ITHACA, N.Y.— Despite being one of the most populated counties in the Southern Tier region, Tompkins County has had zero COVID-19 related local deaths, a trend officials are attributing to Tompkins’ early response to the virus, a smaller population over 65 and an earlier build-out of testing capabilities compared with other counties in the region.

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County-reported data from each county in the region analyzed by The Ithaca Voice showed that, of the five counties in the region hit hardest by COVID-19 — Broome, Steuben, Chenango, Chautauqua and Tompkins — Tompkins is the only county to have reported no local deaths. (Two deaths that were reported by the county were New York City residents who were transferred to Tompkins to be closer to family.)

Doug MacQueen, Chair of Infection Prevention for Cayuga Health System, said there are a few possibilities why Tompkins County has lower COVID-19 cases and deaths than other counties in the region.

“Early on I think we provided people with better access to testing than a lot of other areas in upstate New York were able to offer,” MacQueen said. “People were aware of their status of being infected early on, and we were able to be in coordination with the county and Cayuga Health partners who followed up with those patients at home.”

Tompkins County Public Health Director Frank Kruppa said that early testing and effective contact tracing helped the county slow the spread of the virus.

“It started with our team’s ability to do case investigations and contact tracing to limit exposures to the community,” Kruppa said. “I think our community has been amazing in their willingness to hear the guidance that we provided and change behavior, which played a role in why we see low incidents of COVID-19 in our community.”

Tompkins County issued its first COVID-19 advisory in late January, noting that risk was low at the time, but that residents should visit a doctor if they are experiencing symptoms. Broome County, which is double the population of Tompkins and has had more than four times the number of confirmed cases, issued their first advisory in early March. Steuben County, a county with a similar population and higher COVID-19 case number than Tompkins, issued its first advisory in early February.

Broome and Steuben have both had more confirmed cases of COVID-19 and more COVID-19-related deaths than Tompkins County. Tompkins opened a drive-through testing facility on March 24, a month before Broome County’s facility opened, and a month and a half before Steuben’s opened. MacQueen said that Tompkins County had, and still has patients from other counties coming into Tompkins for testing.

Both MacQueen and Kruppa say we may never know specifically why Tompkins County has had significantly less COVID-19 cases and deaths than other largely-populated counties. Aside from early testing, MacQueen says that one possibility is the county’s early treatment of nursing home patients.

“Early on, Cayuga Health Systems was testing nursing home employees in our area for COVID-19 infections and also testing nursing home patients, so those testing capabilities that we had early on may have helped,” MacQueen said.

Officials in both Broome County, which has had 53 COVID-19 related deaths, and Steuben County, which has had 42 COVID-19 related deaths, say that nursing homes were a hotspot for the virus spreading.

“We were at the height of our own apex in early April. Honestly, a lot of that was due to our nursing home situation. It was a very difficult time for us,” said Darlene Smith, Steuben County Public Health Director.

Broome County Executive Jason Garnar confirmed that 70% to 75% of Broome’s confirmed COVID-19 cases were in care settings.

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People who are age 65 or older make up 19% of Broome County’s population and 20% of Steuben County, while making up 15% of Tompkins County, according to the census. According to a July 11 release from New York State, nursing home patients accounted for 39 of the 53 COVID-19 related deaths in Broome County. In Steuben County, 12 of the 42 deaths were nursing home patients.

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At time of publication, Tompkins County has seventeen confirmed active cases, with 58 results pending. There has been a spike of newly confirmed active cases in the past week, which the Tompkins County Health Department attributed to out of state travel and local gatherings over the Fourth of July holiday weekend.

Tompkins County Public Health Director Frank Kruppa said that residents need to continue taking social distancing seriously.

“Look around the country. You can see cases rising in places that have reopened,” Kruppa said. “We’re not out of the woods yet, and we still need to be vigilant in taking those precautions.”

MacQueen said that he’s anticipating an increase in cases for Tompkins County in the fall.

“We are prepared for and anticipating that we’ll have more cases throughout the summer and then significantly into the fall,” MacQueen said. “Currently, the cases here are in residents from our area who have traveled to other states, become infected and returned here with COVID-19. If you are young and healthy and become infected, it may not make you sick, but it could be deadly for someone you care about.”