-wearing were commonplace. Exactly one year ago, COVID-19 was still a relatively unknown disease that was infiltrating the U.S. case by case, state by state.
One of the first cases in Pennsylvania was in Delaware County on March 6. A day later, Montgomery County reported its first two cases.
"Within a few days, we had more cases," recalled Montgomery County Commissioner Dr. Val Arkoosh. "It became clear pretty quickly that all of these individuals had traveled to someplace where there was an outbreak."
One individual, a doctor at CHOP in King of Prussia, had traveled with his family to Egypt. The doctor continued to see patients when he returned.
"And that led to a very rapid escalation in our county in just a few short weeks," Arkoosh said. "We had quite a few cases."
Arkoosh, a physician with a background in public health, knew from the size of the lockdown in China that this disease was far more severe than initially imagined.
"My assumption from the beginning was this was way more serious than they were letting on. Because I just couldn't believe they had locked down to the extent that they did that whole area."
Arkoosh said Montgomery County implemented contact tracing right away. They charted the spread and watched one person infect another, who in turn attended a social gathering and infected many more.
"And just seeing that happen, that literally before our eyes, over like an eight or 10-day period was the most sobering thing I think I've ever seen as a physician," she said. "I realized then the potential for this virus to spread — and spread so fast."
With the county's contract tracing, health officials thought there was asymptomatic spread early on.
"It was constant, seven days a week, trying to understand what was going on. Trying to reconcile data we were seeing from contact tracing and what we were getting from CDC and WHO and having them not quite make sense. Like this issue of asymptomatic spread. We were certain we were seeing it."
The broader availability of coronavirus testing quickly confirmed it.
Arkoosh said it was all hands on deck, even before the first cases. They met early on with the Montgomery County departments of Public Health, IT, Human Resources and Public Safety, "blowing the dust off pandemic preparedness plans."
More than a week before the first COVID-19 cases, there was a two-hour meeting with school superintendents. "And thank goodness because some of our very first cases — not the first but close to the first — involved school students."
Arkoosh blocked off time each day to read everything that was published about COVID-19, especially out of Italy, China and New York City.
"We shut down fast and we shut down hard," she remembered, adding it wasn't hard to convince people to do so. "I think people were nervous. I think people saw what was happening in Italy, in New York especially, and they saw the hospitals being overwhelmed and they saw how many people were dying. People were scared to death."
Any doubt that it could have been worse was erased in the late fall when cases spiked after Halloween, resulting in a large number of deaths — even though people knew significantly more about the virus by that point.
Arkoosh and her team didn't sleep much during those first few weeks as they tried to assess the situation.
"We were also fairly certain there was a likelihood of respiratory spread greater than was initially appreciated. And remember the mask mandate didn't start until April 16 or 17, so we went for weeks without a mask mandate. Of course, we didn't have any masks even if we wanted to wear a mask.
"Everyone understood that hospital workers needed them. You recall, they were so, so scarce. We would have people donate masks to our Department of Public Safety and literally, we would turn them out that day. We would take them to our hospitals and our nursing homes. They were desperate for masks."
Arkoosh noted it's easy to second-guess their decisions considering everything we know now, but she wishes masks would have been recommended sooner.
"And if I had one thing I could do-over, I wish we'd had that knowledge from day one. We could have encouraged people to wear masks immediately right out of the gate. I think that would have made a big difference."
The county was faced with some difficult decisions, but in retrospect, Arkoosh said they weren't as strict then as they would be now.
"It would almost be a harder decision to make today knowing what I know now than it was then. Because when I was making that decision then, I really thought, OK, we kind of had a sense of the life cycle of an infection in any given person. We close for two weeks, maybe three, maybe on the outside of four, and then we should be able to open the schools back up again.
"I don't think any of us ever really understood we would not be able to open the schools for the rest of the year — and well into this year."
COVID: Then and Now is a KYW Newsradio original monthlong series looking back at the early stages of the coronavirus pandemic in Philadelphia. Reporters revisit the news from exactly one year ago and examine how protocols, restrictions and science have evolved since then. Check back weekdays in March for more.
