March 30 COVID-19 Update – Pennsylvania American College of Physicians

​COVID-19 DAILY UPDATE

President Trump is extending the voluntary national shutdown through April 30, in response to the coronavirus pandemic rise in the U.S.

The initial 15-day period of social distancing urged by the federal government expires Monday, and President Trump had expressed interest in relaxing the national guidelines in at least in parts of the country less afflicted by the pandemic. But instead he decided to extend them for another month, on the advice of the White House Coronavirus Task Force and medical experts. 
 
Governor Wolf requests national disaster status
On Sunday, Governor Wolf said he had formally requested a major disaster declaration from the President through the Federal Emergency Management Agency to provide additional support for state, county and municipal governments and certain nonprofits, as well as individuals who are struggling during the COVID-19 outbreak.

The request for a major disaster declaration, if approved, will provide the same emergency protective measures available under the nationwide emergency proclamation; the following Individual Assistance programs: Disaster Unemployment Assistance, Crisis Counseling, Community Disaster Loans and the Disaster Supplemental Nutrition Program; and Statewide Hazard Mitigation.

On Saturday, the state Agriculture Department announced it had received approval to conduct a Disaster Household Distribution program from the USDA using USDA foods. (See more below)
 
PA DAILY UPDATE
On Saturday, PA reported a total of  533 additional positive cases of COVID-19, and 2,751 statewide, with 25, 2534 negative to date.  Cases were found in 50 counties. The total deaths statewide among positives is 34, all adults.

Of the 316 hospitalized with COVID-19 since 3/6 (11.5% of the total positives),  97 were hospitalized and  required treatment in an ICU, 56 required ventilators.  53% of all cases are among those under 50 years of age, 47 percent among older Pennsylvanians.

Governor Wolf announced he was extending his Stay at Home orders to Beaver, Centre and Washington County, bringing the state total to 22 counties under those orders.  They join Allegheny, Berks, Bucks, Butler, Chester, Delaware, Erie, Lackawanna, Lancaster, Lehigh, Luzerne, Monroe, Montgomery, Northampton, Philadelphia, Pike, Wayne, Westmoreland and York counties under a “stay at home” order.

By Sunday, those numbers had increased significantly.  Dr. Levine reported that the state had 649 new positive cases and 3,394 statewide in 58 counties.  The negative tests total 30,061.  Four additional deaths from COVID-19 were reported, bringing the total to 38 statewide, all among adult patients. 

Among those hospitalized, the total reported hospitalizations remained at 316, about 10.4% of all positives.  Of those, 110 patients required ICU treatment, and 64 of those required ventilators. 

She said the state had 64 confirmed positive cases reported from 36 nursing homes, five percent of the state’s 695 homes, with most in southeastern PA.
The coronavirus death toll in New York state surged overnight with 237 new deaths, setting a new 24-hour record since the virus first emerged in the U.S.
 
How bad can it get in Pennsylvania? “The virus sets the timeline”
While local experts continue to echo Dr. Anthony Fauci, saying “the virus sets the timeline,” Pennsylvania is just more than two weeks away from the worst of the COVID-19 and more than 3,000 people in the state will succumb to the virus, according to a recent analysis by researchers at the University of Washington, published on March 26.

The number of deaths per day and highest hospital ICU needs from the virus will reach a peak in the state in 18 days — on April 17 — according to the analysis. It projects 109 deaths from the virus on that day with 3,094 deaths projected out to Aug. 4. On that day, the study projects a need for 1,471 ICU units, with only 1,043 needed.

The projected peak day for the country is April 14 with 2,341 deaths projected that day.

If the projections for Pennsylvania hold up, the research shows the state will need an additional 428 ICU beds on April 17.

Researchers at Washington’s Institute for Health Metrics and Evaluation compiled the research.

The estimates are based on Pennsylvania maintaining the social distancing measures in place March 25 throughout the pandemic.
 
Business Issues and Information
The Pennsylvania Department of Health will soon release more advice to businesses that have discovered an employee has tested positive for COVID-19.  There’s an existing protocol for businesses on the Health Department website, but Dr. Levine, the secretary of the Pennsylvania Department of Health, said Sunday afternoon that it would be added to this week.

Current information  for essential businesses is available on the Department’s website.  Information from the CDC is available here.

A guide to the full CARES Act is online from the US Senate Business and Commerce Committee. The US Chamber has information on provisions for small businesses in the CARES Act as well.
 
CARES Act personal payment schedule discussed
Treasury Secretary Steven Mnuchin said folks could receive direct deposits from the $2 trillion stimulus bill sometime in the next 21 days.  The bill will ensure the direct payments to many Americans as well as $350 billion in small business loans. Mnuchin also said there will be a web-based application for those who don’t receive the direct deposits.

He said the goal is to deliver enough money to American workers and companies to “get through the next eight to 10 weeks.”

Individuals are set to receive checks up to $1,200 and married couples could receive up to $2,400. For those who make more than $75,000, payments began to lower by $5 for every $100 over that make. Folks who make more than $99,000 will not receive money, according to the report.
 
State Government layoffs begin  
The Wolf administration has laid off about 2,500 part-time and seasonal employees and interns as the financial fallout from the coronavirus deepens, straining Pennsylvania’s cash flow, Employees who work for the state health and labor departments, which are central to the coronavirus response, were not impacted, state officials said.
​
Some of the departments impacted include revenue and transportation, state officials said. It wasn’t immediately clear which other departments were affected, though several employ seasonal workers, including the Department of Conservation and Natural Resources, which oversees state park facilities, and the Pennsylvania Liquor Control Board.

