April 21 COVID-19 Update – Pennsylvania American College of Physicians

PA COVID-19 DATA UPDATE
On Monday the Department of Health reported that Pennsylvania had found another new 948 positive cases in the previous 24 hours, for a total of 33,232. The death total rose to 1,204 deaths, an increase of 92 deaths from Sunday, all in adult patients.  The Health Department said the increase was due to better data collection and confirmation of cases which were originally listed as comorbidity issues.
 
The state Health Department’s breakout of virus data for long-term care living facilities indicates 682 of the state’s deaths, about 57 percent, were nursing home residents.  There were 129,720  negative tests in PA as of midnight Sunday night.
 
At least  1,677 are health care workers – accounting for about five percent of all positive cases; the total figure includes  504 in nursing homes. And from the department’s website, 4,698 cases – accounting for 12.6 percent of all cases- are in 374 of the state’s long-term care living facilities in 36 counties.
 
Two percent of hospitalizations were under 29 years of age, five percent were 30-49, nine percent were 50-64, 19% were 65-79 and 20% were 80+.  The remainder were unclassified yet per age.
 
Of the total through Sunday, 17,744 positive cases (53%) were female and 14,997 (45%) were male. One percent (491) were unreported or neither.  Among the deaths, 650 (54%) were males and 549 (46%) were female with five unreported by sex.
 
By race, 5,699 were Caucasian (17%) 2,878 were African-American (9%) and 301 (1%) were Asian, with 113 listed as “Other.”  The vast majority, 24,241 (73% of all cases) remained unreported on the race of the patient.
 
On Monday at noon,  3,057 were hospitalized, slightly less than 10% of those testing positive.  At that time, 645 were using ventilators or ECMO.  About 42% of beds, 36% of ICU beds are available, and 1449 of 5111 ventilators were in use (nearly 70% of ventilators were still available.) 
 
Of the patients who tested positive to date the age breakdown was unchanged from Saturday: less than 1% are aged 0-4; less than 1% are aged 5-12; 1% are aged 13-18; 6% are aged 19-24; 39% are aged 25-49; 28% are aged 50-64; and 24% are aged 65 or older. 
 
A map detailing positive and  negative tests by zip code is now available online at www.health.pa.gov.
 
GOVERNOR ANNOUNCES PLANS FOR SOME BUSINESS OPENINGS MAY 8
On Monday, Governor Wolf announced tentative plans to begin reopening some businesses on May 8, while extending the Stay at Home order for another eight days.  He said, “We’ve given up so much, but it has paid off. Our new case numbers have stabilized. We made sure our hospitals weren’t overrun but it’s been at a cost.”
 
“Businesses have stepped up. We’re going to allow more as businesses reopen.  Expand curbside pickup to 176 Wine and Spirits stores to see if it can be done safely throughout the supply chain to see if it can be done in a more diverse sector.
 
By signing SB 841, I am allowing electronic signing of notary services, including car sales. Wolf said the reopening industries will be closely observed to ensure that they do not result in a rapid increase in COVID-19 cases. If that happens, he said would use his authority under the emergency disaster declaration to resume restrictions to protect public health and safety.
 
“We will build on the standards I outlined Friday – a measured region by region, sectoral business-by-business – targeted evidence-based reopening. We will operate under guidelines for assured accountability – require adequate PPE and surveillance program for containment or mitigation. Protections for vulnerable populations will remain in place. Limitations on large gatherings must remain in place through the reopening process.
 
He said, “I want to caution that we will not be resuming operations as they were in February. We’re going to continue to take precautions that limit our physical contact with others, and we will closely monitor this to see if it can be done safely.”
 
We also need to have hope – all of us – that we can soon resume activities, even if they are in a different form. That we will soon be able to have time with our loved ones. We can get through this – we will get through this.
 
THE GOVERNOR AND SECRETARTY LEVINE TOOK QUESTIONS:
Do you think the mask order for customers will be heeded? WOLF: Pennsylvanians want to and will do the right thing.  Businesses will require masks.
 
At Mohegan Sun, What’s being done to stop people from stopping at area businesses – LEVINE: traffic patterns will be directed to the site and right back to the highway.  If you’re getting tested, you have symptoms, that means you need to isolate yourself and wait for the results.  Stopping could be dangerous.
 
How can you tell people without Internet how to register?– LEVINE: you could through smartphone or computer, or email address, but we don’t have a way to do that.
 
What do you say to mom and pop stores that sell same stuff from box stores that are closed? WOLF:   Smaller hardware stores have stayed open.
 
What happened on your Conference call w governors and the federal Task Force? WOLF: It was with VP Pence, and was all about testing and we were on the call.  Challenge is to get increased testing.  We need reagents and test kits.  All expressed that hope and the VP assured us the fed govt was moving toward that end.
 
