INSIDE THIS REPORT:

• Wolf and Levine amend green phase orders for eight counties
• Thursday’s COVID-19 numbers and links
• Which Counties go green next week?
• DoH applies for $301 million federal grant, makes fifth distribution of remdesivir
• Wolf continues to promote mask requirement in green counties
• Wolf march for BLM becomes court issue(from Pennlive.com)

Wolf, Levine amend green phase orders for eight counties effective Friday June 19
Governor Tom Wolf and Secretary of Health Dr. Rachel Levine today signed amended green phase orders for the 8 counties moving to green at 12:01 a.m. tomorrow, June 19. The counties include Dauphin, Franklin, Huntingdon, Luzerne, Monroe, Perry, Pike and Schuylkill.

With these orders effective at 12:01 a.m., 54 counties are in green and 13 counties remain in yellow.  Gov. Wolf’s Process to Reopen Pennsylvania includes details of each phase of reopening.

The Governor’s amended green phase order can be found here.  The Secretary of Health’s amended green phase order can be found here.

Thursday’s Department of Health Data Report
On Thursday, the Pennsylvania Department of Health confirmed that as of 12:00 a.m. June 19 there were 418 additional positive cases of COVID-19, bringing the statewide total to 80,236. Approximately 6,092 of our total cases are in health care workers.  The DoH estimates that 76% of all patients testing positive have recovered.

In nursing and personal care homes, there are 16,850 resident cases of COVID-19, and 2,986 cases among employees, for a total of 19,836 at 649 distinct facilities in 47 counties.

There have been 6,361 total deaths attributed to COVID-19, an increase of 42 new deaths in the last 24 hours. County-specific information and a statewide map are available here. Out of our total deaths, 4,332 have occurred in residents from nursing or personal care facilities. A county breakdown can be found here.

There are 543,832 patients who have tested negative to date, and there are 630 patients who have a positive serology test and either COVID-19 symptoms or a high-risk exposure, which are considered probable cases and not confirmed cases. Of the patients who have tested positive to date the age breakdown is as follows:

• Nearly 1% are ages 0-4;
• 1% are ages 5-12;
• 2% are ages 13-18;
• 6% are ages 19-24;
• Nearly 37% are ages 25-49;
• Nearly 25% are ages 50-64; and
• 28% are ages 65 or older.

Most of the patients hospitalized are ages 65 or older, and most of the deaths have occurred in patients 65 or older. More data is available here.

Statewide – The Wolf Administration has since noon, June 16:

• Provided an update from Pennsylvania State Police on business closure enforcement actions.
• Noted that PA is one of three states with a steady decline in cases.
• Announced that four universities receive funding for COVID-19 response through manufacturing innovation challenge.

Which Counties Move to Green next week?
Questions remain whether the rest of the state’s counties now still in “yellow” can move to “green phase” next Friday, June 26.  Statewide figures are all positive and trending the right way, and on sheer numbers, most if not all of those counties could get the “green” light from the Governor on Friday.

The statewide incidence rate is now 47 per 100,000 population over two weeks, below the original Wolf Administration threshold of 50. Two weeks ago, the incidence rate was 64, and it peaked at 164 in mid-April.

Two counties – Erie and Susquehanna remain with two-week incidence rates above the rates they had two weeks ago, but some counties like Dauphin, which had a much higher incidence rate than several yellow counties, were allowed to go green effective at 12:01 a.m. Friday.

If Dauphin County is an example of how the Administration looks at the overall metrics, it’s conceivable that with improved testing, hospital and contact tracing capacity, all of the remaining yellow counties could move to green June 26.

DoH applies for $301 million federal grant, makes fifth distribution of remdesivir
Secretary Levine Thursday said the Department of Health has applied for a more than $301 million grant from the CDC to strengthen state and local public health capacity in Pennsylvania.

