The following is the latest COVID-19 information from Pennsylvania state and federal regulators and others as of 4:30 p.m. on Monday, April 6.
Pennsylvania Update
The Governor Wolf/Department of Health Daily Briefing
- The number of newly diagnosed COVID-19 cases in Pennsylvania has remained relatively constant for the past three days. Secretary Levine said this gives her “hope” but is not yet indicative of a bending of the curve.
- The number of COVID-19-related deaths is not so constant: it has more than doubled since last Wednesday.
- 598 health care workers have now tested positive for COVID-19, as have 518 patients in nursing homes across the state.
- Two weeks ago Secretary Levine ordered hospitals to submit certain utilization data to the Department of Health daily. From this data she reported that 51 percent of hospital beds and 40 percent of ICU beds are currently unoccupied and 70 percent of ventilators are still not in use.
- 533 Pennsylvania COVID-19 patients have required ventilator care to date. This is more than three times the number reported on Friday (147).
- Pennsylvania has more than 5000 ventilators in hospitals today. This is more than the state realized its hospitals had. The state still has a stockpile of ventilators to share and expects more to arrive shortly.
- In response to a question, Secretary Levine said that federal coronavirus response coordinator Deborah Birks, MD probably mentioned Pennsylvania as a next possible COVID-19 hot spot because of the combination of continued large numbers of new cases, rising death totals, and proximity to New York and New Jersey, both of which are hot spots.
- In response to a question, Governor Wolf said while the state has not provided case data for municipalities, such a possibility is now being discussed.
- In response to a question, Governor Wolf acknowledged that the state’s revenue projections for the current fiscal year have “fallen to pieces” and the state is doing everything it can to reduce operating expenses. He said he hoped federal stimulus money will help and that he will be working with the legislature to address next year’s budget.
Department of Health
- The Department of Health updates its interim guidance for collecting clinical specimens for COVID-19 testing, emphasizing that nasopharyngeal specimens are the “strongly preferred” choice for such testing and outlining acceptable alternatives.
- The department has issued an order addressing the cleaning, disinfecting, and other maintenance and security services that are now required for buildings that have been authorized to remain open during the COVID-19 crisis.
- The department sent a letter to hospital administrators, obstetricians, and midwives strongly encouraging labor and delivery providers to follow recommendations from the World Health Organization and the American College of Obstetricians and Gynecologists when caring for pregnant women during the COVID-19 emergency, including permitting a support person to be present during delivery.
Department of Human Services
- In conjunction with the state Department of Education, DHS has issued a memo to local education agencies that participate in the school-based ACCESS Program encouraging the use of telemedicine during the COVID-19 emergency.
- DHS has published a notice limiting the prescription of hydroxychloroquine in the state’s physical HealthChoices, Community HealthChoices, and Medicaid fee-for-service program to prevent shortages and stockpiling of the drug. DHS reinforced this message in a memo on the same subject to all physical health HealthChoices plans.
- DHS’s Bureau of Managed Care Operations has sent a memo to all physical health HealthChoices managed care organizations with guidelines on performing elective surgeries during the COVID-19 emergency. The MCOs are directed to “continue to accept and review prior authorization requests for inpatient and outpatient elective procedures, elective interventional radiology and dental procedures. All requests need be reviewed for medical necessity.” The memo includes criteria for approving surgery under current circumstances.
Office of the Treasury
Pennsylvania’s Treasury Department has announced a bond purchasing program that seeks to provide financial relief to Pennsylvania health care systems. The program’s objective is to provide liquidity to health care systems while reducing their borrowing costs.
Federal Update
Centers for Medicare & Medicaid Services
- CMS has updated its COVID-19 FAQ for state Medicaid and CHIP programs. This FAQ covers a variety of subjects, including the use of Appendix K waivers, eligibility and enrollment flexibility, exceptions to timeliness standards, modification of eligibility verification policies, the use of telehealth, the suspension of premiums and other cost-sharing, and more.
- CMS has posted a video providing answers to commonly asked questions about the expanded Medicare telehealth services authorized under its nation-wide section 1135 waiver.
- CMS has published guidance for processing attestations from ambulatory surgical centers that are temporarily enrolling as hospitals during the COVID-19 emergency.
- See an updated list of the section 1135 waivers CMS has granted to help states and health care providers respond to the COVID-19 crisis.
Food and Drug Administration
- The FDA has posted an emergency use authorization (EUA) about circumstances under which selected imported, non-NIOSH-approved disposable filtering facepiece respirators may be used.
- The FDA has published its enforcement policy for clinical electronic thermometers during the COVID-19 emergency.
- The FDA has posted an FAQ on shortages of surgical masks and gowns. This FAQ addresses current shortages, the reuse of selected materials, the use of products that have not been approved by the FDA, and more.
Occupational Safety and Health Administration
OSHA has provided interim guidance to its regional administrators and state plan designees regarding enforcement discretion to permit the extended use and reuse of respirators, and respirators that are beyond their manufacturers’ recommended shelf life during the COVID-19 emergency.
Department of Health and Human Services/Office of the Inspector General
- The OIG has issued a policy statement regarding the application of certain administrative enforcement authorities due to the COVID-19 crisis. This statement conveys that the OIG will not impose sanctions under anti-kickback laws related to actions by health care providers that fit under the HHS’s previous waiver of the physician self-referral provisions of the Stark law. The OIG also has launched a new FAQ on this policy statement to provide additional information.
- The OIG conducted a national survey of hospitals, asking them about the challenges and needs they faced. See a summary of the survey results here and the full report here.
The White House
During Friday’s coronavirus task force press briefing, national coronavirus response coordinator Deborah Birx, M.D. explained the priority in the distribution of the new COVID-19 test that yields results in 15 minutes.
American Medical Association
The American Medical Association has issued its own “guiding principles” for the protection of current medical students and medical students: those who are graduating early to help in the fight against COVID-19 and those who are being enlisted, while still in medical school, to participate in the direct care of COVID-19 and suspected COVID-19 patients.
Resources to Consult
Pennsylvania Department of Human Services
Pennsylvania Department of Health
Centers for Disease Control and Prevention
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