April 27 Pennsylvania COVID-19 Update

PA COVID-19 DATA UPDATE
On Sunday, the Department of Health reported that Pennsylvania had found another 1,116 confirmed positive cases in the previous 24 hours, for a total of 41,165 confirmed cases.  The death total rose to 1,550 total confirmed COVID-19 deaths, an increase of 13 from Saturday, all in adult patients. 
 
The state Health Department’s breakout of virus data for long-term care living facilities indicates 952 of the state’s deaths, almost 61 percent, were nursing home residents.  There were 157,428 negative tests in PA as of midnight Friday night.
 
At least 2,728  (an increase of 118) are health care workers – accounting for about five percent of all positive cases; the total figure includes  822 in nursing homes. And from the department’s website, 6,813 cases – accounting for 14.5 percent of all cases- are in 431 of the state’s long-term care living facilities in 40 counties.
 
Two percent of hospitalizations were under 29 years of age, five percent were 30-49, 10% were 50-64, 20% were 65-79 and 20% were 80+.  The remainder were unclassified yet per age.
 
Of the total through Friday, 22,236 positive cases (54%) were female and 18,355 (45%) were male. One percent (574) were unreported or neither.  Among the deaths, 825 (53%) were males and 719 (45%) were female with 6 unreported by sex.
 
By race, 8,292 positives were Caucasian (20%), 4,027 were African-American (10%) and 420 (1%) were Asian, with 176  listed as “Other.”  The vast majority, 28,250 (69% of all cases) remained unreported on the race of the patient.  A total of 570 deaths (7% of positives) were among Caucasian victims, 168 (4.3% of positives) were African American/Black, 21 (5% of positives) were Asian and 4 were listed as other.  787 deaths were not reported by race.
 
On Sunday at noon,  2,725 positive patients were hospitalized, slightly less than eight percent of those testing positive.  At that time, 622  were using ventilators or ECMO.  About 40% of the 1,489 intensive care unit (ICU) beds are available, and of the 7909 general medical beds 47% were available. 52 percent of the 1,704 airborne isolation rooms are still available statewide.  And 1376 of 5193 ventilators were in use (nearly 70% of ventilators were still available.)  47% of  beds 40% of ICU beds
 
Of the patients who tested positive to date the age breakdown was: less than 1% are aged 0-4; less than 1% are aged 5-12; 1% are aged 13-18; 6% are aged 19-24; 38% are aged 25-49; 27% are aged 50-64; and 26% are aged 65 or older. 
 
SATURDAY NUMBERS
On Saturday, the Department of Health reported that Pennsylvania had found another new 1,397 confirmed positive cases in the previous 24 hours, for a total of 40,049  confirmed cases.  The death total rose to 1,537 total confirmed COVID-19 deaths, an increase of 141 from Friday, all in adult patients. 
 
The state Health Department’s breakout of virus data for long-term care living facilities indicates 903 of the state’s deaths, almost 61 percent, were nursing home residents.  There were 152,886 negative tests in PA as of midnight Friday night.
 
At least 2,728  (an increase of 118) are health care workers – accounting for about five percent of all positive cases; the total figure includes  942 in nursing homes. And from the department’s website, 6,544 cases – accounting for 14.5 percent of all cases- are in 425 of the state’s long-term care living facilities in 39 counties.
 
Two percent of hospitalizations were under 29 years of age, five percent were 30-49, 10% were 50-64, 20% were 65-79 and 20% were 80+.  The remainder were unclassified yet per age.
 
Of the total through Friday, 21,584 positive cases (54%) were female and 17,902 (45%) were male. Two percent (563) were unreported or neither.  Among the deaths, 818 (53%) were males and 713 (45%) were female with 6 unreported by sex.
 
By race, 7,949 positives were Caucasian (20%), 3,874 were African-American (10%) and 401 (1%) were Asian, with 169 listed as “Other.”  The vast majority, 27,656 (69% of all cases) remained unreported on the race of the patient.  A total of 566 deaths (7% of positives) were among Caucasian victims, 167 (4.3% of positives) were African American/Black, 21 (5% of positives) were Asian and 3 were listed as other.  780 deaths were not reported by race.
 
