May 27 COVID-19 Update – Pennsylvania American College of Physicians

• Daily report from DoH re COVID-19 cases
• Wolf thanks Pennsylvanians, adds Center County to green phase starting Friday
• Wolf and Levine answer questions
• Five-month state budget bill narrowly passes House
• Wolf to release recovery plan

 
TUESDAY’S REPORT FROM DoH
The Pennsylvania Department of Health on Tuesday confirmed that, as of 12:00 a.m., May 26, there were there are 451 additional positive cases of COVID-19, bringing the statewide total to 68,637. All 67 counties in Pennsylvania have cases of COVID-19.
 
There are 5,152 total deaths attributed to COVID-19, an increase of 13 new deaths. County-specific information and a statewide map are available here. 
 
“As Pennsylvania continues to move forward in the process to reopen, we need to remember that the threat from COVID-19 has not gone away,” Secretary of Health Dr. Rachel Levine said. “As counties move into the yellow and green phases, we must take personal responsibility to protect others. Wearing a mask, continuing to maintain social distancing, and washing your hands frequently are all steps we can take to help protect others, including our most vulnerable Pennsylvanians, our essential workers and our healthcare system.”
 
There are 551 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 339,835 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;
• Nearly 6% are ages 19-24; 
• Nearly 37% are ages 25-49; 
• 25% are ages 50-64; and
• Nearly 29% 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.
 
Levine said that concerns remain for children, as CDC is reporting Multisystem Inflammatory Syndrome in Children (MIS-C).  She noted the fact that there are many unknowns about this syndrome at present including whether the syndrome is only an issue in children.  In Pennsylvania there have been 17 reports of MIS-C.  Nine are confirmed, two were not cases, and the remaining 6 are under investigation. 
 
In nursing and personal care homes, there are 14,857 resident cases of COVID-19, and 2,505 cases among employees, for a total of 17,362 at 594 distinct facilities in 44 counties. Out of our total deaths, 3,395 have occurred in residents from nursing or personal care facilities. A county breakdown can be found here.
 
Approximately 5,159 of our total cases are in health care workers.
 
For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.
 
Non-life-sustaining businesses in the red phase are ordered to be closed and schools are closed statewide through the remainder of the academic year. Currently, 49 counties are in the yellow phase of reopening. Eight additional counties will move to yellow and 17 to green on May 29. All remaining red counties are expected to move to yellow by June 5.
 
The Wolf Administration has since noon, May 25:
Provided an update from Pennsylvania State Police on business closure enforcement actions.
For the latest information for individuals, families, businesses and schools, visit “Responding to COVID-19” on pa.gov.
 
Non-life-sustaining businesses in the red phase are ordered to be closed and schools are closed statewide through the remainder of the academic year. Currently, 49 counties are in the yellow phase of reopening. Eight additional counties will move to yellow and 17 to green on May 29. All remaining red counties are expected to move to yellow by June 5.
 
Wolf thanks Pennsylvanians, announces Centre County will move to green Friday
Governor Wolf Tuesday thanked Pennsylvanians who serve in the Armed Forces, includin
g the Pennsylvania National Guard, for their contributions to the pandemic response. He also announced that Centre County will move to green on Friday.
 
On Friday, Gov. Wolf announced eight additional counties will move to yellow and 17 to green, effective at 12:01 a.m., this Friday. All remaining counties in red are expected to move to yellow by June 5 at 12:01 a.m.
 
The counties moving to yellow on Friday include Dauphin, Franklin, Huntingdon, Lebanon, Luzerne, Monroe, Pike and Schuylkill.
 
The 17 counties moving to green, also on Friday, include Bradford, Cameron, Clarion, Clearfield, Crawford, Elk, Forest, Jefferson, Lawrence, McKean, Montour, Potter, Snyder, Sullivan, Tioga, Venango and Warren. Centre County is eligible to move to green on May 29, so county officials chose to vote today to decide to move ahead and Centre will now be the 18th county to move to green on Friday.
 
Counties that remain in red on May 29 and are expected to move to yellow by June 5 include Berks, Bucks, Chester, Delaware, Lackawanna, Lancaster, Lehigh, Northampton, Montgomery, and Philadelphia.
 
Wolf and Levine took questions on Tuesday
What’s your reaction to the large crowds that gathered over Memorial Day weekend?  Should all those individuals self-quarantine for 14 days?  LEVINE: It would not be indicated to self-quarantine, but I would express concern about those individuals and the possibility of spread from those large gatherings.
 