What do you tell life sustaining businesses that are reopening or expanding and need workers, but they had laid off employees and they won’t come back because they make more on UC with +$600?  WOLF:  There’s nothing you can do but raise the compensation of your employees.

What do you think about the protest and social distancing?  WOLF: I haven’t seen it. I’m just hoping they recognize we want to keep everybody safe.
 
Do you have a message for those who are gathering?  WOLF: Please stay safe.  We want to do everything we can to keep PA safe. That includes you.
 
Will you be enforcing your orders at this event today?  NO.
 
The Transit system in Lackawanna CO. says they are exempt from the order – says you only highly recommend, but don’t require passengers to wear masks, but we strongly recommend passengers do that.
 
IF so, Why are they NOT required to wear the masks?  LEVINE: We highly recommend it, but the order was that we wanted to protect staff and employees in stores.
 
How many congregate care homes have been cited?  LEVINE: We don’t have that statistic in terms of LTCs.
 
Emergency Officials at the county level say the emergency is now in nursing homes, not hospitals.  LEVINE:  We see vulnerabilities of seniors in Congregate care facilities.  So far, they are doing well, and we’re working to ensure they have enough beds, staffing and PPE.  They are very challenged.
 
White House guidelines were issued for states, said there should be downward trajectory for 14 day period before opening business.  Are you setting similar benchmarks? WOLF: Yes, we are, but we haven’t made decisions yet.  Too early to declare victory, but hoping we’re giving ourselves the time to have abilities in place to do this.  And Do this right. 
 
WOLF: We’re going to consider a whole lot of things as we approach that May 8 date.  Don’t want to do curbside pickup in urban areas if it means more traffic congestion.  Reasoned common sense way – more out in an equally reasoned common sense way.
 
Your Phase 3  for reopening reads like a progressive platform – aren’t you capitalizing on the pandemic to push a progressive liberal agenda?  WOLF: No, if you are concerned about losing employees, pay them more!  If c
ustomers are reluctant to buy stuff, maybe think of more people.  We need to show greater concern for our fellow citizens.
 
Some are asking you to rescind your orders. Are you considering that? WOLF: Everybody wants to get through this faze as quickly as possible, but the question is what’s the reality?  Not safe for too many people.  As much as we might dream of a magic wand, we face unappetizing choices.
 
Self-employed individuals having difficulty with the PUA system.  If they were formerly employees, they can’t file as owners. What can you say to them?  WOLF: The site only went up at 10 pm on Friday night and there’s a crush of people filing for the first time, a lot are signing up with new technology – so they actually can and there’s a crush of demand.
 
You cited a May 8 date – do you plan to end Stay at Home order then?  WOLF: It’s a target date and the question is how do we do it?  If you’re in Cameron County, it doesn’t mean the same thing as in Philadelphia.  Absent a vaccine and cure, we will continue to monitor.
 
Coroners feel the death totals are not accurate – victims of COVID 19 have not been tested – do you agree with that?  LEVINE: We are looking at merging different data systems, and will be updating to count for every patient who died of COVID-19 and we look forward to working with the Coroners on that to make our count as accurate as possible.
 
General Assembly
The Senate and House are in session this week.  Today, House Democrats offered a Discharge resolution for two bills, HB 470 and HB 471, which would prohibit lifetime and annual limits on essential health benefits, and HB 471, which would prohibit exclusions for pre-existing conditions in health insurance.  
 
House leadership may consider several other health related bills in the next few weeks, based on internal discussions.
 
The Senate scheduled SB 857, the Telemedicine bill, for consideration in its Rules Committee on Tuesday April 21, and a possible vote.  PA-ACP supports the original bill, but opposes language put in by the House that would limit prescription and administration of drugs on the FDA Risk Evaluation and Mitigation Strategies(REMS)list via telemedicine.
 
REMINDER – MAIL IN BALLOTS NOW AVAILABLE FOR JUNE 2 PRIMARY
Recent voting reforms established a new convenient way for Pennsylvanians to vote: mail-in ballots.
 
Similar to an absentee ballot, you may apply to receive a mail-in ballot in the mail to complete, and return to  your county election office – but unlike an absentee ballot, you may simply request a mail-in ballot without providing a reason.
 
All registered voters can apply to vote via mail-in ballot.  Registered voters can apply to vote via mail-in ballot for the primary election with a valid PA driver’s license or photo I.D. from the PA Department of Transportation (PennDot).
 
Apply for a mail-in ballot .
 
By Mail, you can download a mail-in ballot application form at votespa.com . Print, complete, sign, and deliver or mail the application to your county election office .
 
In-Person, voters can stop by a county election office to apply in person and have your ballot promptly presented to you. Find a county election office near you .
 
What is the deadline to apply?  From the primary election forward, the deadline for your county to receive your application for a mail-in ballot is before 5:00 p.m. on the Tuesday before the election.