May 20 Pennsylvania COVID-19 Update


  • Tuesday‘s COVID-19 data update
  • CDC teams assigned to Pennsylvania
  • Sec. Levine Q/As
  • Governor Wolf Q/As
  • DoH releases information on COVID-19 and long term care facilities

On Tuesday, the Department of Health reported that Pennsylvania had reported 610 new confirmed positive cases in the previous 24 hours, for a total of 63,666 confirmed cases.   
The death total rose to 4,624 confirmed COVID-19 deaths, an increase of 119 from  Monday’s report, all in adult patients.  3,145 of the state’s deaths, 68 percent, were nursing home residents.   For the first time, one pediatric death was reported, but the child was not a resident of Pennsylvania.
With newly reconciled data, it was reported that just 1.8% of all deaths were among those 30-49, 10.6% were in patients 50-64, 29.2% were among those 65-79, and 58.2% were in those ages 80 and above.
There were 286,034 negative tests in PA as of midnight Monday night.
About 4,600 positive cases were in health care workers – accounting for about seven percent of all positive cases.  The total figure includes 2,191 workers in nursing homes.  13,813 residents – accounting for 22 percent of all cases- are in 558 of the state’s long-term care living facilities in 45 counties. 
Two percent of hospitalizations were under 29 years of age, five percent were 30-49, 10% were 50-64, 20% were 65-79 and 19% were 80+.  Forty-four percent remained unclassified per age or unreported by the Department.
Of the total through Saturday, 34,914 positive cases (55%) were female and 28,068 (44%) were male. One percent (684)  were unreported or neither.  Among the deaths, 2,197 (49%) were males 2,296 (51%) were female.
By race, 16,387 positives were Caucasian (26%), 7,522 were African-American (12%) and 781 (1%) were Asian, with 342  listed as “Other.”  The vast majority, 38,603 (61% of all cases) remained unreported on the race of the patient.  A total of 3,263 deaths (72.6%) were among Caucasian victims, 904 (20.1%) were African American/Black, 118 (2.6%) were Asian.  Of the total, 242 (5.4%) were Hispanic.
On Tuesday afternoon, 1,846 positive patients were hospitalized. At that time, 375 were using ventilators and 16 were on ECMO machines.  About 1,216 (38%) of the 5,199  intensive care unit (ICU) beds were available, 5,634  general medical beds (45%) were available and 1,483 (53%) of the airborne isolation rooms are still available statewide.  And 1,279 of the state’s 5,376 ventilators were in use (more than 75% of ventilators were still available.) 
Of the patients who tested positive to date the age breakdown was: less than 1% are aged 0-4; less than 1% are aged 5-12; 1% are aged 13-18; 6% are aged 19-24; 37% are aged 25-49; 26% are aged 50-64; and 29% are aged 65 or older. 

CDC teams now helping state in congregate settings
The state requested and received additional support from the CDC for the next two weeks.  Three teams arrived last Thursday and were briefed and prepared for the response. Two of the teams are assisting with outbreaks in long term care facilities, and the third is assisting with outbreaks in food facilities. The teams are helping the Department assess the situation in thee congregate settings, teaching infection control practices, and offer personal training on PPE.  They are also assisting with outbreak response at the facilities they visit.  They are helping develop facility specific testing strategies, and using expertise to cohort residents and staff.
Since the start of the outbreak, state infection control officers have completed 465 inspections, 459 remotely and six on site.  They have 192 infection control surveys in progress, 175 remotely and 17 on site. 
Q/As with Secretary Levine
There are many couples planning to get married this summer, and many businesses depending on these marriages.  Is there any expectation that weddings with 50-100 or more guests could be allowed this summer, especially in counties that turn yellow? LEVINE: IN red counties we would not recommend those weddings.  That would pose a significant risk.  However, in yellow counties, weddings could occur with less than 25 people, and those type of weddings with those types of numbers could occur in green zones, although we still would recommend social distancing and wearing of masks as much as possible.
As people plant their gardens this year, are there any foods that could provide safeguards or protection from any of the health problems the virus delivers?  LEVINE: No I’m sorry  but there’s no evidence that any particular food can provide any protection from the virus.  Of course, we always want people to eat a healthy diet with plenty of fruits and vegetables.