Cases are rising in other states.  Do you expect to see an increase in Pennsylvania after the Memorial Day weekend?  LEVINE:  We believe most people followed the recommendations, but we will remain vigilant to ensure we take the best care of the citizens of the Commonwealth.
 
Friday we’ll see the first counties moving into the green phase.  Do you have any updates or guidance for those counties moving to green?  LEVINE:  There’s broad guidance on the Governor’s website, and there will be more specific guidance put out later this week.
 
The Department said it was concerned about spikes in Union and Snyder County, which is why they aren’t going green this week.  Any improvement there so far?  LEVINE:  Our teams will be looking at all of those areas closely.
 
In what phase will large gatherings like weddings be allowed, and what do you expect those to look like?  LEVINE:  There will be more guidance on life in the green zone this week.  Certainly not gatherings like a large concert, we will still want masks and social distancing even in the green zones and want people to be vigilant about the potential spread of COVID-19.
 
What did you make of the letter that alleges hospitals are rationing N95 masks, what changes will the Department make to guidance about reusing these masks, and is it true the state appropriated $58 million for purchase of PPE, medical supplies and hand sanitizers since March 6? LEVINE: I don’t know about the letter, but we want the hospitals to follow our guidance about PPE and procedures, so we’ll continue to work closely with them to ensure they follow our guidelines and rules.
 
Is it true that the state authorized that $58 million for PPE, supplies and sanitizers, but that the Department of General Services has only secured $14.5 of the ordered supplies?  LEVINE: I know that the Department has been looking everywhere in Pennsylvania, in the US and around the world for this equipment and supplies. Much of that is very hard to find, because it is a global pandemic.
 
Now that Dauphin County is going to yellow on Friday, will state agencies under the Governor’s jurisdiction begin processing Right to Know requests again, and will you host in person news conferences?  WOLF: WE are going to do whatever we can to make sure the RTK requests are acted on.  A lot of state employees will continue to telework, but we’ll work on that.  In terms of in-person press conferences, we plan to hold our first with reporters in the room here on Friday.
 
NJ Governor Murphy announced today that graduation ceremonies could be held there beginning July 6 as long as they were held outdoors and with social distancing.  When can such events be held in Pennsylvania?  WOLF: The guidelines as we develop them in the green and yellow will have numbers beyond which we don’t really feel it would be safe. I don’t know what Governor Murphy is doing but in Pennsylvania, what we’re saying is this is all about staying safe.
 
Today, Governor Murphy announced that professional sports teams can return to training and even game action.  Where do you stand on professional sports teams in Pennsylvania?  WOLF: We have been working for the last several weeks with professional and amateur sports teams to figure out what the guidelines ought to be in PA.  Again, to keep players and citizens safe. 
 
It seems the budget is going to be broken into segments, a five month budget and then a seven month budget.  Can you tell us why it’s going to be done that way? WOLF:  We are moving with the General Assembly and al of us are struggling to look at what the budget is going to look like this year.  We’re still working on it and I hope we get to a conclusion very quickly that takes into account the situation we find ourselves in.
 
Was your decision to go along with this tied to agreement that education funding would not be cut for the 12 month budget for the fiscal year?  WOLF:  Not that was not part of any deal. We don’t know what revenues will look like, and we don’t know how much – or whether there will be more funding from the federal government.  There’s just a lot of unknowns and we’re all struggling to determine what the best way is to move forward from a budgeting standpoint.
 
What do you want to see in a budget from the General Assembly?  WOLF: We want to see that funding is there for the necessary services we need to support, given all the uncertainties that are out there in this world right now.
 
Centre County Commissioners today asked you to let the County go green after all.  Will you grant Centre County’s request this week?  WOLF:  YES.
 
The state put out guidance for green counties on Friday that included 50% occupancy for restaurants, barbers, salons, etc.  How did you decide on that figure and how will it be enforced?  WOLF:  We’re working with the Pennsylvania Restaurant and Lodging Association on guidance and we should have those sometime later this week.  We’re trying to lay out guidelines to keep people safe.  Ultimately what’s going to work is not enforcement.  It’s each individual and each business doing everything they can to protect their employees and their customers.
 
Have you given the green light for the race at Pocono or is that still subject to negotiation?  WOLF: We’re not negotiating.  We’re working with them and other professional sports to make sure that the guidelines are in place to keep the competitors and the people who work around Pocono Raceway safe.  That’s all we’re trying to do.
 