On Saturday at noon,  2,746 positive patients were hospitalized, slightly less than eight percent of those testing positive.  At that time, 638  were using ventilators or ECMO.  About 40% of the 1,489 intensive care unit (ICU) beds are available, and of the 7909 general medical beds 47% were available.  And 1444 of 5182 ventilators were in use (nearly 70% of ventilators were still available.)  47% of  beds 40% of ICU beds
 
Of the patients who tested positive to date the age breakdown was: less than 1% are aged 0-4; less than 1% are aged 5-12; 1% are aged 13-18; 6% are aged 19-24; 38% are aged 25-49; 28% are aged 50-64; and 26% are aged 65 or older. 
 
DR. LEVINE TOOK QUESTIONS SATURDAY
Experts estimate 750,000 tests are needed nationally.  How may for PA?  LEVINE: We don’t have an estimate – were working on that as we speak and just had a call about it. Especially in those areas we are considering going from Red to Yellow.
 
There are questions about the metrics for advancing regions.  Will hospital surge capacity and bed availability be considered? LEVINE: Yes, that’s why we’re looking at this on a regional basis. Some rural areas don’t have sufficient bed resources.
 
Cambria county is in same region as Allegheny with just 20 deaths vs. Allegheny with 1200.  It seems unfair to have reopening in Johnstown tied to Pittsburgh.  LEVINE: We’ll take specific case ratios in each county and all of that into consideration as we make decisions.
 
Does shortage of testing materials remain a problem and is that a problem with considering opening? LEVINE: We have shortages of swabs, sterile salt water, extraction and testing chemicals too. It’s all been a challenge.  We’re doing somewhat better.  The state laboratory has gotten additional supplies and hospitals can expand their own testing. We had a phone call with DHS, CDC and White House about a sufficient supply chain. Of those resources.  But I don’t expect a shortage to impact the regions going from red to yellow.
 
How many years ago did the Department carve out those regions?   LEVINE:  It was back in the ‘60’s, that they were identified.  I don’t know what the rationale was for that. It is how our state health centers are identified and the regions we use with the health systems and HAP are identified.  That said, we don’t want any specific schema to impede our progress.
 
How stressful have the last couple of months been for the department?  LEVINE: Thanks for asking.  We have great public health nurses, lab technicians, epidemiologists and all aspects of the Department. I would like to thank them. It’s been very challenging.
 
US Congressman Conor Lamb said that the feds won’t be providing any more PPE to Pennsylvania. Is that true and why?  LEVINE:  All of our federal delegation are working with us.  We have received two shipments of N95 masks from the federal government.  Where we’re low is in traditional surgical procedure masks, and gowns. We’ve been told the federal stockpile is very low and don’t expect to get any from that at this time, but we’re relying on the health systems and HAP through their mutual aid agreements with moving stock to hospitals that need them.  We’re going to look for more from the federal stockpile and look for more resources wherever we can find them.
 
What effect does this have on state’s ability to fight the pandemic?  LEVINE: I don’t think it will affect our efforts.  The hospitals that need the equipment will
get them and we’ll work to fill those needs.  It won’t affect the reopening process, but those hospitals with needs are not in those regions.
 
Do you know how many different PPE’s were requested?  It’s not only hospitals that need PPE.  The challenges are also in long term care centers and nursing homes, which need PPE as well.
 
What are the chances that PA will have to practice social distancing through the summer?  That’s the summer and we’ll see how things go in the summer.  We know the virus determines the timeline.  We are starting this progressive reopening May 8 and today is much too soon to talk about what things will look like in the summer.
 
How much will the reopening of things in other states impact PA?  It’s a global society and what happens in other states will impact PA but we’re going to focus on Pennsylvania and deal with those impacts from other states as we go.
 
With restaurants, carnivals, events pushed back to Green, what’s their place in the new normal? LEVINE: It will be a new normal – We won’t go back to where we were before, but Pennsylvanians are strong and resilient.
 
