Coronavirus Update for Monday, July 13

The following is the latest information from the state and federal government as of 2:45 p.m. on Monday, July 13.

Pennsylvania Update

Governor Wolf

Governor Wolf has signed an executive order authorizing state agencies to conduct administrative proceedings remotely. Several state agencies conduct administrative proceedings, including meetings and disciplinary hearings of the 29 occupational licensing boards and commissions under the Department of State. The order took effect immediately.

Department of Health

The Department of Health has revised its guidance for hospitals responding to COVID-19.

Department of Health – by the numbers

After a week of continued large numbers of new COVID-19 cases in Pennsylvania, the new case count announced today was less than half of each of the three previous days. Secretary Levine warned, however, that slow data reporting tends to make Monday figures low and that today’s number includes no new cases from Philadelphia.
The number of Pennsylvanians hospitalized with COVID-19 has now risen daily for the past week after more than a month of nearly daily declines.
The number of Pennsylvanians on breathing machines also is down and has fallen below 100 in recent days – lower than it has been since the start of the pandemic.
The number of new COVID-19-related deaths remains down significantly compared to recent weeks.
The recovery rate for Pennsylvanians who contract COVID-19 is now 77 percent.
Overall, case counts are up in 43 of Pennsylvania’s 67 counties over the past week.
In a news release issued late last week, the Wolf administration noted that “While the statewide percent-positivity rate is at 4.4%, counties with concerning percent-positivity rates include Allegheny (7.9%), Beaver (6.3%), Butler (5.5%), Clarion (14.6%), Fayette (5.2%), Greene (5.4%), Lawrence (5.8%), Lebanon (5.6%), Philadelphia (5.1%), Washington (7.2%), Westmoreland (5.4%) and York (6.3%).”
The state-wide rate of positive cases, though, is down – currently, 4.4 percent. Secretary Levine said she would worry if it reached five percent.
To date, residents and staff of 750 long-term-care facilities in 55 counties have accounted for more than 21,700 cases of COVID-19 in the state.
Universal testing in such facilities is identifying many new cases but many of those new cases are residents and employees who are asymptomatic.
300 long-term-care facilities have now completed the universal testing mandated by the Department of Health last month.
Overall, the proportion of Pennsylvanians over the age of 65 who test positive for COVID-19 is now declining.
More than 7100 health care workers have contracted COVID-19.
In the past seven days, 135,000 Pennsylvanians have been tested for COVID-19.
In the state, an average of 15,800 tests have been performed daily over the past 30 days.
From March 3 to date, 1,148,174 Pennsylvanians have been tested – about nine percent of the state’s population.
When tests are performed by hospitals and local labs, results are usually available in a day or two. The national companies, such as Labcorp and Quest, are struggling under their current workload, with some results taking as long as a week. The Department of Health has scheduled calls with the nation-wide labs to discuss this.
The state still does not have the capacity to engage in population-wide testing. The kind of simple, nearly instant-result test needed to do such widespread testing, Secretary Levine explained, does not yet exist.
Currently unoccupied are 40 percent of state hospitals’ acute-care beds, 42 percent of their ICU beds, 59 percent of their pediatric beds, 37 percent of their pediatric ICU beds, and 65 percent of their airborne isolation rooms.

