COVID-19 Update: March 30, 2020
COVID-19-related developments in Pennsylvania as of 4:00 p.m. on Monday, March 30. To receive this daily update directly, sign up for our mailing list at info@pasafetynet.org.
State Update
Governor Wolf
- On Saturday the governor requested a major disaster declarationfrom the President to provide additional support for state, county, and municipal governments, certain non-profits, and individuals who are struggling during the COVID-19 outbreak.
- Over the weekend Governor Wolf expanded his ‘Stay at Home’ order to include three more counties to mitigate the spread of the virus: Beaver, Centre, and Washington counties. Today, he added four more counties to the order: Carbon, Cumberland, Dauphin, and Schuylkill counties and extended the order to April 30 for all 26 affected counties. The governor’s amended order, the secretary of health’s amended order, and the stay at home guidance are available online.
- Today Governor Wolf announced that all schools and non-life-sustaining businesses will remain closed until further notice.
Governor’s Daily Briefings
- Four percent of all cases are health care workers.
- The COVID-19 death rate is now more than 10 percent. All deaths so far have been adults.
- Over the weekend nine Pennsylvania counties experienced their first cases, so the total is now cases in 59 counties.
- There are people with COVID-19 in about five percent of the state’s nursing homes (36 out of 695); most of those cases are in southeastern Pennsylvania.
- Two field hospitals will be established in southeastern Pennsylvania through an effort led by the Federal Emergency Management Agency (FEMA).
- 40 percent of the state’s ICU beds are currently unoccupied.
- The state has more than 4000 ventilators in hospitals and other facilities, has an unstated number in its own stockpile, and has purchased more that should be arriving shortly. Governor Wolf said that if the state could add 1400 more ventilators he thinks it would be in good shape.
- Based on the criteria the state currently employs for who is to be tested, the supply of testing materials in the state is adequate for now.
- Governor Wolf said there has been no discussion about limiting or prohibiting New Yorkers from entering Pennsylvania.
- The governor acknowledged reports of residents of New York coming to Pennsylvania for health care and specifically mentioned reports of increased newborn deliveries in Philadelphia by women from New York. He offered no numbers. He said no hospitals have reported an unmanageable surge of patients as a result.
- Governor Wolf said that he and his staff are still trying to figure out how much money the latest stimulus law will bring to Pennsylvania and when that money might arrive. It will come in a lot of buckets, he said. They expect about $5 billion but have no idea yet on how it might be allocated.
Pennsylvania Department of Health
The Department of Health sent a reminder to providers through its message board to report all initial “Activation of Internal/External Emergency Plan.” Providers may submit additional reports as updates if necessary and must report under ‘Health Department Reportable Disease’ all COVID-19 positive test results for staff and patients including name, date of birth, symptoms (if known), and date of test results.
Department of Human Services
- Under the governor’s order, child care is still available for people who work in life-sustaining jobs. DHS has published a tool to help find those child care providers.
- DHS has announced that it will suspend some licensing regulations for personal care homes and assisted living residences during the COVID-19 crisis. It also has posted guidance with a detailed description of the suspension and the regulatory language to be suspended.
Protocols for Procuring Difficult-to-Source Personal Protective Equipment
The protocol for procuring difficult-to-source PPEs is:
- Your first contact should be with your regional health care coalition (HCC). HCC contacts can be found at the bottom of the web page linked here.
- The HCC may decide to forward a formal request to the County Emergency Management Agency. Agency contact information can be found here.
- At that point, the County Emergency Management Agency may submit a resource request to the Pennsylvania Emergency Management Agency (PEMA).
Federal Update
The White House
- Vice President Pence has written to all hospitals asking them to provide to the Department of Health and Human Services daily statistics on all of their in-house COVID-19 testing and results.
- The White House has published its executive order on exercising the president’s authority under the Defense Production Act on matters involving health and medical resources.
