Rural South Jersey spared from coronavirus so far. But lack of testing could be to blame.

PNC Testing Site

A New Jersey State Police trooper guards the entrance of the coronavirus drive-through testing site at PNC Bank Arts Center in Holmdel on March 23, 2020. Noah K. Murray | For NJ AdvanceNoah K. Murray | NJ Advance Media

As the coronavirus pandemic ravages communities in North Jersey, counties in South Jersey report a relatively low number of infections and deaths.

New Jersey reported 6,876 cases as of Thursday, with 81 deaths. Most of those are in the north.

The reason for the wide variance may have to do with population density — many South Jersey counties are more sparsely populated — but experts say it also involves the number of people being tested.

Cumberland County has seen four confirmed COVID-19 infections and reported its first death on Wednesday. Salem County has reported two infections, while Cape May has reported six and Atlantic County has counted 10.

Counties immediately to the north, however, are seeing a steadier climb, with Camden County reporting 61 cases, Burlington County registering 59 and Gloucester County reporting 33. Burlington County has reported three deaths, while Camden has reported one.

Testing is a big factor

While there are several reasons for fewer confirmed cases in South Jersey, Salem County Health Officer Robert Dickinson said testing is a big one.

“One of the main reasons is because we are testing far fewer symptomatic persons,” he said Thursday. “There is a shortage of testing swabs and viral transport media. These materials are diverted to the north where the need is greater.”

That means South Jersey counties are having a difficult time getting the testing supplies they need to establish drive-through clinics, he added.

While tests were initially handled by the federal Centers for Disease Control and Prevention, the addition of private companies has helped, according to Dickinson. “The availability of testing through commercial labs has allowed the southern counties to increase testing slightly.”

Dickinson said South Jersey is about two weeks behind North Jersey in terms of transmission and number of confirmed cases.

“I expect increases in confirmed cases,” he said. “I can’t predict as to what level.”

Salem County has a dedicated testing site, Dickinson said, but hasn’t been able to acquire testing materials in order to operate. Cumberland County officials said they are planning to open a site soon, but are also waiting on kits, as is Camden County. A testing site opened in Burlington County on Thursday and one in Ocean County will open Monday.

“We had another planning meeting this morning and upon receipt of testing kits, we will be moving forward with our plan,” Cumberland County Health Officer Megan Sheppard reported Thursday afternoon, adding that more details should be released Monday.

Social distancing is built in

The absence of social distancing guidelines early on in the outbreak meant the virus spread more quickly as it entered North Jersey, Dickinson said.

“When confirmed cases in Bergen County were connected with ties to confirmed cases in New York, there were no social distancing restrictions in place anywhere in New Jersey,” he said. “This allowed more rapid transmission of the virus. Fortunately for Salem County, statewide social distancing requirements were imposed before our first case was confirmed. It is also likely that social distancing is more effective in less populated areas.”

The numbers may be low in Cumberland County, too, but Sheppard knows the area won’t be spared.

Densely populated spots tend to experience the impacts of a health emergency first, she noted, while areas such as Cumberland benefit from a smaller population that’s more spread out.

“We kind of already are social distancing to some extent,” she said.

Cumberland’s population of nearly 151,000 is spread across 483.4 square miles, meaning the population is about 312 people per square mile. Salem County’s population is 62,600, with a density of 189 people per square mile

Compare that to Bergen County, the county hardest hit so far by the virus in New Jersey, where the population of more than 936,000 averages more than 4,000 people per square mile.

While the lack of mass transit services in Cumberland County has long been cited as problem, no one is complaining right now. “It’s a benefit that people aren’t congregating on them and traveling to work and other places,” Sheppard said.

The county also sees fewer visitors, since it isn’t home to enormous concert venues or similar attractions that would pack thousands into a restricted space.

Hospitals aren’t swamped yet

Comparing COVID-19 testing rates between counties is difficult. Sheppard didn’t have information on Cumberland County’s testing rate and a state health department official confirmed this week that county-by-county testing rates weren’t available.

“I do not know the testing rates in South Jersey, but I am assuming they are low and probably lower than up here,” said Dr. David Cennimo, an infectious disease specialist who teaches at the Rutgers New Jersey Medical School in Newark. “Bergen County has tested the most and has seen the most cases.”

With no reports of South Jersey hospitals being overwhelmed with patients, though, “the lack of very sick people can be a proxy for assuming that there is not a great deal of transmission down there, yet,” Cennimo said.

Inspira Health Network, which operates hospitals in Cumberland, Salem and Gloucester counties, hasn’t seen a surge of patients, but is preparing.

“We are not seeing more patients at this time as a result of a number of steps we have taken,” said Paul M. Lambrecht, Inspira vice president of quality and patient safety. “We have suspended elective procedures and converted some patient visits to telemedicine.

“At the same time, we are preparing for the surge of patients that national and state authorities are predicting for our region.”

Inspira plans to reopen a recently-closed hospital in Woodbury to help absorb some of that surge.

The health network also opened a community hotline — 1-800-772-2848 — to provide COVID-19 information and the status of services provided at the network’s various offices, and added a coronavirus virtual assistant to its website to assist anyone who believes they may need testing or treatment.

Based on patterns around New Jersey, increased testing will lead to a sharp rise in official cases reported by the state, Lambrecht noted. “Community spread is occurring in most, if not all, regions of our state so we must take basic preventive measures to flatten the curve,” he said.

Cumberland County has a smaller health care community than some counties — which means a smaller number of outlets providing COVID-19 testing at this point — but testing is taking place, Sheppard said, adding that her office has received plenty of negative test results.

While the confirmed number of local positive cases is low, “we are all aware that there are more cases than what we are showing, which is why we are recommending to the population to social distance, adhere to the governor’s executive order, adhere to what your health officers are telling you … you need to plan and be prepared,” Sheppard said.

The county’s high rate of chronic disease among the population — which makes those residents susceptible to a new virus — means locals cannot sit back and assume it won’t get bad here, she added.

“Our main message is, we’re not immune to this. Our health care system can quickly be overwhelmed.”

‘We try to educate everyone’

Sheppard feels most residents understand the danger. “Of course, you are going to have those who don’t think it’s that important,” Sheppard said. “We try to educate everyone.”

This includes reaching out to people who may gather at parks for basketball or soccer and working with local leaders to ensure the message reaches everyone, including the county’s large immigrant population, Sheppard noted.

Salem County officials report similar awareness.

“For the most part, I believe that Salem County residents are taking this public health issue seriously,” Dickinson said. “When they are not, they are being cited.”

Like Cumberland, Salem County also benefits right now from a lack of mass transit and immediate access to major airports and large population centers, explained Stacy Pennington, Salem County’s deputy administrator and public information officer.

Among local residents, she sees a growing understanding of what’s at stake.

“I don’t think they were in the very beginning,” she said, but now she sees residents giving each other more space with social distancing. Many conversations have gone online, she said, with group chats replacing in-person exchanges.

“I think people are being very creative so they can stay in touch with each other,” she said.

Matt Gray may be reached at mgray@njadvancemedia.com. Follow him on Twitter @MattGraySJT. Find NJ.com on Facebook.

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