As more places open up, WHO is already talking about a second peak.  How is that playing into your plans? LEVINE:  We will see what happens, but we have plans in place to support these moves from red to yellow to green.  We’ll be paying close attention and will take all necessary steps, including isolation and quarantine of individuals to lessen the possibility of more significant community spread.
 
Do you have a timetable for when testing of residents and facilities in Long Term Care facilities will begin?  LEVINE:  That has begun and started two weeks ago with pilot testing before we announced our plan.  We
are working toward that to detect asymptomatic individuals to prevent the spread of the disease in these vulnerable facilities.
 
On Friday you said the 50 positives per 100,000 metric was no longer as important as it once was.  Can you elaborate on how and when that metric became less important, and any specific improvements in other metrics?  LEVINE:  As we have significantly increased our testing, we will be picking up more and more people with COVID-19.  That makes an incidence rate like that much less useful to us.  We are looking at trajectories, CMU data, models from CHOP and their policy lab in order to make decisions to go from yellow to green and that all counties could go to yellow next week.
 
What parameters does a county have to meet to go from yellow to green?  And how specifically will they be monitored for risk in those transitions?  LEVINE: Continual decreasing rater of COVID-19 at least two weeks when they go yellow, then they will be considered to go to green.
 
What can you tell us about the state’s excess deaths this year?  LEVINE:  We’re looking at the excess death information to see if it would be useful – we’ll consider publishing that.
 
Has the state found anything that may have been involved in outbreaks in a number of nursing homes that are owned by the same company? Anything that may have been done in a system of homes that may have led to the outbreaks?  LEVINE:  Not specifically.  But we have published the actions we’ve taken for infractions at these homes and we will hold them accountable for those infractions.
 
Why isn’t the state publishing the results of negative antibody tests, when you are publishing the results of positive antibody tests?  Without knowing how many are negative tests, isn’t the state lacking transparency about its capacity to perform diagnostic testing for the virus? LEVINE:  It’s important to remember that the antibody test is not a best used as a  diagnostic test.  We are including the positive antibody tests as probable’s, but are not counting them in any of our decision making.  We are being as transparent as we possibly can.  That’s an interesting question about negative tests, and we will discuss it.
 
Are counties prepared to handle all the mail in ballots they are expecting to receive?  Counties have been expressing concern that they will be unable to manage this, especially in the fall election.  WOLF: I think that’s a legitimate concern.  WE have gotten money together to give counties in counting those ballots, but with COVID-19, it’s a better safer way to handle voting.  While there’s going to be an increase in costs, there will be reduced costs in in-person voting.
 
The primary election is one week ago today.  Do you have a message for those considering going out?  WOLF: Yes, please consider your health, and consider voting by mail and vote from home!
 
Five-month state budget narrowly passed by House – Senate moves bill up on calendar
The State House late Tuesday afternoon passed a five month budget which holds the line at expenditures from the current year, but extends education funding for 12 months.  The vote initially failed on a 101-101 vote, but a second vote was taken which resulted in passage of the bill by a 103-99 vote.
 
The budget would flat fund most line items from the 2019-2020 budget for five months, because of the almost total lack of certainty revolving around revenues due to the COVID-19 pandemic, and inability to know what kind of federal assistance may yet be coming to the states this year. Education funding would remain at 2019-2020 levels for the entire Fiscal Year.  The process would result in the General Assembly having to pass another budget for the remainder of the fiscal year before November 30, when the General Assembly adjourns sine die in accordance with the state Constitution.
 
Wolf to release plan for recovery
The Governor’s Office confirmed Tuesday that a recovery framework will be announced this week to help Pennsylvania residents recover from the pandemic. 
 
As part of the lead up, this morning, the Governor called for increasing the minimum wage to $12/hour with a path to $15/hour, with additional hazatrd pay to essential workers during the emergency declaration for the pandemic.
 
He called for better employee protection standards that would protect workers from losing their job if they have to self-isolate due to the coronavirus, and an expansion of student loan forgiveness and repayment plans, focusing on debt relief for individuals on the front lines of the pandemic.
 
Gov. Wolf is also working on a long-term recovery plan for businesses struggling amid the pandemic. That includes vigorous financial support for small businesses who would otherwise have to close their doors for good while shelter-in-place orders remain in effect.  The Governor’s Office said the support would be based on incentives for businesses to attract workers by providing good paying jobs.
 
The governor’s plan will also include investments in PA’s agriculture industries and others that support a safe food supply.