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(This story was updated to fix incorrect information at 1:20 p.m. Friday).
Blair County this week set a record for daily COVID-19 cases, while the state Thursday set its fourth record in a week with 2,900 infections.
Blair County's count reached 80 on Sunday and Wednesday, then fell one short of that on Thursday -- the latest in a run of numbers higher than at any previous time in the pandemic.
The community spread that has been causing the rise locally is reflected in the positivity rate for symptomatic patients at UPMC's Pleasant Valley Boulevard test center, which for the past week was 25% — up from 16% for October and 6% in September, according to Dr. David Burwell chief quality control officer for UPMCs Altoona, Bedford, Somerset and Western Maryland.
The outbreak over the past month has led UPMC to put into practice elements of its COVID-19 plan, including the cohorting of patients in COVID-19 units and the addition of staff, Burwell said.
"(But) we are not overwhelmed," Burwell said.
Those recent moves exceeded what the system needed to do in the summer when it put into practice some "lower level" changes to accommodate a smaller spike, according to Burwell.
There are 288 COVID-19 inpatients throughout the UPMC system and 83 in the Altoona region, which comprises the hospitals that Burwell serves, Burwell said.
He declined to provide numbers for UPMC Altoona and UPMC Bedford Memorial in particular.
The mortality rate for COVID-19 infections at UPMC has gone down from earlier in the pandemic due to "a better clinical understanding" of the disease and the use of treatments like steroids and Remdesivir, Burwell said.
Steroids calm the body's inflammatory response to the virus, he said.
That response is designed to kill the virus, but it can cause problems with the lungs and other organs, according to Burwell.
Remdesivir, an antiviral, inhibits the coronavirus' ability to reproduce, shrinking viral loads and helping the body fight off the virus that remains, according to Burwell.
The percentage of patients who need intensive care and ventilator assistance is also down from earlier in the pandemic, Burwell said.
Some hospital employees have contracted COVID-19, but almost all of those infections have been acquired from out in the community, Burwell said.
When employees test positive, they isolate, in keeping with Centers for Disease Control and Prevention guidelines, he said.
UPMC employees have done a "phenomenal" job of following guidelines designed to prevent COVID-19 from spreading in the hospitals, Burwell said.
The hospital has continued to allow visitors for inpatients who don't have COVID-19, with the proper precautions required, because the organization believes such support is important for patients to achieve "clinical success," Burwell said.
The rise in community spread seems to be driven by small gatherings -- dinner parties, bridal showers, funerals, according to Burwell.
Whether COVID-19 numbers in the region continue to rise will probably depend on "how the community responds," Burwell said.
If people wear masks, keep their social distances, wash their hands and stay home when they're sick, the region may "see this peak and reduce and go downward," he said.
"If not, I don't know," he said.
"Folks do seem to be masking and following other protections in other communities," the doctor said.
There are places locally where "people take it very seriously," he said.
But there are also "pockets where they're over it," he said.
Those pockets seem to include people who think COVID-19 is a mere "belief," or people who may not have witnessed any personal evidence of the disease or who haven't felt personal impacts from it or who think it simply won't happen to them, he said.
"I can see why people are maybe fatigued," Burwell said. "(But) now is not the time (to let up)."
To eliminate the resistance to mitigation, he has been urging community leaders -- including school district and municipal officials -- to become role models for correct behavior.
That will be especially important with the holidays approaching, he said.
The doctor's message for Thanksgiving, Christmas, Hanukkah, Kwanzaa and New Year's is the same message recently delivered by state Health Secretary Dr. Rachel Levine: Restrict your in-person events to the members of your own household.
Celebrations that involve others should be "virtual," Burwell said.