Gov. Tom Wolf and Sec. Rachel Levine, Department of Health (DOH), held a press conference today to announce new COVID-19 mandates.

Gov. Wolf noted that Pennsylvania is “in a precarious place” and announced that several new restrictions would be implemented as the state enters into a much-anticipated winter resurgence of COVID-19. He reported that the commonwealth has had more new cases, hospitalizations and deaths than in the spring. He remarked that every state, aside from Hawaii, has seen a higher number of cases. However, Gov. Wolf commented that the mitigation done in the spring had kept new cases low enough to allow the health care system to prepare as the scientific community also learned new ways to treat COVID-19.

“We’re in a different position in that regard than we were in the spring, so we have a different strategy now to make sure that we are still effective in saving lives,” he said. Gov. Wolf pointed out that it is the public’s duty to protect themselves and ensure hospitals and health care workers are not overrun. “We want to make sure we protect public health but also help support our very fragile economy,” he said.

Gov. Wolf stated that the new enforcements are targeted responses that aim to limit large gatherings and increase the enforcement of existing mandates. Additionally, he issued a stay-at-home advisory. “In order to stay safe, we ought to stay home,” he said. “It is vital that every single Pennsylvanian takes these mitigation steps seriously.” He reminded viewers that every number reported in COVID-19 statistics is a person, family member or friend who gets sick and may die.

“Sadly, the statistic shows that more people are getting sick at a faster rate than what we’ve seen before,” he said. Gov. Wolf noted the various professionals and community members who have been working to mitigate COVID-19 and asked the public to protect hospital capacity through mitigation methods and adhering to the new requirements.

He warned that if hospitals or hospital staff are overrun with COVID-19, then emergency and chronic care will also suffer. “We cannot let our health system crack under the strain of COVID-19,” he said. “We all need to be a little more careful, we all need to wear a mask and stay at home whenever possible.” Gov. Wolf encouraged the public to unify and stay strong.

Gov. Wolf announced that the state will institute a stronger enforcement of public health orders, but it is the public’s cooperation that will help mitigate COVID-19. He asked that the public stay home for the holidays to keep people safe. Although some reports regarding vaccine trials are encouraging, he affirmed, “We are not out of the woods yet.”

He reiterated the personal responsibility involved in keeping others safe. “When we make good choices and follow mitigation measures, we actually get good results,” he said. “So, let’s work together, all of us, to stop the spread.”

Sec. Levine reported 3,379 individuals are hospitalized, with 575 of those in the intensive care unit (ICU) and 371 on ventilators. “The number of hospitalized patients per day has increased by more than 2,100 since the end of September,” she said. Sec. Levine enumerated that there were 4,762 new cases today with 28 new deaths, and 7,074 new cases on Sunday with 41 deaths.

She explained that this brings the total number of COVID-19 cases in Pennsylvania to 314,401 and the total number of deaths to 9,870. She added that 63 percent of the total number of cases have recovered. She remarked that Cameron is the only county to have reported a percent positivity below 5 percent.

“Throughout the pandemic there have been nearly 24,000 cases of COVID-19 ages 5 to 18. 7,100 of those have been reported in the last two weeks alone,” she said.

Sec. Levine announced that the new restrictions are intended to stop the spread of COVID-19 and to protect hospitals, health care workers and all Pennsylvanians. “These measures include targeted protections for businesses and gatherings, an advisory, as the governor has discussed, for Pennsylvanians to please stay at home, a commitment by schools to protect students and staff, steps to protect hospital capacity to treat sick patients, empowering local governments to protect their own communities, and a new enforcement plan that includes liability protection for businesses enforcing the now-strengthened masking order,” she said.

Additionally, Sec. Levine stated that alcohol sales at all bars and restaurants are suspended at 5 p.m. on Wednesday, November 25 until 8 a.m., Thursday, November 26. She maintained that restaurants are still required to operate at 25 percent unless they self-certify to serve 50 percent of their occupancy.

Further, she announced businesses must allow employees to telework when possible by November 27.

For various sectors, she expounded: retail stores are allowed 75 percent of their occupancy; gyms, salons, barber shops and other personal care establishments, 50 percent; large gatherings indoors, less than 500 people; and outdoor events, less than 2,500 people.

“I have also issued an advisory for Pennsylvanians to avoid leaving their homes unless it is absolutely necessary,” she said. Sec. Levine clarified that it is not a shutdown order, but is recommended as the new cases of COVID-19 continue to rise.

Sec. Levine urged the public to avoid family gatherings for the holidays and warned that grouping with others could put people at risk for contracting COVID-19.

She recommended that public schools maintain in-person instruction when possible, but noted that schools in the 59 counties that have been at a substantial transmission level for two weeks are encouraged to revert to remote 3 learning. Any schools in those 59 counties are required to sign an attestation form to confirm that safety protocol is in place if they wish to continue with blended or in-person learning. She warned that schools who refuse to sign the attestation form will be required to only provide remote learning and cease all extracurricular activities.

Sec. Levine emphasized that DOH has worked closely with regional hospital networks to ensure they have an available capacity for COVID-19 patients and remain cautious of staffing shortages, spikes in COVID-19 cases and sharp reductions in hospital bed availability. She noted that if a hospital has been marked as having symptoms of an outbreak, they must immediately stop elective procedures. She clarified that regions, not counties, will be notified if they no longer meet qualifications.

