The local hospital had long since taken down the coronavirus triage tent it erected during the pandemic’s first wave. County schools were reopening, grade by grade, and had made it to the fifth graders. The public university had some in-person classes, and people still could attend some local government meetings.
But in the space of several weeks, Allegany County went from relatively low levels of COVID-19 cases to now Maryland’s highest rate of infection.
In Maryland’s lightly populated western panhandle, closer to Pittsburgh than to Baltimore, Allegany had a seven-day average case rate at the end of the week of more than 145 per 100,000 people, far above the statewide average 35 cases per 100,000, state data showed.
The rise was swift, with the county going from fewer than 750 cumulative cases Oct. 28 to more than 1,900, shaking many out of a comfort zone that developed earlier in the pandemic, when relatively few had contracted the illness.
“I think what happened is we got lulled into a false sense of security,” Cumberland Mayor Raymond M. Morriss said. “People became a little complacent and started to socialize more.”
Why Allegany, with a population of about 70,000, has been hit so hard by the virus is unclear, although it comes at a time when COVID-19 is spreading rapidly across much of the country. Midwestern and Plains states that previously escaped large numbers of cases are engulfed by waves of them. Other states, including Maryland, that had seen cases peak earlier in the pandemic are facing a resurgence.
While largely rural and remote — one in four acres of the county is public land, making it a favorite of hikers, bicyclists and kayakers — Allegany has its share of places where people live in the kind of close quarters where the virus spreads easily. It is home to Frostburg State University, state and federal prisons, and several nursing homes, where many of the county’s earlier cases emerged.
Allegany’s neighbors, Garrett and Washington counties, also have seen increases, although not as dramatically, with 97 and 48 COVID cases per 100,000 population, respectively.
Some point to pockets of resistance to mask-wearing and social distancing as perhaps contributing to the spread in Western Maryland.
Calling rural areas, “particularly Allegany and Garrett” counties, “our absolute worst” for rising infection rates, Gov. Larry Hogan said Tuesday that perhaps some residents in those areas “weren’t being as careful” and “maybe not wearing masks and not following advice.”
“And now they’re calling us, begging us for help,” the Republican governor said at a Tuesday news conference at which he announced new statewide restrictions. “We’re trying to move patients out of their overflowing hospitals.”
Some in Allegany acknowledge that, like anywhere, there are those loath to mask up and socially distance. Others say the behavior of residents alone isn’t to blame. They say their region can be ignored by officials “downstate,” a catchall term for the more populated central part of Maryland, and note it was among the few locales without a state testing site until recently.
What is clear is that the virus has taken root in the community.
“We’ve been very careful," said the Rev. Martha Macgill, rector of Emmanuel Episcopal Church in Cumberland. “You don’t want your church to have a spreader event.”
Earlier this month, her friend and fellow priest, the Rev. Dr. Marsha Bell, fell ill with COVID, Macgill said. Bell is now recovering at home. But the priests and their husbands had formed a social “pod” over the course of the pandemic, and the other three tested positive, as well.
Macgill said her case was mild, but the church is now closed to in-person visits for the rest of the month. As “an essential spiritual worker,” she is offering sermons and prayers online.
None of the roughly 30 people who attended Nov. 1 services at which Bell officiated, nor those at a church event she was at later that day, are believed to have been infected, Macgill said.
Much of the county, having lifted some restrictions, is retrenching.
UPMC Western Maryland in Cumberland, a hospital in the University of Pittsburgh Medical Center system, brought back its triage tent. Government buildings retightened restrictions on visitors. And schools that had some in-person instruction have gone all-virtual.
Allegany schools began the academic year online, then began Sept. 21 to gradually return kids to classrooms. By the week of Nov. 2, with staff falling ill and others quarantining because of possible exposure, officials returned to fully virtual instruction the following week.
Frostburg State switched back and forth between hybrid and all-virtual instruction, too, ending the semester on the latter. It started the semester two weeks early, aiming to finish at what normally would be Thanksgiving break. In the two weeks ending Nov. 14, 73 students and staff tested positive. The school had a nearly 14% positivity rate of tests conducted on and off campus, the latter of which doesn’t include every negative result.
The university required that students and staff coming to campus be tested at the start of the academic year and then again Sept. 21-23. It also tests a sample of students and staff every two weeks.
Jasmine Bonomolo, 20, a junior, is recovering from COVID-19 but feels let down by the school. When she developed symptoms, including a sore throat and cough, at the end of October, she said she was told to get tested off campus rather than at the campus health center.
Then, Bonomolo said, she isolated herself in her dorm, where she is a resident assistant. She thought she should go to a hotel where the school had rooms for quarantining, but was told the facility wasn’t equipped for someone with serious symptoms.
Going home was not an option, Bonomolo said, because her household in Dundalk includes an elderly person with existing medical conditions. She eventually did move to the hotel for about a week, but Bonomolo said the entire experience left her disillusioned.
“It’s a big slap in the face from a place I fell in love with as a junior in high school,” Bonomolo said.
Liz Medcalf, a Frostburg State spokeswoman, declined to comment on what happened to Bonomolo. She provided a statement issued to the student news organization, the Bottom Line, which covered Bonomolo’s ordeal. Frostburg State said its health center offers nonurgent care and handles minor cases, while referring serious ones elsewhere. The statement said a doctor has to review students with severe symptoms before they can go the quarantine hotel, in case they should instead be hospitalized.
Frostburg State also is under fire from some workers represented by the American Federation of State, County and Municipal Employees.
Blair Knouse, who manages the chemistry lab and is a member of AFSCME, said employees hear about cases not through official communications but via the grapevine, such as a worker saying, “So-and-so got sent home and they asked us to disinfect the break room kitchen.”