Levine said “we earmarked about a third of that funding, more than $100 million, to bolster county and municipal public health departments’ response. We intend to use the balance of the grant funding to expand our testing efforts, case investigating and contact tracing and our data infrastructure to improve our response.”

The Department will also continue its close collaboration with the Philadelphia Department of Public Health, who separately received more than $92 million to assist their work from CDC.

Throughout Pennsylvania, there are six county health departments and four municipal health departments with primary responsibility for public health efforts inside their jurisdiction.

The funding will support six primary strategies to respond to the COVID-19 pandemic. These include continuing work to develop a robust testing and contact tracing strategy, supporting local health departments and investing in public health surveillance and laboratory infrastructure. The grant submission focused on ensuring minority and underserved communities are targeted for testing, outreach and we have improved demographic data collection.

Here is a breakdown of these six strategies and the corresponding funding:
1. Strengthen Laboratory Testing: $96,407,366

• Stand up regional hub and spoke testing network to ensure testing is available and accessible across the commonwealth.
• Partner with vendors to deliver testing at long term care facilities, community-based testing sites and other locations with a focus on minority communities.
• Purchase necessary supplies and equipment for the PA DOH’s state laboratory to increase testing capacity at the state level, prioritized for long term care and other congregate care settings. This includes supplies and equipment for both diagnostic and antibody testing.

2. Advance Electronic Data Exchange at Public Health Labs: $3,133,542

• Implement an IT solution to enhance and expand laboratory results information infrastructure, to enable faster and more complete data exchange and reporting for public health data.

3. Improve Surveillance and Reporting of Electronic Health Data: $5,048,277

• Implement IT solutions to enable comprehensive, automated, daily reporting to the CDC and others in a machine-readable format. This includes hiring a vendor to populate missing demographic information to ensure state has a complete picture of impact of COVID-19 by race and ethnicity.

4. Use Laboratory Data to Enhance Investigation, Response and Prevention: $84,815,746

• Develop a robust investigation and contact tracing infrastructure for in depth case investigation and contact tracing including nurses, contact tracers, outbreak response and IT solutions, including a mobile app for exposure notification. Additionally, this strategy includes funding for six outreach specialists to serve as trusted messengers to reach traditionally underserved communities.
• Target $10 million of funding to research and address health disparities related to COVID-19 and ensure communities and systems are intentionally focused on ensuring a healthy Pennsylvania for all.

5. Coordinate and Engage with Partners: $103,529,626

• Support the state’s county and municipal health departments (CMHDs) so they can bolster the infrastructure and workforce needed to address local public health needs now and in the future. Create and provide additional programs to LTCF to support response.

6. Enhance Laboratory, Surveillance, Informatics and other Workforce Capacity: $8,102,129

• Build expertise to support management of the COVID-19 related activities within the commonwealth.

The Department of Health also announced that it has distributed a fifth shipment of remdesivir.  The latest remdesivir shipment from the federal government contained 4,788 doses of the medication. They were divided between 82 hospitals.  Distribution is decided based on a hospital’s need for the drug.

Wolf again reminds mask wearing is required
Governor Wolf again took time to remind Pennsylvanians that mask-wearing is required when entering any business in all counties in the state in both yellow and green phases of reopening. Masks are considered critical in stopping the spread of COVID, now and in preparation for a possible resurgence of the virus in the fall.

The mask requirement is part of Secretary of Health Dr. Rachel’s Levine’s order, “Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations,” which pertains to all counties regardless of the phase of reopening.

“In yellow and green counties, it is required that masks are worn when visiting businesses to protect employees, employees’ families, and communities as a whole,” Gov. Wolf said. “Mask-wearing has proven to be an important deterrent to the spread of the virus, and as more counties move to green and more things reopen, we need to be vigilant in our efforts to continue our mitigation efforts.”

Wolf noted that a recent study from Cambridge and Greenwich universities in the United Kingdom found that cloth masks, “even homemade masks with limited effectiveness can dramatically reduce transmission rates if worn by enough people, regardless of whether they show symptoms.”