Is our food supply chain still running as it should? How can we be confident if we stay at home? LEVINE: There have been challenges in the food supply, and we have had many food processing and supply businesses with employees testing positive.  Secretary Redding has been monitoring that and we have spoken with food manufacturers and food stores and we’ll make sure the system stays intact and we’ll make sure every Pennsylvanian gets the food they need.
 
We have multiple death reporting systems.  Were any of the deaths reported Thursday due to duplicate records mistakenly put in that count?  LEVINE: I will have to get back to you on that.  I think there was some question about some reports, so I think I’ll say no but its more nuanced than that.
 
NY Governor Cuomo said he thinks it’s not as deadly as we once thought. Do you agree? LEVINE: There are more cases than we’ve been able to detect.  Some patients have no symptoms, some . minimal symptoms.  So we won’t know till we can do virus and antibody testing.  There are probably many more than we have listed through the testing we’ve done. Data indicted 2 out of 100 patients died from COVID-19 in China.  As we get more surveillance info, we’ll know more.  Influenza has Flu has just 1/10 of 1 percent of patients that die, so even a 1%, this is still much worse.
 
Of the 201 deaths taken off the list this week how many were duplicated in two counties?  LEVINE:I don’t know, but the deaths I report will be confirmed deaths.  We are meeting next week with the Coroners and plan to work collaboratively.
 
Of the current deaths how many had comorbid conditions?  LEVINE:  Many of them also had COPD, emphysema, kidney disease, heart issues, or were nursing home patients with clusters of comorbid conditions.
 
Why is the online reporting system only giving three options for death causes? LEVINE: I don’t know the answer to that.
 
What guidance will you share with Rep. Benninghoff when you meet with him later today?  x We want to work closely with the Coroners Association president and executive director to schedule a meeting to explain our opinion and work out a solution.
 
When will our Right to Know law requests to your office be responded to?  LEVINE: I don’t know the answer to that question.  Our attorneys are working through many pandemic related issues, so we are not able at this time to do that. Busy
 
What do you say to those with the presumed back and forth with numbers, they are skeptical of the data and transparency?  LEVINE: We are really trying to relay information in a clear and concise way.  Sometimes there are issues with so many positives and so many deaths.  When we had problems reconciling, we have been as open as possible and thank you for your support.
 
What is the biggest obstacle to tracking recovered cases of COVID-19? LEVINE:  We’re not trying to do that – we’re trying to track new cases.  The long term care centers and nursing homes are a challenge, companies in the food chain, working with many stakeholders to make sure we are tracking this.  With more than 40,000 cases, we will not have the staff to track the patients as they recover.  Moving from Red to Yellow will take a huge effort to do tracing, diagnose patients with it, isolation, making sure they are notified, and they quarantine when contacted. We do not have the ability to call all and see when and how long they recovered.
 
Of Mohegan sun site, how many positives do we have? LEVINE: I don’t have that at my fingertips, but its lower than we might have thought.
 
How is it being transmitted, since it’s been weeks with stay at home orders?  LEVINE:  It is transmitted by ANYBODY who’s not Just AT HOME.  If you are working in life sustaining businesses, getting food, medical supplies and medicines and working with staff and supply chains. With just the essential businesses people have to be out and about, there will always be transmission if people are out.  It’s why we ordered masks.  The biggest areas are where there’s population density.
 
How important is contact tracing to the reopening process?  LEVINE: All of that is very important and those plans should be ready this week to go for certain counties to go Red/Yellow.
 
Can you clarify the 50 per 100,000 benchmark?  LEVINE: It is that fewer than 50 new confirmed cases per 100,000 people in the region in the previous 14 days.  For example, with 800,000 people, you would need fewer than 400 cases in last 14 days.  If that target is met, we’ll meet with the counties. BUT that’s not the only factor. We also want to see the ability to do testing, case investigations, contact tracing, high risk settings, LTC and nursing homes, stability and ability of hospitals to take care of patients, modeling dashboard from CMU and then the Governor will make his decision.  It will be region to region, county to county.
 
Certain counties have much higher death rates than others.  Looking at why? LEVINE:  We are not doing that now, as our efforts are dedicated to determining how many, and developing resources, rather than the why’s of the pandemic.  I’m sure there will be studies about those things in the future.