June 5 Afternoon Pennsylvania COVID-19 Update

INSIDE THIS REPORT:

  • Wolf, Levine announce 12 more counties to move to green effective June 12​
  • Friday’s COVID-19 numbers and links
  • Friday Q/As with Governor and Secretary Levine
  • HHS Releases New COVID-19 Demographic Data Reporting Requirements for States
  • Long-Term and Congregate Care Restrictions Will Remain in Place as Pennsylvania Reopens 
  • New Deputy for Long Term Care Programs named at DHS

GOVERNOR ANNOUNCES CHANGES, PHASES EFFECTIVE JUNE 12Friday afternoon, Governor Wolf announced that effective 12:01 a.m. June 12, another  12 Counties would be transitioned to the green phase as Pennsylvania Reopens.  The Counties are Adams, Beaver, Carbon, Columbia, Cumberland, Juniata, Mifflin, Northumberland, Union, Wayne, Wyoming, and York. He noted that every county in the state was now in the yellow phase, and that 34 of 67 counties were now in the green phase.  He repeated that the red phase had been intended to “buy time,” and allow hospitals and health systems to meet the challenges.He also noted that despite continuing good news throughout the state, that new positive cases continue to rise in Erie County, and positive rate, calling that alarming.  He noted some concern that there may be an outbreak in that County.  With these signs of community spread, he said the County will remain in yellow.  He said the state was sending six contact tracers to the County to help mitigate the spread.
Thursday’s Data Report from the Department Of Health
The Pennsylvania Department of Health today confirmed as of 12:00 a.m., June 4, that there were 443 additional positive cases of COVID-19, bringing the statewide total to 74,385. All 67 counties in Pennsylvania have cases of COVID-19.

There are 5,886 total deaths attributed to COVID-19, an increase of 69 new deaths. County-specific information and a statewide map are available here. 
There are 620 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. There are 424,201 patients who have tested negative to date. Of the patients who have tested positive to date the age breakdown is as follows:

  • Nearly 1% are ages 0-4;
  • Nearly 1% are ages 5-12;
  • Nearly 2% are ages 13-18;
  • 6% are ages 19-24; 
  • Nearly 37% are ages 25-49; 
  • 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.

In nursing and personal care homes, there are 15,929 resident cases of COVID-19, and 2,768 cases among employees, for a total of 18,697 at 611 distinct facilities in 45 counties. Out of our total deaths, 4,077 have occurred in residents from nursing or personal care facilities. A county breakdown can be found here.  Approximately 5,659 of the total cases are in health care workers.
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For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov. Currently, all 67 counties are in the yellow or green phase of reopening.

Statewide – The Wolf Administration has since noon, June 4:

Friday Q/As with Governor and Secretary Levine
The Governor was asked what’s beyond Green?  Wolf said that yes, it was something that is now being discussed internally – he called it the “new norm,” and said that it would still involve social distancing, wearing masks, etc.  Dr. Levine said that  from a public health perspective, it may be a color, such as Gold, but the practical matter would be further relaxation of limitations on businesses, but remaining vigilant and waiting for a vaccine.

Wolf was asked again about his participation in the protest.  Wolf acknowledged his participation was “inconsistent,” but that he was showing his support for that protest.  Gov. Cuomo said all protesters should be tested and go into self-quarantine.  Wolf said, “I took a real gamble but decided it was worth the risk.” 

He was asked why the State Police Commissioner wasn’t standing with him in announcing police reforms.  Wolf said he worked with the Legislature Black Caucus and had discussed it with him, but his presence wasn’t necessary.

The General Assembly passed Speaker Turzai’s bill on funding and health system participation with nursing homes.  Why weren’t health systems brought on earlier to help in the nursing homes? Levine said that many have already been, and they are looking forward to the work.  Wolf said this has been a learning situation, and that “as we learn things, we need to be flexible.” He said Speaker Turzai’s bill was a good bill.