Pennsylvania has the ninth highest death rate of any state, but the 14th lowest testing rate. Why is the testing so low?  LEVINE: We are working right now to ramp up our testing. In fact, today we are reporting that we did more than 11,000 tests yesterday, the highest we have had and a significant increase overall in the last week/week and a half, and we will continue to expand testing throughout Pennsylvania.
With two deaths and hundreds of positive cases at SCI Huntingdon, please be specific about what the plan is to deal with the outbreak.  Is the National Guard assisting?  How frequently are inmates and employees being tested? LEVINE: We are in frequent communication and collaboration with Secretary Wetzel of the Dept. of Corrections, I don’t have granular data about that facility, and I refer you to the Department of Corrections, but I know they are doing everything they possibly can to stem that outbreak.
Why has there been such a long  delay in releasing the information on nursing homes as families wait to make life saving decisions or watch their loved ones pass away without the full knowledge of what’s going on inside? LEVINE:  It is actually the responsibility of the facilities to let family members know about cases in these facilities and to keep families updated.  However, after CMS put out their guidance about ten days ago, we worked on that last week and today we are reporting out numbers.
Is there any information on a timetable for moving counties from yellow to green and if so, what is the timetable? LEVINE:  As I said yesterday, we are working on that as we speak and as soon as we have the metrics, we will release them.
Are there metrics yet, and is there some idea of when we might see counties start to move from yellow to green?  LEVINE: As soon as the Governor is ready to make an announcement, he will.
Spas have the ability to conduct business with social distancing easily controlled, strict access and limited appointments that would allow contact tracing if necessary but have been left out of consideration for opening.  Wellness facilities that have gone through these procedures should be considered for reopening.  Why is the plan for them to not open until the green phase?  LEVINE:  Our concerns over hair salons, barbers and massage therapists is because it is impossible to provide those services and provide for social distancing, because it provides hands on services, so that’s why they are to remain closed in the red and yellow zones.
Do you have any hope for people who want some normalcy this Memorial Day weekend, especially those who live in red counties?  LEVINE:  Twelve more counties will go yellow on Friday, but I know its really difficult for those who live in red zones.  Hopefully, the weather will be warmer, and it will be sunny, and it’ll be great for people to go outside, but of course if you’re going to go outside and meet with other people you must practice social distancing and wear a mask.  Hopefully, we’ll all have as enjoyable Memorial Day weekend as we can.
Will sleep away camps be allowed to open this summer, and if so, under what conditions?  LEVINE: The Governor’s office is working on guidelines for those types of facilities, and as soon as they are ready, they will be released.
The test results reported today seem to be more than 9,000 and as many or a higher number than any other day’s reports.  How close is todays total to the number of results the state is hoping to reach?  LEVINE: We were hoping for 8,000 or more and we’re actually exceeding that.  So we’re very pleased terms of the testing going on.  We are expanding testing and we’re actually ahead of schedule.
If you had to do it over, and could do it now, how would you handle long term care facilities differently? LEVINE:  We think about that every day, how we can help those facilities, help them in any way, with the National Guard, the CDC teams, we’re continuing to evolve out plans to do everything we can to help them.
The death histogram looks like the number of deaths has fallen to a handful n the past couple of days compared to a high of 175 on April 25.  How do you account for the precipitous death drop-offs, even as the number of positive outcomes has declined more gradually? LEVINE:  It’s always later that you’re going to see the death drop-offs, so we’re watching that in terms of cases and deaths, and they’re never going to turn be exactly the same, but we have had a significant decline in the number of new cases and we hope to see a similar decline in the number of deaths.
Twenty-four yellow phase counties will reach the two week mark on Friday.  What have you seen there in terms of outbreaks, and when do you see them moving to green?  LEVINE: We don’t know what the metrics are to move to green so we don’t know when they will, but we have not seen any large outbreaks, we have some congregate facilities that have had a number of cases, but so far the yellow counties are doing well and as we work on those metrics, we’ll work on a plan for when those yellow counties can move to green.
