INSIDE THIS REPORT:

• Wolf extends emergency disaster declaration
• Wednesday’s COVID-19 numbers and links
• 6-3 Q/As with Sec. Levine
• Four finalists selected for Operation Warp Speed
• DoH releases dental guidance
• Education guidance provided for school openings

Wolf renews emergency disaster declaration for another 90 days
Governor Wolf on Wednesday renewed the 90-day disaster declaration he originally signed on March 6 following the announcement of the first two presumptive positive cases of COVID-19 in the commonwealth. The declaration was set to expire on June 4. 

The emergency disaster declaration provides for increased support to state agencies involved in the continued response to the virus and recovery for the state during reopening.  The Department of Health’s Department Operations Center at the Pennsylvania Emergency Management Agency is still active as is the CRCC there.

Also today, Gov. Wolf announced that he would allow the amended stay-at-home order to expire at 11:59 p.m., June 4. The-stay at-home requirements were only in effect for counties in the red phase.

“As phased reopening continues and all 67 counties are either in the yellow or green phase by Friday, we will no longer have a stay-at-home order in effect,” Gov. Wolf said. “I remind Pennsylvanians that yellow means caution and even in the green phase everyone needs to take precautions to keep themselves and their communities healthy.”

Read the amendment to the emergency disaster declaration online here.

WEDNESDAY’S REPORT FROM THE DEPARTMENT OF HEALTH
The Pennsylvania Department of Health today confirmed as of 12:00 a.m., June 3, that there were 73,405 positive cases of COVID-19 statewide in 67 counties and 5,742 confirmed deaths. Most of the patients hospitalized are 65 or older, and most of the deaths have occurred in patients 65 and older. More data is available here.

Statewide, the Department said 408,269 positively tested patients have recovered, which is 68% of the total positive cases. 

For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.

Announced partnership with the Jewish Health Foundation for the SW contact tracing consortium.  Also working with Temple (200) and Penn State (46) medical students.  New partnership with Walmart and Quest diagnostics in areas with fewer testing sites.  Nineteen new sites will be testing M-W-F mornings from 7-9 a.m. at those locations in rural Pennsylvania.  Clarion, Erie, Clearfield, Mercer (Hermitage) and Lycoming (Montoursville) Counties with more in coming weeks.

LEVINE TAKES Q’s WEDNESDAY AFTERNOON
Has DoE provided more information about opening schools, and do you have concerns about a spoke in MIC-C occurrences?  LEVINE:  It’s an inflammatory condition that occurs after the fact, and we’re learning more all the time, so it’s hard to say.  We are seeing that syndrome being taken care of in our teaching hospitals.

How much PPE does the state have in reserve? LEVINE:  We do have a reserve and we’re getting more in every day, but we’re pushing it out, so we’re not really keeping it at this time.  The federal government is starting to stockpile, and we may get to that point, but not now.

With opening schools, and preliminary guidelines, what do you want to see to make sure schools are safe in the fall?  LEVINE:  We’re collaborating with Sec. Rivera, and we are working to make sure schools are safe.  I don’t know if they have to prove anything, but we’re going to be monitoring for spikes.

Will masks be required for students?  LEVINE:  Masks will be suggested, yes, there are some medical conditions where people can’t wear masks, but masks will be part of the process.

Dauphin County just went yellow on May 29 and there’s currently a gathering going on that has several hundred people in it.  Can you clarify the Administration’s position when on May 11, small business owners were called cowards for wanting to reopen their businesses, but today the Governor is marching in that.  Is that not in violation of your order and his order against large gatherings?  LEVINE:  The Governor has always said the people have the right to protests and have free speech.  We want, say, a party or a concert to be under 250 people, but we are not limiting peoples’ right to protests, there are significant social issues and we want people feel they  have a voice and so the Governor is always supportive of that, and so, and is, participating in that.

Erie County after Friday will be one of two counties in the yellow in the west.  Can you give us any inkling of when Erie County may go int the green?  LEVINE:  We’ll be looking at that tomorrow, and then we’ll discuss those we’ll have new modeling, new cases, incidence rate trends, percent of positivity of testing over the last two weeks, will discuss that ourselves, then discuss that with the Governor, and then he will make a decision.

The Governor five days ago outlined three criteria for moving, and you just mentioned two of them.  LEVINE:  If there’s any significant outbreaks that could affect that.  We’re looking at trends over two weeks.  If a county had a trend upward, that would be troubling.

Are those three measuring sticks the main ones?  LEVINE: We’re going to be putting out a scorecard on Friday so people will know what we’re looking at.  We’re looking at testing capability, contact tracing capacity, all of those and other issues go into this. But on Friday, we’ll put up a scorecard so that people can see what we’re thinking of.  We want to make it visual.