The Governor of Texas said he would allow up to 50% occupancy for fans.  Are you considering something like that, and what’s the status?  Wolf said the status right now is NO fans.  The NFL are the only ones he said have suggested this, he said, and they are selling refundable tickets.  Other professional sports are not asking for that right now.

What’s the percentage of Pennsylvania’s total deaths in nursing homes?  About 70%.

You asked for the collection of LGBTQ statistics for COVID-19.  When do you expect to release that information? Levine said they were collecting it and it would be released when a  robust enough response provides sufficient number has been aggregated.  She noted that they are also asking for collection of data on race, ethnicity, etc.  We’re doing much better as far as race, but less successful with ethnicity, and less with LGBTQ.

Beaver County’s status?  Levine said, the county’s numbers are improving, and we’re pleased they will go to green next Friday.

What’s going on with Perry County?  LEVINE: In terms of our metrics, they did not meet our criteria of stable or decreasing rates over the last two weeks.  We’re very hopeful we can do that next week but have to see what the data shows.

Just 157 state inmates have been released to date, is that moving too slow?  Wolf said since March 1, over 3,000 have been released.  With criminal justice reform, the reprieve process has gone more slowly that we thought.

Yesterday you were discussing the inherent bias in the system. Can you define that?  WOLF: Economics, health care, housing, there is a real divide in the country.  It’s felt in the African-American community.  If one part of our population feels that way and has over a long period of time, we have to do something about that. 

Will the Administration be taking additional steps to address those?  WOLF: I will continue to, with education funding, expanding Medicaid, and it’s not something I woke up Wednesday thinking about.  I take it very seriously, and what I tried to do was publicly rededicate myself to what I came here to do.

When you talk no fans, are you saying in the fall, or right now?  WOLF: I’m talking right now.  Places like Penn State have not yet figured out what they are going to do.  In the next month or so, though, no fans.  Dictate is not the wrong way to look at this.  How many stop signs are out there?  You stop because it’s in your best interest to do that.  It’s whether all of us can make each other feel comfortable go to school, go to work, buy something.  There’s no dictate that will wave a magic wand, but it’s in your self-interest to do that.

Many counties are still counting ballots.  How concerning is this and can it be fixed by the general elections?  Wolf said, I’m sure that by the general election results will come in faster.  But in the 2012 presidential election primary that year, there were 1.5 million voters turned out.  We had 1.5 million who voted by mail and another million who voted in person.  It’s a huge surge from the 200,000 we’ve been having.   Other states have faced the same thing, and have invested in scanning technologies, putting more people into the mix, and we’ll want to help the counties in November to improve the process.

Can you update the Philadelphia situation?  Has the National Guard calmed things?  WOLF: It appears things are moving in the right direction, and the violence in some parts of the city seem to be abating.  I wouldn’t attribute it to any one thing.

Can you comment on Pennsylvania’s job numbers with this morning’s news?  WOLF: It’s too soon to know what Pennsylvania’s numbers are and I don’t know what that means for PA yet.
 
HHS Releases New COVID-19 Demographic Data Reporting Requirements for States
The Trump administration on Thursday released new requirements for states to report coronavirus data based on race, ethnicity, age and sex of individuals tested for the virus in response to calls from lawmakers to gain a better picture of the pandemic. All laboratories — as well as facilities offering on-site testing and in-home testing — will be required to send demographic data to state or local public health departments based on the individual’s residence, according to details released by the Department of Health and Human Services.
 
Long-Term and Congregate Care Restrictions Will Remain in Place as Pennsylvania Reopens
The Pennsylvania departments of Health and Human Services issued guidance for nursing homes, personal care homes, and other long-term and congregate care facilities as counties enter the green phase of the Governor’s Process to Reopen Pennsylvania. To further prevent outbreaks within these vulnerable populations, ongoing restrictions in long-term and congregate care facilities will remain in place at least 28 days after the respective facility’s county enters the green phase.

