Somerset County has Maryland's top COVID-19 positivity rate. Where cases are coming from

Rose Velazquez
Salisbury Daily Times

Somerset County is home to one of Maryland's smallest populations, yet the community has held the state's highest COVID-19 positivity rate for more than a week straight.

That metric has been above 10% for the county for almost two weeks now, and has been well above the Maryland rate since Nov. 1. It sits at 19.48% compared to a statewide positivity rate of 8%, as of Friday, Dec. 4.

Maryland's positivity rate is a seven-day rolling average of the daily positivity percentage, which is calculated using the total number of tests reported to the Maryland Department of Health versus the number that are positive.

Somerset County is one of five Maryland jurisdictions with a positivity rate above 10% and nine jurisdictions with a rate above that of the state.

More than half of the counties with rates greater than the state's are on the Eastern Shore as of Friday morning, and Somerset and Queen Anne's counties are the only two in the region with rates that exceed 10%.

Somerset gained 480 cases in November, with more than 5,200 tests administered to residents throughout the month. More than half of those new cases were among inmates at Eastern Correctional Institution in Westover. 

About 95% of those inmate cases were reported in the last two weeks of November. While the prison is responsible for much of the county's active cases at the moment, it's not the only factor that's contributed to the county's growing case numbers across the pandemic.

Spikes in nursing home cases, for example, in late October and early November — before cases began to climb dramatically among ECI inmates — have also coincided with elevated positivity.

Testing has increased significantly in Somerset compared to the earlier months of the pandemic. However, there were almost 10% fewer tests administered in November compared to October, even though there were almost three times as many cases reported for November.

Even without the inmate cases factored in, new cases for the rest of the county were approximately 42% higher for November than in October.

Where are the cases?

There are six ZIP codes exclusively in Somerset County where at least eight COVID-19 cases have been identified among residents.

The Maryland Department of Health only reports data for ZIP codes that have had eight or more people test positive for the virus.

Those ZIP codes are home to a combined 1,076 cases — approximately 95% of the county's overall infections.

The bulk of those infections — nearly 42% — are from the 21890 ZIP code that covers only Eastern Correctional Institution.

Here's the breakdown:

  • 21817 (Crisfield) - 172
  • 21821 (Deal Island) - 15
  • 21838 (Marion Station) - 44
  • 21853 (Princess Anne) - 355
  • 21871 (Westover) - 39
  • 21890 (Westover - ECI) - 451

ECI is considered Maryland's largest prison. A fiscal 2019 report put the average daily population for the medium security east and west wings at just over 3,300 inmates.

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The annex, which is for minimum security and pre-release inmates, had 608 beds. The average daily population for pre-release was 170 inmates.

As of Wednesday, Dec. 2, Maryland Department of Health data showed an overall 542 COVID-19 cases associated with correctional facilities in Somerset County:

  • 111 staff cases and 346 inmate cases for ECI
  • 18 staff cases and 86 inmate cases for the ECI annex
  • 1 staff case for the Eastern Pre-Release Unit

For comparison, the 21853 ZIP code for Princess Anne has more than twice the population of the main prison compound's average daily population, yet there are almost as many inmates as Princess Anne residents who have contracted the virus.

When did the COVID-19 positivity rate start spiking?

By the top of August, Somerset County was consistently seeing a weekly volume of at least 500 tests administered.

The county's rolling positivity rate at the time was below that of the state: 4.02% compared to 4.6%. Its low for August was 1.08%.

The county level metric remained on a track of staying well below the statewide rolling average until the latter half of the month.

It spiked above the Maryland positivity rate for nine days starting Aug. 19, and at its highest point during that time reached 5.93% next to a statewide average of 3.23%.

That nine-day period coupled with the seven days prior saw Somerset County gain 46 COVID-19 cases, an increase of more than 32%. Cases statewide for that same period of a little more than two weeks increased by about 9%.

There had yet to be large numbers of cases associated with ECI. The prison reported an additional four staff cases over this time period, but no change in the number of inmates infected, which stayed around five.

The largest portion of that 46-case increase came out of the 21817 ZIP code for Crisfield and 21853 ZIP code for Princess Anne. They added 19 cases and 18 cases, respectively.

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That included two new cases associated with the Alice B. Tawes Nursing and Rehabilitation Center in Crisfield and one case connected to the Manokin Center for Rehabilitation and Healthcare in Princess Anne.

The Somerset County positivity rate came back down by Aug. 28, and remained below the state's seven-day average for almost a month, falling as low as .9% at one point.

It started to surpass the Maryland positivity rate again Sept. 22, at about the same time that case numbers started to see a sharp uptick in the county's long-term care facilities.

In the last two weeks of September, the case count at Crisfield's Manokin Center for Rehabilitation and Healthcare grew from six infections to 37 — another seven staff members and 22 residents had tested positive for the novel virus.

The county's positivity rate remained consistently elevated through Oct. 26. Its highest point for this period was 6.2% in comparison to a statewide rolling average of 3.2%.

The Manokin Center for Rehabilitation and Healthcare had reached 14 staff members and 29 residents infected over this stretch of a little more than 30 days. The Alice B. Tawes Nursing and Rehabilitation Center gained 10 staff cases and 25 resident cases.

This was also when cases started to spike among staff at ECI.

The first COVID-19 case at ECI was identified in a staff member in April. Since then, any weekly gains in positive test results for the facility were in the single digits, until the week of Oct. 21.

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Between Oct. 14 and Oct. 21, the number of prison staff who had tested positive for the novel virus grew by roughly 67% from 27 to 45.

Inmate cases remained low at no more than 10 by the end of October, but another seven ECI staff members were positive for the virus as of Oct. 28.

Though the Somerset positivity rate fell below that of the state Oct. 27, that shift lasted less than a week later. The spike picked up again Nov. 1, and the seven-day average has been elevated ever since.

On Nov. 12, it reached 10% for the first time since the county had started recording at least 500 tests administered a week. That was just before large numbers of ECI inmates started testing positive for the virus, but the county consistently started to see at least 40 new cases reported each week around that time.

Then, the final two weeks of November saw 241 inmate cases added for ECI. There were also at least 23 new infections among staff, who travel between their home communities and the prison.

The prison accounts for a significant number of the Somerset cases identified during this time, but there were also another 162 infections from other parts of the county.

Cases reported in that two-week period for the rest of the county were almost equal to what was added to Somerset's tally of infections throughout all of October.

Somerset County's highest positivity since this surge in cases began was calculated for Dec. 1 at 23.39%. The statewide average at that time was 7.51%.

Where can Somerset residents get tested?

The Somerset County Health Department has three testing opportunities scheduled for the upcoming week.

Testing will be conducted inside the Washington High School gym at 10902 Old Princess Anne Road. These are the dates and times:

  • Monday, Dec. 7, 12:30 p.m.-3:30 p.m.
  • Tuesday, Dec. 8, 9 a.m.-noon
  • Friday, Dec. 11, 12:30 p.m.-3:30 p.m.

Appointments are not needed for these walk-up testing events, and masks must be worn at all times.