The affected workers, which include temporary clerical staff and employees who help out in departments across state government during busy periods, were placed on “leave without pay” Friday. There is currently no timeline to recall the
m back to work, according to Gov. Tom Wolf’s Office of Administration.

Wolf has also ordered a hiring freeze and general purchasing ban for state agencies in an effort to cut spending. For the past two weeks, state officials have been focused on preventing the health system from being overwhelmed with a crush of sick patients.
 
Licensing Board easing regulations raising questions
In an effort to boost the number of health care professionals on the front lines of the coronavirus outbreak, Governor Wolf and the Department of State have eased regulations to help nurses and doctors on licensing renewals, retirees returning to practice and expediting applications from those licensed in other states.

Kensinger also said the temporary relief offered so far — like waiving fees for retired professionals who want to get back to work — is already paying off. On Saturday, the governor said that 119 medical professionals have applied to reactivate lapsed licenses over the past three weeks.

More temporary waivers are in the works, said Wanda Murren, a spokesperson for the Department of State, which oversees 29 professional licensing boards and commissions. Murren said staff is working nonstop to research and vet new regulatory changes — changes that typically take between 18 to 24 months to enact
Now two state senators say that broader, more sweeping changes — like limiting which criminal convictions are considered disqualifying — are needed to tackle dual crises: the virus and the impending economic downturn.

Sen. John DiSanto (R., Dauphin) and Sen. Judy Schwank (D., Berks) introduced a bill last spring that would reduce barriers for people who have old or irrelevant criminal histories when applying for professional licenses.  “More needs to be done,” DiSanto said in a statement. “Combatting COVID-19 is an all-hands-on-deck situation and it is unfortunate that barriers to occupational licensing prohibit otherwise skilled and qualified professionals from working to save lives.”

Schwank said the bill is especially relevant now, as the state prepares to get people back to work. “It will make sure the regulations are published, that they’re fair,” she said.  The bill passed the Senate unanimously in November and is awaiting consideration in the House Judiciary Committee.

Lyndsay Kensinger, press secretary for Wolf, said in a statement that the governor is supportive of the bill but that it “won’t help address the immediate need to add health care practitioners.”

Nationally, licensing costs the economy nearly 2 million jobs annually. In the states, licensing’s toll on jobs ranges from around 7,000 (Rhode Island) to nearly 196,000 (California).

By a conservative measure of lost economic value, licensing may cost the national economy $6 billion. However, a broader and likely more accurate measure suggests the true cost may reach $184 billion or more. At the state level, the broader measure finds losses ranging from $675 million (Rhode Island) to over $22 billion (California).

Licensing likely leads to these losses because it restricts competition, effectively giving licensed workers a monopoly. With fewer competitors, licensees can charge more for their services. Consumers and the wider economy pay the price.
 
USDA and Emergency Food
Just one day after a letter from Governor Tom Wolf to U.S. Secretary of Agriculture Sonny Perdue, Agriculture Secretary Russell Redding received approval for the Pennsylvania Department of Agriculture to operate a Disaster Household Distribution program, through The Emergency Food Assistance Program (TEFAP), to provide critical food supplies to Pennsylvanians adversely affected as a result of statewide COVID-19 mitigation efforts.

“Hundreds of thousands of Pennsylvanians have applied for unemployment compensation after just two weeks of COVID-19 mitigation efforts. I’m incredibly grateful for the U.S. Department of Agriculture’s acknowledgement of our need to feed Pennsylvania,” Wolf said. “This waiver lifts a weight off the shoulders of our food banks and families across the commonwealth.”

On Thursday, March 27, 2020, Governor Wolf sent Secretary Perdue a letter urging him to approve the department’s waiver application that would allow more food to be distributed at hundreds of locations across the state, while temporarily waiving the need to verify household eligibility. Late Friday, March 28, 2020, the department received approval to use USDA Foods as part of a Disaster Household Distribution program being operated through the state’s network of food banks, food pantries, and pop-up distribution sites. The approval allows the department and its partners to more efficiently distribute a variety of foods – including meats, vegetables, fruit, canned goods, cereal, rice, pasta, eggs, and more – to those most affected by the closure of non-life sustaining businesses in Pennsylvania.
 
GENERAL ASSEMBLY
The State House and Senate are now in recess unti April 6, unless sooner recalled by the Speaker of the President Pro Tempore. When they return, they are expected to take up legislation that will necessary to impact the state’s ongoing response to the coronavirus pandemic.

State Budget?
With COVID-19’s impacts on state government ranging from hundreds of millions of dollars in unexpected costs and hundreds of millions (billions?) of lost revenues, the state budget is now a back seat issue for the Wolf Administration and General Assembly.  Response to the emergency is the #1-#10 priority at this point.
​
All of the above may result in lawmakers trying to craft and pass a budget without knowing how badly tax revenues have been impacted or how much more may have to be spent in recovery efforts in the 2020-2021 state fiscal year.

Jake Corman, Senate Majority Leader, has already said moving the filing deadline for state income taxes to July 15 will cause “significant disruption to the budget process,” with the June 30 deadline for passing the budget.  Corman suggested a short term budget may be a necessity.