Sec. Levine said law enforcement and state agencies will issue citations and fines or regulatory actions for repeat offenders. “It has to be our collective responsibility to protect our communities, our health care workers and our most vulnerable Pennsylvanians from COVID-19,” she said.

Nicole Faraguna described her father-in-law Jack Faraguna’s death due to COVID-19. At 92, she stated, he contracted COVID-19 in his nursing home and died several months after due to the disease weakening him. She thanked health care workers for their efforts.

“We have encountered individuals who think this pandemic is a hoax or have attempted to downplay its seriousness,” she said. “Unfortunately, we know their denials will lead to people pointlessly dying.” She emphasized that the momentary inconvenience of wearing a mask is worth saving lives.

State Health Secretary Dr. Rachel Levine on Friday also announced the department will be working with the federal government to distribute to healthcare systems throughout the commonwealth monoclonal antibodies, which are proteins built in a laboratory that mimic the immune system’s ability to fight off harmful antigens, like the COVID-19 virus.

“The department will determine which healthcare systems receive allocations based upon county case counts,” Levine said. “Then, the federal government will distribute the antibodies to the respective healthcare systems to further help communities struggling with the spread of COVID-19. Monoclonal antibodies may provide short term protection from the SARS-CoV-2 virus for appropriate COVID-19 patients.”

The department stated that health care systems will determine eligibility for the antibodies based upon the U.S. Food and Drug Administration (FDA) emergency use authorization (EUA) guidelines.

Sec. Levine opened the floor for questions for the Governor and herself:

Could you give us more data points that would trigger hospital cutbacks on elective procedures and which regions are currently exceeding those data points? Sec. Levine replied that none of the regions exceed the triggers, but they include that 33 percent of hospitals anticipate staffing shortages in the next week, a 50 percent increase of COVID-19 cases in the region and if less than 10 percent of the total hospital beds are anticipated to be available in the next 72 hours. She added that DOH wants to partner with hospitals to ensure there is enough space for both COVID-19 and non-COVID-19 patients.

How close are we to reaching projections that indicate the state may be out of hospital beds in several weeks? Sec. Levine responded that most of the regions are doing well. She added the Northeast region is the most challenged in bed availability but does not have any other issues. She commented that the projects were concerning, but DOH will continue to monitor the situation.

What resources will be given if ICU beds are filled and how would the capacity be increased? Sec. Levine answered that the goal is to avoid ICU beds being filled, but DOH, health care coalitions and hospitals would need to coordinate to solve an issue such as that. “If one hospital is having issues with a surge, then another hospital could take that load,” she said. Assurances have been made that there will be collaboration, she added.

If hospitalizations lag behind increases in new COVID-19 cases, are you prepared to take further steps in mitigating the spread of the virus? Sec. Levine clarified that the DOH mandates that have been issued today have been created while acknowledging the future hospitalization rates. Gov. Wolf said, “Hospitalization is a bit of a lagging indicator but the availability of staff is not, and the availability of ICU beds is a daily indicator. So, we’re looking for things that are contemporaneous.”

Can you explain why the sale of alcohol is barred 5 p.m. on Wednesday, November 25 until 8 a.m., Thursday, November 26? Gov. Wolf replied that it is one of the largest “days for drinking,” which could potentially cause an increase in COVID-19 cases. He urged the public to forgo drinking at bars for that night. “We have to get through this rough patch,” he said.

He acknowledged that restaurants have been “hit hard” but he cannot ignore the reality that the virus will spread in locations such as those. “We have to recognize that as tough as that is, it would be harder if people die,” he said.

Have you rethought going back to the red-yellow-green phase, and what would cause the state to return to that? Gov. Wolf said there is no situation that would require a phased approach. He emphasized that the mitigation efforts in the spring were to “buy time” so that the state would be more prepared in the future. He stated that Pennsylvania now has better techniques and methods to pinpoint mitigation to prevent the economy from being further damaged. “We have a lot more things to do before we beat this virus, but we have a lot more in terms of resources than we did back then,” he said.

What does the increased enforcement of COVID-19 mandates mean? Gov. Wolf explained a progressive discipline system where a business will receive larger fines as they continue to disregard the mandates. “If they come inside, they need to follow the procedures,” he said. He expounded that the first violation is a warning, the second is a required 24-hour closure, and the third violation is a 24-hour closure and a fine. He stated the system has been effective in other states and he hopes it will be effective in Pennsylvania.

For business that do follow the mandates, HB 1737 recently passed both houses and would offer liability protection. Do you plan on signing that? Gov. Wolf directed the questioner to his legal counsel for a full legal answer but maintained that there is a limited immunity that would accrue to the owner or manager of the establishment. He remarked that he is unaware of how the bill compares to the law as it already exists but believes it is “the same idea.”

What is your position on extracurricular activities in schools? Should they be cancelled? Gov. Wolf replied that his current position is that school administrators should sign the attestation form. Not all sports are the same, he commented, and added that he removed the required mask mandate from swimming competitions and football, among other alterations. “We want to have a commonsense approach here,” he said.