Federal Update

Department of Health and Human Services

HHS has announced that it will distribute another $4 billion in CARES Act Provider Relief Fund money. Of that sum, approximately $3 billion will be distributed to safety-net providers, with the agency expanding its criteria since its June distribution of safety-net provider funding to encompass some safety-net hospitals that did not meet the previous criterion that addressed hospital profitability. Another $1 billion will be distributed to specialty rural hospitals, urban hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas. Hospitals are expected to see deposits as soon as Wednesday.
As part of these newest distributions of CARES Act money, HHS has added extensive updates to its CARES Act Provider Relief Fund FAQ. Most of the new questions involve these latest distributions and are all marked “7/10/2020.”
HHS also has updated its CARES Act Provider Relief Fund FAQ with new information about finding the status of applications or payments; the impact of changes on ownership in eligibility for payments; the eligibility of Programs of All-Inclusive Care (PACE) for payments; accounting for full-time employees by applicants for the Medicaid and CHIP distribution; and the ability of providers with tax identification numbers that have not yet been validated to apply for funds. All changes are marked “7/8/2020.”
HHS has posted a video titled “Five Things About Nursing Homes During COVID-19” that presents five things the agency is doing to stop the spread of COVID-19 in nursing homes.
HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) announced the adoption of a revised Confidentiality of Substance Use Disorder Patient Records regulation that seeks to advance “…the integration of healthcare for individuals with substance use disorders while maintaining critical privacy and confidentiality protections. Under Part 2, a federally assisted substance use disorder program may only disclose patient identifying information with the individual’s written consent, as part of a court order, or under a few limited exceptions.” Under the new rule, however, “Health care providers, with patients’ consent, will be able to more easily conduct such activities as quality improvement, claims management, patient safety, training, and program integrity efforts.” Go here to see HHS’s announcement and go here to see HHS’s fact sheet about the new regulation.

Centers for Medicare & Medicaid Services

CMS has updated its fact sheets describing the administrative flexibilities it has extended to different types of providers during the COVID-19 emergency. All of the updated fact sheets linked below describe extended deadlines for filing Medicare cost reports.
CMS announced that it will deploy Quality Improvement Organizations (QIOs) to provide immediate assistance to nursing homes in hotspot areas identified by the White House Coronavirus Task Force.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Home Health and Hospice Calls

Tuesday, July 21st at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 6080197

Audio Webcast Link: go here.

CMS COVID-19 Office Hours Calls

Tuesday, July 14th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2550919

Audio Webcast link: go here.

Tuesday, July 21st at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 7477995

Audio Webcast link: go here.

Tuesday, July 28th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 1492795

Audio Webcast link: go here.

Nursing Homes Call

Wednesday, July 22nd at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1143564

Audio Webcast Link: go here.

Dialysis Organizations Call

Wednesday, July 22nd at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7692208

Audio Webcast Link: go here.

Nurses Call

Thursday, July 23rd at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7971869

Audio Webcast Link: go here.

Lessons from the Front Lines

Friday, July 17th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Code: 3096434

Web Link: go here.

Conference lines are limited so CMS encourages interested parties to join via audio. To listen to the audio files and read the transcripts for the COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

Food and Drug Administration

The FDA has issued emergency use authorizations (EUAs) for seven new commercial diagnostic tests for COVID-19. Find them here, here, here, here, here, here, and here.
The FDA has issued an EUA for a new commercial serology test for COVID-19. Find it here.
The FDA has issued an EUA for the emergency use of a device intended for acute use at home or in a health care setting to treat adult patients with known or suspected COVID-19 who are experiencing exacerbation of asthma-related dyspnea and reduced airflow.

Centers for Disease Control and Prevention

The CDC has updated its interim infection prevention and control recommendations for health care personnel during the COVID-19 pandemic.
The CDC has updated its interim guidelines for collecting, handling, and testing clinical specimens from persons with COVID-19.
The CDC has updated its information about transferring patients to relief health care facilities when responding to community transmission of COVID-19.
The CDC has updated its guidance for health care facilities for COVID-19-related issues.
The CDC has updated its FAQ on laboratory testing for COVID-19.
The CDC has updated its strategies for optimizing supplies of personal protective equipment.
The CDC has updated its toolkit on shared and congregate housing.

Department of Labor

The Department of Labor announced the launch of a public awareness campaign to remind workers that it is committed to ensuring their workplace rights during the coronavirus pandemic and to ensure that employers know their responsibilities. The campaign will include public service announcements to provide employers and employees information about the new paid sick leave and expanded family and medical leave benefits available under the Families First Coronavirus Response Act.