April 3am COVID-19 Update – Pennsylvania American College of Physicians

April 3 (morning) Pennsylvania COVID-19 Update

PA COVID-19 DATA UPDATE
Pennsylvania had 1,211 additional positive cases of COVID-19, for a total of 7,016 total cases statewide in 62 counties.  More than 730 patients have been hospitalized since 3/6 (approximately 10% of the positive cases).  Of those patients, 216 have required stays in the ICU and 130 required use of a ventilator.  To date, 90 total deaths have occurred statewide, all in adult patients.

Health care workers constitute 345 of the total cases – roughly 5%, and approximately 10% of 695 nursing centers have at least one case.

There are 47,698 patients tested negative to date.  Of the patients who have tested positive to date the age breakdown is as follows: nearly 1% are aged 0-4; nearly 1% are aged 5-12; 1% are aged 13-18; nearly 9% are aged 19-24;  nearly 41% are aged 25-49; nearly 29% are aged 50-64; and 19% are aged 65 or older. 

Most of the patients hospitalized are aged 65 or older, and most of the deaths have occurred in patients 65 or older. There have been no pediatric deaths to date. More data is available here

Dr. Levine answered questions from the news media on April 2:

Several questions were about when to expect a peak of hospitalizations in PA.  LEVINE:  Modeling is important, but what’s most important is what’s happening NOW.  We’re offering guidance to prepare for the surge, and it’ll be more than one day, over time. We need to prevent the surge from overwhelming our health system.

WFMZ – Of those intubated and on ventilation, how effective? LEVINE: These are very effective for those who are unable to breathe on their own. They’re used in response to many conditions.  Don’t know the death rate, but patients put on ventilators are the most ill.  They are very effective though.

WNEP – Can you recap answer about businesses notifying employees when a coworker is identified as positive.  LEVINE:Notify close contacts, that person will be in isolation, and those in close contact will need to be quarantined for up to 14 days, vigorous deep cleaning then return to normal life sustaining business.

Scranton Time, Morning Call – NE PA Caseload per 10,000 people is 3 times that of Phila and bedroom counties (now collar counties) Is this significant? LEVINE: We’re paying close attention and making sure hospitals are prepared for those patients.

WJAC – How many negative tests in each county? Will you be sharing that information?  LEVINE: That would be interesting, but we’re not finding that all that useful from a public health standpoint.  Trying to track who has recovered, will be done over next few months and over a year-as more serology testing is available, we can determine who is immune to determine preparations for the future.

Reporting times – If a county doesn’t have a health department, does it slow reporting?  LEVINE: No not really.  The DoH does that if they don’t.  As soon as a death is entered, we get that information and I review it.

NBC10 – Limerick power plant is bringing 1400-1800 workers in from out of state. Are you concerned about that?  LEVINE: Energy is essential, we are working with Montgomery Co. closely and Exelon to make sure all necessary safety measures in place.

WNEP – Hydrochoroquine is now unavailable in many areas? What is PA doing to ensure it is for ongoing patient treatment?   LEVINE: We’re doing everything we can to make sure its available.  We reached out to the pharmacies and Board of pharmacy.

WTAE – Many new tests on emergency basis suggests more false negatives from these quick approved tests? LEVINE: FDA is approving these tests on an emergency basis.  We’re using very well accepted tests at state lab, hospital labs and commercial labs.  All of them have false positive/negative tests.   If not fever, significant cough, etc. no need to get testing.  Just rest and recover.  If fever spiking, chills, cant keep fluid down, chest pain, call your doctor.

How accurate do you think rural numbers are with so few test kits?  LEVINE: We think our accuracy is good, but there is community spread.  Some patients have few symptoms, others are critical.  We know the number is far above our case counts.

PXI – Lessons learned from past pandemics?  LEVINE: Lessons learned social distancing and prevention efforts. Example parades in St. Louis vs. Phila in 1918…Highlights critical nature of stay at home orders.

NEWSTALKS 104.1 – for those positive but no hospital stay 14-21 days?  Is that the same for those who are in hospital?  LEVINE: We are seeing that milder courses have a shorter time frame.

PGH Bus=Times – Increasing levels in several counties – hospitals managing by county?  LEVINE: In the SE, PHILA and NE PA yes.  Some in SW, but not as large as in the east.  Hospitals are coping very well.

PublicSource – With numbers rising, is the epicenter moving from Philadelphia, or is this because of testing?  LEVINE: With more cases, that’s most likely.  More community spread.

Is Lehigh Health asking for more help and field hospitals?  LEVINE:  We have two from DHHS at feds, no additional ones coming that we know of.  Have alternative sites, ASFs, hospitals that closed recently, for other patients, and hotels for convalescence.

WPSU – Should counties in center of the state expect the same types of increases with a more spread out population?  LEVINE: We expect that but less chance for community spread because of rural.

How does mitigation impact patients regular health care needs during this epidemic?  LEVINE: Urgent needs, see your doctor.  Heart, lung, kidney see your doc.  For routine checkups, asking people to NOT do that – puts your family at risk.

NEWSTALK – Any idea of whether increase in mental health services since last night?  LEVINE: Have been to DHS and their divisions recently, this is a very stressful time for patients, families, health care personnel.

WFMZ – If people travel to NYC do they still need to self quarantine for 14 days if wearing N95 respirator?  LEVINE: Yes,  these masks are not 100% and you could have touched surfaces.

PUBLIC SOURCE – 345 total cases have been positive in health care workers, how fast is it increasing and compare to other states?  LEVINE: I don’t have those numbers, but we will work on that.

How would a CPAP machine work on someone quarantined at home?  LEVINE: I’d say to use as normal.  If positive, be really careful because underlying lung conditions are serious.

SCRANTON TIMES – Any thought to breaking down the positives/negatives by municipality?  LEVINE: We don’t have resources to do everything.  We’ll release by county, and we’d like you to stay at home positives will be isolated, so best thing you can do is stay home.

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Statewide Priorities for Testing remain unchanged
PRIORITY 1
Ensure optimal care options for all hospitalized patients, lessen the risk of nosocomial infections, and maintain the integrity of the healthcare system

  • Hospitalized patients
  • Symptomatic healthcare workers

PRIORITY 2
Ensure that those who are at highest risk of complication of infection are rapidly identified and appropriately triaged

  • Patients in long-term care facilities with symptoms
  • Patients 65 years of age and older with symptoms
  • Patients with underlying conditions with symptoms
  • First responders with symptoms

PRIORITY 3
As resources allow, test individuals in the surrounding community of rapidly increasing hospital cases to decrease community spread, and ensure health of essential workers

  • Critical infrastructure workers with symptoms
  • Individuals who do not meet any of the above categories with symptoms
  • Health care workers and first responders
  • Individuals with mild symptoms in communities experiencing high COVID-19 hospitalizations

NON-PRIORITY

  • Individuals without symptoms