With the new testing capability in western Pennsylvania are you suggesting anyone who wants to, should get tested, or are you still asking that only people showing symptoms get tested?  LEVINE: We are prioritizing testing among symptomatic individuals.  But that can be any symptom and there are many. So any individual can get a test.  We’re not yet doing – but we would like to when we have a rapid POC test – population based surveillance testing.  That we’re not doing. If people feel they’ve been exposed and want to get a test, they can get a test.  We’re hopeful that as we prepare for the fall, those tests will be available.

Is SE PA still on the track for reopening, and if so, what are the main parameters for that?  LEVINE: So yes, southeastern PA including Philadelphia are on track to go to yellow on Friday, and the parameters are everything we just talked about. We’re very comfortable with SE PA.

Given the fact that you had your first consortium to discuss contact tracing in southwest PA last week, how many contact tracers will you need, and how many does the region currently have?  LEVINE: I can’t tell you how many the region has.  I know the Department has over 380 contact tracers and that does not include the county and municipal health centers.

Why aren’t nursing home residents recovering in the hospital when they do, instead of in the nu
rsing home?  LEVINE: It can take weeks for someone to test negative for COVID-19. We don’t think they are contagious at that time.  But you can be shedding the DNA even though you don’t have the live virus. It’s not practical to have people stay in the hospital even though they don’t need hospital care  for weeks and weeks waiting for a negative test.  The specific criterion for the CDC is when you are no longer contagious.

With the school reopening guidelines released earlier today, what kind of discretion do school districts have? We’ve already discussed masks, but what else individually?  LEVINE: I know there’s local control, but I don’t know the specifics, so I’m going to leave that to the Department of Education.

There’s been a lot of talk about a second waver of the virus in the fall.  Do you have an idea of when that may happen, what it might look like and what preparations if any the state is taking?  LEVINE:  The answer to the first couple questions is no, we don’t know what that’s going to look like or when that will occur.  We know the normal course of influenza, but coronavirus is not influenza.  We need to be ready, so to be ready we want to have robust testing, a rapid accurate point of care test that can be done, even by a lay person to tell in 15-20 minutes if someone is positive or negative., and it’s possible antibody testing may be helpful.  We don’t’ know for sure what those exactly meaning of those antibodies yet, but knowing people are at least partially immune. We will be prepared, but I can’t promise the tests I discussed will be there – if they are available, it will be much easier.  I am hopeful they will be and that will make the job much easier.

Leading up to yesterday’s elections, the state allowed counties to consolidate polling places, and from a public health perspective, do you have a concern about funneling more voters into fewer spaces? If something like that is considered for the fall, would you recommend against it?  LEVINE: We want to make sure that people exercising their Constitutional right to vote are also safe.  So we want to make sure they are wearing masks, remaining socially distanced, have hand sanitizer, and the polling place is kept clean. I think THAT will be really important as we head into the fall. I think voting from home offers people the safest way to vote and I know the Governor has been strongly supportive in this election of people voting from home by mail. Voting by mail is the safest way to vote given that we’re voting in the middle of a pandemic.

Allegheny County consolidated hundreds of places with a large number of people voting yesterday. Didn’t that worry you at all?  LEVINE:  I know there were specific reasons for that and I’m not plugged into the reasons with the Department of State, but I know that there were facilities that might have been voting in nursing homes and LTC facilities, but as long as people follow the things I say every day, that would be the safest way to vote in person, but by far voting by mail is the safest.

Has there been any discussion about eliminating the phases in the fall? Given the possibility of a second round, has there been any discussion of coming out of this with a label at all? LEVINE:  We have had preliminary discussions, but mostly about counties in red and those what would have to go to green  The Governor has emphasized the fact that being prepared for the fall is utmost, no one wants to issue stay at home orders anymore.

As people’s attention turns to other things going on in the world, is there anything you want to emphasize, as they think we have this behind us and we’re moving on?  LEVINE:  The Governor has said over and over again that we are in a “new normal.” COVID-19 is not behind us.  There are significant outbreaks happening around the world.  That’s why I say stay alert now, people need to stay alert and vigilant.

With the schools being able to open in the fall, what are the guidelines that will be put into place to keep them safe?   LEVINE: Those guidelines were outlined in the report released by the Education Department today.  It’s available on PDE’s website.

In March, the FDA had approved rapid tests for health care workers.  Are any PA hospitals using these?  LEVINE:  There are some, but there were significant issues getting these tests.  There’s one test per kit.  But the FDA has also put out concerns about its sensitivity- it’s false negative rate. That’s really concerning if you have a screening test. You want to be sure you’re not missing people, so it’s a valuable test, but we will eventually want and need a test with more accuracy and rapidity in the future.

You mentioned a “new normal;” what will that look like, what metrics will have to be achieved, will your scorecard coming out Friday reflect that?  LEVINE: The scorecard will outline what counties need to do to go from yellow to green.  The new normal is going to continue.  We will want people to wear masks for the foreseeable future. We’ll want people to wash their hands for the foreseeable future.  We’ll want people to use hand sanitizer liberally for the foreseeable future. We want people to practice social distancing for the foreseeable future. That’s what the Governor means by the new normal, COVID-19 is not gone, and we don’t have anywhere near herd immunity here or anywhere in the world. Really until there is a vaccine that can be safely administered and distributed.