Peer-reviewed studies published in scientific journals such as The New England Journal of Medicine corroborate the need for masks and the U.S. Surgeon General said that wearing a mask doesn’t impinge on our freedom – it gives us more freedom from unknowingly spreading COVID-19.

The state’s business guidance outlines mask-wearing requirements and additional safety parameters for both employees and customers.

Wolf march for BLM becomes court issue (Pennlive.com)
Gov. Wolf’s march alongside Black Lives Matter protesters became an issue Thursday when an openly skeptical Commonwealth Court judge refused to issue an order to immediately curb the size of the crowd at the Spring Carlisle car show and flea market over Department of Health claims it poses a dire COVID-19 risk.

Instead, because of a dispute over whether the law firm for Carlisle Events, the show’s presenter, can represent the company, Judge Anne E. Covey rescheduled a hearing on the case for noon Friday to give the car show organizers time to get new lawyers.

It appears, however, that Covey is far from automatically inclined to side with the Health Department’s claim that the car show should be allowed to have no more than 250 attendees at a time because of the risk of spreading the coronavirus.

In fact, she really grilled the department’s lawyer, Brian Downey.  Why, she asked, is it a health risk to have more than 250 people at a time in the outdoor car show at the 100-acre Carlisle Fairgrounds when the governor decided it was OK for him to march shoulder to shoulder with hundreds of protesters through Harrisburg two weeks ago?

Downey replied that the protests against police brutality in Harrisburg, Philadelphia, Pittsburgh and other Pennsylvania communities involved the exercise of free speech rights.

Then why, Covey added, is it not a public health risk when people are allowed, without state interference, to flock to speedways for auto races that are attended by far more than 250 spectators?

Downey said “the risk we are looking at right now is so significant” with the car show because the event draws tens of thousands of spectators, including people from COVID-19 “hot spots” in and outside Pennsylvania.

Covey countered that all those protesters certainly included people from virus hot spots, but the Health Department didn’t ask the courts to shut them down, even though many weren’t even wearing protective masks. “Isn’t Philadelphia a hot spot? Isn’t Pittsburgh a hot spot?” she said.

She also asked why the department didn’t file legal action against Carlisle Events until 4 a.m. on Wednesday, the day the car show was to begin. Downey said the department didn’t know Carlisle Events planned to go through with the show after being refused a COVID-19 waiver by the state Department of Community and Economic Development.

In any case, how would the department expect car show officials to enforce the 250-person cap? Covey asked. “What are you going to do, have people go around and count heads at the fairgrounds?” the judge said.

“They count people already” at the gate, Downy replied.

Covey also asked about the COVID-19 restrictions that will apply to Hersheypark, which is to open in early July. Under the current regulations, the park can segregate people into groups of no more than 250 and allow several pockets of that size to be in the park simultaneously provided they are separated, Downey said. Carlisle Events could do the same thing, he said.

Attorney Mark Stewart, whose representation of Carlisle Events was challenged by the Health Department because his firm, Eckert Seamans, does other work for the state, said car show organizers aren’t violating COVID-19 restrictions.

They are limiting attendance at the show to 50 percent capacity – the same cap imposed on indoor shopping malls, casinos and other venues – and are mandating social distancing and encouraging use of face masks, Stewart said. He said only one out of every three vendor booths is occupied.

He claimed Carlisle Events is a victim of “wild inconsistencies” in the state’s COVID-19 restrictions that simply aren’t logical or fair.

“The state parks are open. The beaches at the state parks are open at 50 percent occupancy,” Stewart said. And he said those protests, like the one in which Wolf participated, “weren’t compliant (with COVID-19 curbs), period.”

Covey adjourned Thursday’s hearing for 24 hours so Carlisle Events can secure new counsel to challenge a Health Department injunction to impose the 250-attendee cap on the last two days of the Spring Carlisle show and on subsequent events, including another show scheduled for the fairgrounds next week.