With the continued rise of Covid-19 cases in Philadelphia, Health Commissioner Dr. Thomas Farley cautioned that further increases are anticipated as the city enters “a difficult, dangerous period of this epidemic — possibly the worst period of the entire epidemic.”

 “The risk is increasing now with the colder weather, the drier air and more people being indoors,” said Dr. Farley at Tuesday’s Covid-19 update press conference, describing what he called the fall-winter surge. “It appears that this virus, Covid, is following the same pattern as other respiratory viruses like influenza: rise throughout the fall and peak typically in January and February.”

 For Friday, 356 confirmed cases were reported by the Philadelphia Department of Public Health. Each day this week saw daily case counts well over 300 per day. For the week that ended on October 24, the city averaged 296 confirmed cases per day — the highest since the first week of May. For the week prior, the average was 205 cases per day.

The percent of people testing positive is still increasing. Last week’s positivity rate reached 7.2% — the highest since the first week of June.

The rise in cases is being seen in every age group, every racial and ethnic group, and every zip code in the city. The total number of cases in Philadelphia since the beginning of the epidemic is 44,027 and the total number of deaths is 1,875. In Friday, seven deaths were announced. Pennsylvania and the county as a whole are experiencing all-time highs in daily case counts.

 As rising cases point to increased hospitalizations, the city will be watching hospital capacity and hospitalizations and deaths, not just daily cases counts, will impact the city’s policy decisions Farley said.

Philadelphia has averaged about 10 deaths per week over the last few weeks and an increase in deaths has not been tied to this recent surge in cases yet.

“One positive change we’ve seen since the beginning of the epidemic is that we are seeing fewer deaths for every case identified than we did early on in the spring,” said Dr. Farley.

In the spring, there was about one death for every 15 cases. In August and September, there was about one death for every 60 cases.

One reason is that increased testing has identified people with mild or no symptoms as being positive for the infection. This category of people was not being tested back in the spring. Younger people are also increasingly among those testing positive and are not falling as severely ill. According to Farley however, even with those hospitalized with a severe infection, “mortality rate appears to be going down.” He attributed this to improved treatment, better tools, medication and familiarity with the virus.

Farley does expect an increase of deaths in the next 1-2 weeks as a result of the current rapid rise in cases. On Tuesday, the city announced it will be stepping up safety precautions, but Dr. Farley did not elaborate beyond emphasizing expanded testing, protecting vulnerable communities and shifting contact tracing efforts and capacity to the patients themselves. 

The most recent recommendation is to cancel all family gatherings and social get-togethers over the holiday season.

“Much of the surge will happen before the vaccine arrives,” said Farley, adding that following safety guidelines, wearing masks and limiting social gatherings are critical over the next few months, for the holiday season and into next year.