President Trump told governors yesterday that the federal government will step in if they see anything wrong or if they disagree with anything.  Do you have any views on that from a public health standpoint?  LEVINE:  I have no specific comment.  We collaborate with public health in the federal government very well, we have regular phone calls with the CDC, and we are in frequent contact with HHS.
President Trump is taking what he calls “hydroxy” prophylactically.  What is your view of the drug for that purpose, and are you concerned about the message this sends to the public? LEVINE:  There is no proven benefit to taking hydroxychloroquine for prevention of COVID-19.
The Governor has already talked about NASCAR, but w
here does PA stand on other pro sports without fans, would these counties with the stadiums have to be in yellow as well?
LEVINE:  Those decisions are being addressed to the Governor’s Office, they are consulting with the Department of Health, from the public health standpoint, but those decisions will be made by the Governor.
Several questions were asked about a particular facility where 73 of the 83 residents have tested positive and 12 have died, with 14 staff persons also testing positive.  LEVINE:  We are doing all that we can to assist them, and the deaths are reported by the county of residence for the people living there.  Many have not changed their residence from where they lived before entering the facility.  We’ve been in contact with the facility and will do whatever we can to assist them to protect the residents and staff in that facility.
Do you have DoH nurses in each county and enough staff to do contact tracing?  Is contact tracing under way in all yellow counties with sufficient staff to succeed?  LEVINE: We have our nurses and other staff in all yellow counties, and we are working to increase our staffing every day.
Why has DoH not been in touch with county emergency management officials to get assistance in contact tracing?  LEVINE: We will discuss that with PEMA since PEMA has the most contact with those individuals.
Gyms are included in the first phase of the president’s plan for reopening, but not for Pennsylvania.  Several gyms have reopened in Pennsylvania despite the Governor’s orders. Why can’t gyms operate and what is unsafe bout them at this time?  LEVINE: Well, we’re concerned about the possible transmission of COVID-19 and its possible our plan is different than the federal plan. We will work to have all businesses open as we go from yellow to green, but we don’t know when that will be yet.
As you break down deaths at a more granular level, is there a way to document which deaths were in patients who refused treatment?  LEVINE: No it’s not possible to report that metric.
Several other questions were asked about reconciling numbers of deaths between coroners’ offices and the Department. LEVINE: Now that we’ve started to fully reconcile those numbers, there will be fewer instances where it appears the numbers are significantly different, and that’s only because of our two different reporting systems.
Did you see anything significant in the numbers on nursing home facilities you released today? What do you say to critics who say you were too slow to respond to the crisis in these facilities? LEVINE:  We have been reacting to the challenges in long term care facilities. Other states have had the same experience. We have done everything we can, and going forward, we’re continuing to evolve our strategies and will do everything we can to protect them.
What kind of antibody tests would you like to see and what will it take to make those tests useful in controlling future outbreaks? LEVINE: We’d like to see a number of different antibody studies.  They are happening at some of our commercial laboratories and at the hospitals. What we don’t know is how protective those antibodies are at preventing a reinfection from COVID-19.  The suggestion is that they are at least somewhat but not completely protective, so we need more information about that; and we need more information over time about how long those antibodies last. If it turns out that they are, that will be very useful to know who’s at least partially immune and it would be really important information to know.
Why did you tell NPR that everyone in Pennsylvania’s long term care facilities will be tested, when the guidance is not mandatory, and suggested testing only 20 percent in those facilities without confirmed or suspected cases?  LEVINE:  Well, we’re going to be testing all the facilities. We are going to go out and we will be testing at every facility, all the staff and all the residents at the 1900-2000 facilities.
Last week you told us the Department was tracking the incidence of positive cases and outbreaks among workers at food processing plants.  Why won’t you tell the public the names and locations of the plants with outbreaks.  Isn’t this information more vital than ever as more counties enter the yellow phase? LEVINE:  We’re working with those facilities very closely, and with the Department of Agriculture.  We’ve had various conversations with the facilities themselves to try and keep the facilities open and limit the outbreak and spread of COVID-19 in those facilities.