Centers for Medicare & Medicaid Services
CMS has posted a fact sheet explaining to health care provider how to apply for stimulus bill-authorized accelerated and advance Medicare payments during COVID-19 crisis. We sent you a more detailed memo about this process earlier today.- CMS has published a toolkit for long-term-care facilities to help them make better use of telehealth services during the COVID-19 national emergency.
- CMS’s Office of Civil Rights has published a bulletin addressing civil rights, HIPAA, and COVID-19. The bulletin answers questions and points users to other resources.
Department of Health and Human Services
The HHS Office of Inspector General (OIG) published a statement regarding the discretion the OIG will employ when investigating any conduct during this emergency that may be subject to OIG administrative enforcement. The office also advised providers to contact the OIG for extension of any OIG investigation deadlines during this time.
Food and Drug Administration
A new update outlines FDA efforts to increase the supply of ventilators and respirators.- The FDA has outlined its steps to help mitigate supply interruptions of food and medical products.
- The FDA has issued an emergency use authorization (EUA) addressing the use of hydroxychloroquine sulfate and chloroquine phosphate to treat COVID-19. Go here and scroll down.
- The FDA also has issued a letter warning against the use of chloroquine phosphate intended for fish as treatment for COVID-19.
- The FDA has published an updated list of COVID-19-related emergency use authorizations (EUAs).
- The FDA has posted guidance on its enforcement policy for sterilizers, disinfectant devices, and air purifiers during the COVID-19 crisis.
- The FDA has published a letter clarifying its approval of the use of the Battelle CCDS Critical Care Decontamination System for use in decontaminating D95 and N95 respirators.
- The FDA has issued guidance on its enforcement policy for gowns, other apparel, and gloves during the COVID-19 crisis. This guidance includes non-binding recommendations.
Department of Veterans Affairs
The U.S. Department of Veterans Affairs has published its emergency response plan for the COVID-19 emergency.
Environmental Protection Agency
The EPA has published a memo outlining the discretion it intends to exercise in fulfilling its inspection and compliance efforts during the COVID-19 emergency.
Department of Homeland Security
In a new document with guidance on the essential critical infrastructure workforce, the Department of Homeland Security specifies essential jobs within the workforce during the COVID-19 emergency.
Resources to Consult
Pennsylvania Department of Human Services
Pennsylvania Department of Health
Pennsylvania Emergency Preparedness Guide
Centers for Disease Control and Prevention
To receive this daily update directly, sign up for our mailing list at info@pasafetynet.org.
Since yesterday, the Department of Human Services has issued the following four new guidance documents:
Federal 
The insurers – Aetna, Capital Blue Cross, Cigna, Geisinger, Highmark, Independence Blue Cross, Pennsylvania Health & Wellness, United Healthcare, and UPMC Health Plan – will cover such tests when they are medically ordered and performed by approved medical labs.
As described in The Impact, DHS’s weekly newsletter:
At last count, various parts of Congress were considering four major surprise medical bill proposals: one from the Senate Health, Education, Labor and Pensions Committee, one from the House Energy and Commerce Committee, one from the House Ways and Means Committee, and a compromise proposal from the Senate HELP and House Energy and Commerce committees. Some have been around for some time while one emerged only in the past week.
Senate Bill 314, passed by the legislature and signed by Governor Wolf, establishes a new Rural Health Redesign Center Authority and Pennsylvania Rural Health Redesign Center fund that will seek to support the delivery of health care by rural hospitals in the state by, as a legislative co-sponsorship memo explained,
The shift away from using the federal exchange and developing a state-based exchange was approved by the state legislature earlier this year. That shift took a major step forward recently when the state hired a contractor to create the site’s platform.
The report presents information on hospital volume and outcomes for 17 different medical conditions and surgical procedures from October 2017 through September 2018. It also compares hospital performance over the five-year period from 2013 through 2018 on an aggregate state-wide basis and for individual hospitals.