On March 18, the department issued guidance for nursing home facilities on COVID-19 mitigation. This guidance required visitor limitations, personnel restrictions, and other measures to reduce the spread of COVID-19 in nursing facilities. This guidance has since been updated on May 12.

DHS has issued guidance restricting visitation to its licensed intermediate care facilities, assisted living residences as well as DHS’ 17 state-run facilities, which include state centers, state hospitals, youth development centers, and youth forestry camps. Individuals served by these facilities often have chronic medical conditions and are at a higher risk of complications fro
m COVID-19, so caution and care must be taken to keep residents and staff at these facilities safe from the virus. Guidance to DHS providers is available here.

DHS has worked with licensed providers and staff at state-run facilities to encourage and facilitate virtual visits and communication to maintain connection between residents and families while they are unable to be together. Unless otherwise indicated by the individual, the expectation is that communication with family and friends is supported on a regular and routine basis for each individual. Means of safe visitation include:

  • Arranging a meeting that occurs between an individual or family/friends viewing each other through a window or glass door, so that social distancing guidelines can be followed.
  • Using technology such as FaceTime, Skype, Zoom meetings, Facebook, Messenger, etc.
  • Promoting communication through telephone calls, email, writing letters, texting, sending photographs or videos, or the use of virtual assistant technology (ex. Amazon’s Alexa or Google Home).

Following the guidance from the Centers for Medicare and Medicaid Services, these restrictions will be among the last restrictions eased to ensure resident health and safety during the COVID-19 pandemic.

The department is conferring with stakeholders including the state’s ombudsman, representatives from skilled nursing care facilities, nursing home associations, other government agencies, and academia. Upon completion of that process, the department will issue guidance that amends the restrictions currently in place.  Since the beginning of the COVID-19 pandemic, the Department of Aging Ombudsman has served as a source of encouragement and connection for families who are trying to reach loved ones, because, by the very nature of their personalized advocacy approach, they’ve been very successful in working with nursing homes to develop connections in accordance with a family’s needs and a facility’s procedures/capabilities.

Family and friends who are unable to see loved ones living in long-term care facilities because of the COVID-19 emergency may struggle with changes in protocol, rights and policies. The Pennsylvania Long-Term Care Ombudsman Program is available to help with a new statewide resource called Virtual Family Council.

The Ombudsman Program has a ground force of 73 local ombudsmen in communities across Pennsylvania, advocating and empowering on a case-by-case basis for long-term care residents to resolve complaints and issues. The number to call for assistance from a local representative is 717-783-8975.

The Wolf Administration has taken a three-pillar approach to protecting the vulnerable residents living in long-term living settings from COVID-19:

  • Ensuring resident safety through testing, education and resources;
  • Preventing and mitigating outbreaks; and
  • Working in partnership with state agencies, local health departments and long-term care facility operators.

The Department of Health distributed over 1,812 shipments of personal protective equipment to all long-term care facilities in Pennsylvania. Additionally, the department continues to work with ECRI as they provide technical assistance and our Healthcare Acquired Infection (HAI) team to further assist and remain connected with the nursing homes in order to best assist their needs.

For additional resources regarding COVID-19 and nursing homes in Pennsylvania, please visit the department’s COVID-19 Information for Nursing Homes webpage.
 
New Deputy Named for Long Term Living Programs at PA DHS
After leading Pennsylvania through its multi-phase launch of Community HealthChoices over the last two and a half years, Office of Long Term Living (OLTL) Deputy Secretary Kevin Hancock is bidding farewell to OLTL and state government in mid-June.  He will continue his public health work at Health Management Associates, a public health research and consulting firm. 

Jamie Buchenauer has been named the OLTL Deputy Secretary after serving as the Office of Medical Assistance Programs Director of the Bureau of Fee-for-Service Programs since 2015. She has extensive experience in state government, including as Director of Pennsylvania’s Money Follows the Person Program, which aims to move people from institutional settings to the community, as well as public policy experience outside of state government.