So is a vaccine really your threshold?  LEVINE:  Yes.  The way to get through this without a safe and effective vaccine.  I know the federal government is working really hard on promoting that. 

In discussing herd immunity, there’s talk of developing it in Sweden – is that an example?  LEVINE: In terms of Sweden, they have not developed herd immunity, so while that was one of their goes, the antibody levels are nowhere near herd immunity there. They had, as did every other county, significant issues with transmission in senior living centers and congregate settings, so Sweden is not an example for the world. They had more cases and more deaths than any other country in the Nordic region.

Can you provide an update on MIS-C cases in Pennsylvania? LEVINE: Those numbers are available on the website, but I don’t have them in my head.

Can you provide more guidance for high school sports that want to get started in a safe manor?  The Governor’s order says they can begin in the green phase, but doesn’t provide information on what’s necessary to begin.  What guidance are you giving the PIAA and what considerations should youth programs consider in safely participating in athletics?  LEVINE:  I know the Governor’s Policy Office is coming out with more information, about sports in general and youth sports, and I would anticipate that this week, although sometimes things get delayed as they go through the review process. There will be more detail about that.  All that I would emphasize is everything I’ve talked about before.

Four finalists selected for Operation Warp Speed
The Trump administration has selected its COVID-19 vaccine finalists for Operation Warp Speed, which aims to deliver safe and effective coronavirus vaccines to Americans by the end of the year, The New York Times reports.

The finalists—from AstraZeneca, Merck, Pfizer, Johnson & Johnson and Moderna—have a clear Big Pharma slant, with biotechs like Inovio and Novavax being left off the list. Moderna is the smallest company among the group, but the biotech is pressing ahead into mid- and late-stage testing with its mRNA candidate at a record pace.

The vaccine programs selected will get access to additional government
funding, clinical trial assistance and manufacturing help, the Times reports, citing senior administration officials. Already, Johnson & Johnson, Moderna, AstraZeneca and Merck have scored federal funding for their projects.

Operation Warp Speed officially unveiled last month, aims to speed COVID-19 vaccines to the public in record time. The administration has tapped former GSK vaccine head Moncef Slaoui as a leader for the group that’s incorporating expertise from the U.S. Department of Health and Human Services, the Department of Defense and more in the work.

DoH releases dental health care guidance
The Pennsylvania Department of Health today released an update to the dental health care guidance as part of the commonwealth’s phased COVID-19 reopening plan. This guidance allows dental health care providers the ability to safely provide oral healthcare, including routine cleanings.

“This latest update provides dentists the opportunity to resume non-emergency dental care, including routine care, if they can provide it safely,” Secretary of Health Dr. Rachel Levine. “Oral health is a key part to one’s overall health, and we strongly encourage all Pennsylvanians to regularly see a dentist and receive oral healthcare. As more dental procedures are performed during the phased reopening, dentists should prioritize dental care for the highest need, most vulnerable patients first.”

Dental providers should follow protocols outlined by the CDC for all procedures. Providers should ensure they have the appropriate amount of personal protective equipment (PPE) and supplies to support their patient volume. The appropriate level of PPE, according to CDC guidance, must be available for all dental care practitioners including dental hygienists prior to providing any dental treatment. Providers should regularly check CDC guidance when providing care as recommendations and guidance could change frequently. The full guidance can be found here.

All patients should be screened for symptoms of COVID-19 before arriving at the practice and social distancing should be maintained while in the practice. Patients should wash or sanitize their hands frequently and wear a mask when not undergoing treatment. Tele-density should continue when possible as patients may be able to be treated virtually.

Education guidance provided for school openings
Elementary and secondary public schools in Pennsylvania counties under yellow or green reopening phases can resume in-person instruction starting July 1 provided they have approved health and safety plans in place, the state education secretary said Wednesday.

Higher education institutions in yellow and green counties can resume in-person instruction starting Friday if they have health and safety plans.

Education Secretary Pedro Rivera outlined the preliminary guidelines for schools to weigh in reopening during the COVID-19 pandemic in a conference call with reporters. Schools have been closed since Gov. Tom Wolf declared a statewide disaster emergency in early March although some have provided remote learning to students.

The Education Department’s preliminary guidance is considered a starting point and will be updated as the state Health Department and the federal Center for Disease Control provide more information about health and safety precautions, said Rivera. The department will issue additional guidance later this month in such areas as teaching and learning, student wellness and sports. The guidance applies to school districts, charter schools, regional charter schools, cyber charter schools, career and technical centers and intermediate units.

Rivera said a number of school officials are considering offering a hybrid form of education with some learning offered on-line and other learning provided in a classroom setting.

Also, the secretary said the actual start of a school’s calendar year could be different from the traditional timeline of late August.