“Or you read between the lines,” Knouse said. “‘There will be no package deliveries.’”
Medcalf said the university doesn’t publicly identify the locations where someone has tested positive because of privacy concerns. Sometimes, only one person holds a particular job, and identifying where they work would reveal who it is.
Knouse said he is worried about what happens in the coming months, after students leave by Tuesday for winter break and return Jan. 25.
“The holiday season is going to be rough. People are going to want to see each other,” Knouse said. “They’re going to have to figure out how to bring people back safely.”
Frostburg State plans to begin the next semester with a hybrid model, but will monitor the course of the local COVID spread and adjust, if necessary.
“The virus is fully in charge,” Medcalf said.
AFSCME workers in area correctional facilities are worried, too. Cumberland has two maximum-security state prisons, the North Branch Correctional Institution with about 680 beds and the 1,800-bed Western Correctional Institution, and a Federal Correctional Institution.
“Once it’s in there, it’s an incubator,” said Jeff Grabstein, a correctional officer at North Branch.
According to the state, 106 inmates and 34 staff at North Branch and Western together had tested positive as of Monday. The union says the number is higher now.
At the medium-security federal prison, which has about 1,100 inmates, the U.S. Bureau of Prisons reports that two staff members and one inmate have contracted COVID.
Grabstein said he would favor more restrictions on how many inmates are allowed in the yard or on food service jobs at any one time to help prevent the spread. For now, Grabstein tries to be as safe as he can, wearing a mask and not going out to bars. When he visits his parents, he tries to sit outdoors at a safe distance.
With the surge of area cases still relatively recent, Republican state Del. Jason Buckel said he believes there has been a lag in data and information about the disease. He said he has been frustrated by a lack of information on where specifically in the county people have tested positive.
The county health department said the state has data at the ZIP code, nursing home and school level, although the latter did not appear to have any Allegany cases listed recently.
“We probably didn’t need it before,” Buckel said. “But that’s changed now.”
Health officials say that with COVID spreading throughout the country, no area is immune. Even a more remote locale such as Allegany has people moving in and out, such as Frostburg students going home for a weekend.
“It’s mobility, moving back and forth, that presents the greatest opportunity for transmission,” said Dr. Clifford Mitchell, director of the state health department’s environmental health bureau. “The virus does not respect borders.”
Mitchell said restrictions were initially more lax in Western Maryland, given its relatively lower rates earlier and the flexibility local jurisdictions have to order tougher restrictions than those set by the state. But now, those counties will need to ramp up with the rest of the state and country.
Allegany generally has followed the state’s guidelines on restricting capacities at restaurants and other gathering spaces, which Hogan recently set at 50%, but has not gone beyond them.
Local officials have welcomed a new free testing site that state and county health officials opened at the Allegany fairgrounds.
City and county officials wrote in an August letter to Hogan that with fall approaching, residents were concerned that they didn’t have a state testing site.
“It is important that our community members have access to testing,” they said. “We are respectfully requesting your consideration of establishing a testing site in Allegany County. We would be happy to work with your staff to find an appropriate location for the site.”
The state health department’s chief operating officer, Dennis R. Schrader, responded in an Aug. 27 letter that UPMC and two urgent care centers offered tests, and the county’s testing rate of more than 21% was the seventh-highest in the state. Additionally, he noted, residents were able to get tested at two public events in July, and at pharmacies and their health care providers.
“The current infrastructure of testing sites, which includes primary care providers, urgent care clinics and UPMC Western Maryland [the local hospital] is expected to be able to handle the volume of COVID-19 tests needed,” Schrader wrote.
Two months later, with cases soaring, the state moved to establish the test site.
“Allegany County was one of the ones who didn’t want any restrictions. Nobody wanted to wear masks,” Hogan said at a Nov. 5 news conference. “Now, they’re meeting about actions they might want to take in Allegany County and they’re reaching out to us for help.”
Hogan also said the state was working with the county on the fairgrounds testing site, which opened Nov. 11.
“We were pleased about that,” said Jacob C. Shade, president of the county commissioners. “The turnaround time was very quick.”
As case numbers have risen, more people are getting tested, which should help detect the virus in those without symptoms.
Cumberland Fire Chief Donald Dunn said the department had six confirmed cases, discovered after one firefighter got tested before traveling and came up positive prompting coworkers to be screened. Without a test, some might never have known they had the virus, he said.
“Especially this time of year,” Dunn said. “Everyone gets colds anyway.”
With winter approaching Western Maryland sooner than other parts of the state, many fear what’s to come.
While Hogan said rural hospitals are “overflowing,” UPMC Western Maryland said it believes it has the capacity to handle what may be in store because it is part of a 40-hospital system.
Nancy Adams, UPMC Western Maryland senior vice president and chief operating officer, would not say how many COVID patients the Cumberland hospital has. Adams said there were 156 cases earlier in the week at four hospitals in the region, which includes three in Pennsylvania. That works out to about one of every five beds at the facilities.
The Cumberland hospital is “working within our system to share resources, transfer patients and manage capacity,” she said.
“Our region has disproportionately higher numbers of patients hospitalized with COVID-19 than other regions UPMC serves,” Adams said. “We are currently seeing a higher number of cases than we did at our peak earlier this spring.”
Health officials say the advice for Allegany is the same as for the rest of the country as the winter holidays approach.
“Avoid gatherings, even though it may be difficult,” Jenelle Mayer, Allegany County’s health officer, said in a statement. “We need to protect the most vulnerable among us and slow the spread of COVID-19.”