State Rep. Russ Diamond is calling for your resignation over your response to the outbreak. He’s not the only one doing so amid the growing complaints about the state’s response to COVID-19. What is your reaction to this growing sentiment?  LEVINE: I have no specific reaction to the Representative, but what I can say is that I remain committed to protecting the citizens of Pennsylvania, wherever they live and wherever they go, whether it’s in a facility, it’s at home, whether its in Philadelphia or Pittsburgh, Erie or Harrisburg, whether it’s in their communities.  And whether they agree with me or not, I will do everything I possibly can to keep them safe.
The number of new positive cases has been under 1,000 for more than a week. What do you make of this? Is it a positive trend, and do you e it to continue?  LEVINE: We do consider this a very positive trend; I think that we have been successful in terms of continuing to bend and straighten the curve. We have been able to buttress the health care systems and they were not overwhelmed, and now after those mitigation efforts have been successful, we are working under the Governor’s leadership in a progressive, iterative, phased fashion to reopen Pennsylvania, to protect those businesses and protect the public health for everyone in Pennsylvania.
Can you explain how redacting death counts at a facility would be an invasion of privacy? Don’t you think that information is important for the public to know if they are considering putting a loved one in that facility right now?  LEVINE:  It’s the responsibility of the facilities to let families know of cases of COVID-19 in the facility. It is the responsibility of the facility to tell them that if a family is considering placement there.  We have to balance public health vs. the privacy and confidentiality of patients in these facilities, and the metric of five is the number the Department has always used.
How current are the data for nursing homes, and how often is that updated?  LEVINE: The information is current today and it will be updated daily.
Q/As with the Governor
When Dauphin County goes yellow, will you open up the Capitol? WOLF:  In yellow category things start to open up, and 25 people is still above the guideline, so whatever we do we have to make sure that we’re doing everything to keep that virus from infecting people.  So if that means keeping things shut down for longer, I think that’s what’s going to have to happen.  State workers continue to telework and that will continue.
Should colleges reopen in the fall. Will it matter what phase the counties are in?  WOLF:  The question is What can they do to make sure the teachers and students are safe? What can they tell the parents?  And that’s the same for higher education and secondary schools, private and public. As I talk to educators who are looking to the fall, all of them are looking at a very different kind of atmosphere than preceded this pandemic.
The White House is strongly recommending every state test every resident and staff person in nursing homes by May 25.  What are the reasons Pennsylvania can’t accomplish that?  WOLF: We’re trying to accomplish that as quickly as we c
an. We actually kicked off weekly testing for patients and employees a week ago. We had 11,000 tests done yesterday, the third straight day we’ve had more tests done, and as we build this capacity, it will allow us to fully implement the testing in all of our long term care facilities. There are 2,000 long term care facilities in Pennsylvania, and we hope to have weekly testing of all employees and all patients as soon as possible.
More than 2/3 of the state’s deaths from COVID-19 are in nursing homes.  That is one of the highest rates of death in the country.  What could Pennsylvania have done better to protect its older citizens?  WOLF:  That’s a question we ask ourselves every day, and we have done things like provide PPE for employees, shut down all visitors, moved to weekly testing as we can do that, but we keep trying to figure out what can we do better.  There is no question here and around the world that these places are places the virus has wreaked havoc.
What is your reaction to critics who say the state was way too slow to recognize the danger and way too slow to react to it? WOLF: In hindsight, there are maybe things we’ll learn. Keep in mind that LTC facilities are places that have dealt with infectious disease throughout their existence.  This has just overwhelmed them. This is more contagious than anything we’ve seen in our lifetime, and that any country has seen.  We keep trying to get better. This has just overwhelmed everybody.
A bill that would allow restaurants and bars to sell cocktails to go is on your desk.  Do you plan to sign it and let restaurants and bars begin rebuilding their businesses?  WOLF:  I do plan to sign it.  It was passed unanimously in both chambers of the General Assembly so I will sign it.
How do you want to focus the state share of the $3.9 billion in coronavirus relief funds? When do you expect you will begin appropriating funds? Why haven’t you done so yet? WOLF: Working with the General Assembly, I don’t want to do this unilaterally, I want to do this in partnership with the General Assembly, and that has taken some time, but the focus for me is that when we begin directing those funds, that everybody in Harrisburg recognize that it’s best for meeting the challenges that this pandemic has given us.
