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This illustration, created at the Centers for Disease Control and Prevention, reveals the structure of the novel coronavirus. The illness caused by this virus is COVID-19.

An early surge in the Philadelphia region. Summer spikes in Pittsburgh and the west. And localized flare-ups in smaller, scattered counties along the way.

The coronavirus has cast its eerie spotlight on various parts of the Keystone State at different times as the pandemic has ground on, with localized rates rising and falling and sometimes rising again.

But more than five months after Pennsylvania’s first diagnosed cases of COVID-19, the large eastern counties hit fast and hard in the early going still claim the state’s highest cumulative rates of COVID-19 cases, an LNP | LancasterOnline analysis shows.

In 11 eastern counties, including Lancaster, more than 1% of the population has tested positive for the virus so far, according to the analysis of Department of Health data and 2019 Census estimates.

Most of those 11 counties also rank high in the portion of their population tested (9% to 13%) and in their overall rates of tests that came back positive (9% to 14%).

Philadelphia tops the list for overall rate of cases, with 27,177 cases as of Thursday. That translates to 1,716 cases per 100,000 people, or 1.7% of the population. Looked at another way: One in every 58 people in Philadelphia has had a confirmed case of COVID-19.

The least-scathed county in the state is rural Warren, in the northwest corner, with only 22 cases of COVID-19 so far. That translates to 56 cases per 100,000 people, or a rate only one-thirtieth of Philadelphia’s. In Warren County, only one in every 700 people has had a confirmed case of COVID-19.

Dense populations

Nate Wardle, a spokesman for the state Department of Health, noted that while “COVID-19 does not discriminate” and has spread to every county, “from the beginning, the eastern part of the state has been hit hardest by this outbreak.

“As with most communicable diseases, large populations centers are more likely to be affected, and so it is not surprising to see the largest effects in the more populous counties” in the southeast.

Many of the hardest hit counties have been trending better recently, Wardle said, but “population density certainly plays a significant role in this.

“With the flu, we often see it occur in counties with higher populations because of how easily it can spread. This disease is even more transmissible, so population density absolutely plays a role.”

Statewide, the rate was 954 per 100,000, reflecting the fact that many of the counties with the highest per-capita rates are also among the state’s most populous. The county with the median rate is Erie, at 431 cases per 100,000. Thirty-three counties had higher rates than Erie and 33 had lower rates.

Ranked list of counties

Here are all 67 Pennsylvania counties ranked by overall rates, showing total cases and the rate per 100,000 population:

COUNTYTOTAL CASESCASES PER 100,000 POP.
Philadelphia27,1771,716
Delaware9,4961,676
Lehigh5,0361,364
Northampton3,9821,304
Berks5,4911,304
Montgomery10,2641,235
Bucks7,3181,165
Lebanon1,6321,151
Luzerne3,5531,119
Lancaster6,0991,118
Dauphin2,9141,047
Chester5,213993
Monroe1,655972
Pike527944
Lackawanna1,952931
Franklin1,393899
Beaver1,374838
Allegheny9,192756
Columbia483743
Huntingdon313693
Schuylkill930658
Union276614
York2,751613
Carbon379591
Montour106581
Northumberland524577
Juniata135545
Susquehanna218541
Cumberland1,339528
Adams539523
Lawrence414484
Fayette595460
Westmoreland1,586455
Erie1,163431
Mercer468428
Washington880425
Indiana343408
Butler707376
Lycoming426376
Armstrong237366
Greene121334
Clinton125324
Wayne162315
Bedford 145303
Snyder113280
Perry128277
Cambria353271
Mifflin123267
Blair304250
Centre380234
Wyoming62231
Clearfield182230
Clarion84219
Fulton28193
Crawford161190
Somerset138188
Elk54181
Cameron8180
Jefferson75173
Sullivan10165
Forest11152
Bradford91151
Venango67132
Potter20121
Tioga4099
McKean3484
Warren2256
PENNSYLVANIA122,121954

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