What did you think about Pittsburgh Steelers quarterback Ben Rothlisberger getting his hair and beard cut at an Allegheny County barbershop?  Will the barbershop face disciplinary action?  Is the state investigating?  WOLF:  My concern is just a general concern.  Anyone who puts himself in harm’s way is something that we ought to try to avoid. And when you go to something like a barber shop and you’re not protected, I don’t care who you are, the chances of that virus wreaking havoc on your life increases.  I don’t think personally any Pennsylvanian ought to take that chance.  I certainly don’t want to take that chance myself.
You said you would approve the NASCAR race if the county was in the yellow stage, yet you and Dr. Levine have in the past said organized sports would not be able to resume in the yellow stage.  Why the apparent hypocrisy?  WOLF:  I’m not sure.  We’re working with lots of organizations, the NHL, the NFL, major league baseball, to figure out how, when sports start again, and they can do it safely.  I know that NASCAR are looking at competing in front of empty stands, doing all kinds of things to make sure the competitors are safe, as far as housing, eating in a safe fashion, practicing social distancing, wearing masks, and that’s what we’re looking at.  The guidance will be about making sure people are safe.  I’m going to have a problem and the Administration is going to have a problem opening back up.  This is not something that’s just focused on NASCAR.  How do we reduce the possibilities that this virus is spread, and get back to normal as quickly, effectively and as efficiently as we can?
There are reports that a State Senator has called on the Attorney General to investigate the Southeastern Veteran’s Center, run by the Department of Military and Veteran’s Affairs.  Can you comment on the widely publicized complaints of family members and people associated with the facility? Do you think an investigation by the Attorney General is necessary?  WOLF: I’m not sure if that is absolutely necessary.  I think in every long term care facility we have work to do to make sure we protect the people in these facilities. That particular center has been cited, and I’m sure we’ll find out more as we ask more questions.
Can you comment on House passage yesterday of a special committee to focus on topics related to COVID-19?  Do you think such a committee is necessary and do you have suggestions on what the committee should look at?  WOLF:  I think we need to work together.  I have expressed a long time willingness and eagerness to discuss how we as a Commonwealth address COVID-19, and with local and county elected officials.  There are partnerships we need to have all across the Commonwealth, health care professionals, elected officials.  We need to continue to work together and I look forward to getting the details of that resolution.  Whatever we do, we can get a lot more done working together than doing these things in silos.
Is there a realistic timeframe for when more populated counties in the Northeast like Lackawanna and Luzerne can move from red to yellow phase?  WOLF:  I don’t have specific information, or we have not made a decision yet on when Lackawanna or Luzerne County may move to yellow.
You and Attorney General Shapiro recently announced protection from evictions due to COVID-19.  What would your message be to landlords who are raising some tenant rents right now? WOLF: In a pandemic, in any crisis where we’re all trying to work together, I think I’d be a little careful about that.  Every landlord and every business has to make their own decision, but what the Attorney General and I were trying to do was to extend the Supreme Court’s ban on evictions.  WE did not put off rent or mortgages being due, it was just postponed.  The idea was to make sure that people had shelter in this pandemic, and anything anybody does that jeopardizes that is going to be a problem.
Why are counties with very low case counts remaining in the yellow phase?  What is the threshold to move to the green phase?  WOLF: I’m not sure any county with a very low case count hasn’t moved into yellow.  The criteria we use for deciding if a county is to move from red to yellow is multiphased.  The 50/100,000 metric, I’m not sure what that has been used, but I am not aware of any county that is close to that metric hasn’t been moved.
DoH releases information on COVID-19 and Long Term Care Facilities
The Pennsylvania Department of Health has released information on the number of coronavirus cases and deaths at individual long-term care facilities in Pennsylvania.
The data includes the number of resident cases, number of employee cases and number of deaths that have occurred at each facility. For facilities with less than five in any of these data points, the information is redacted.
About 68 percent of the state’s deaths have occurred in long-term care facilities – both nursing homes and personal care homes and assisted living facilities.  And 61 percent of those deaths have occurred in facilities located in southeast Pennsylvania (1,343 deaths in facilities located in Bucks, Chester, Delaware and Montgomery counties, and 380 in facilities located in Philadelphia County).