COVID-19 Update: Friday, August 7

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Friday, August 7.

Pennsylvania Update

News Conference

Governor Wolf and Health Secretary Levine held a joint news conference on Thursday, August 6. Among the issues they highlighted:

Pennsylvania now has 445 testing sites.
The state’s testing capacity, about 8000 tests a day in April, is now more than 22,000 tests a day.
The state is now testing about four percent of its population a month. It would like to exceed five percent.
The positivity rate on those tests is less than five percent. More than five percent is considered a problem.
One of the biggest challenges is the turnaround time for test results. Hospital and small commercial labs are often turning tests around in 24-48 hours but the major labs are struggling under their workload. With many cases and often lacking reagents needed for testing, they are averaging a turnaround time of seven days. State officials have spoken to them about this and to the federal Department of Health and Human Services about the lack of testing reagents that is a major part of the problem.
The national labs also often need to focus on states in the midst of serious outbreaks.
The number of Pennsylvanians hospitalized daily for COVID-19 has fallen from an average of 1028 in June to 700 at the end of July and the number of patients on ventilators daily has fallen from an average of 222 in June to 94 at the end of July.
With mandatory nursing home testing now completed, the state will turn its attention to continued testing at nursing homes based on what the first round of testing revealed and testing at the more than 1200 assisted living and personal care facilities.
At this point, everyone who needs a test can get one. The challenge remains getting the results of such tests in a timely manner.
The state laboratory has expanded its testing capacity. In addition, it can prioritize tests taken in areas where there appear to be outbreaks, to ensure more timely results.
The state lab and the county labs have enough reagents and testing materials for their own use but they do not have any to share.
Governor Wolf expressed a desire for a simpler point-of-care test that is less uncomfortable to administer. He revealed that he has not yet been tested.

Department of Health

The Department of Health has revised a previous health alert on infection prevention and control in health care settings to reorganize the information and add new recommendations about protective eye wear. This advises personnel working in health care facilities located in areas with moderate to substantial community transmission to wear eye protection in addition to a face mask for all patient care encounters.

Department of Health – by the numbers

The number of new COVID-19 cases has declined from the higher totals of late July. With occasional exceptions, daily death totals also are generally down.
22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 26 percent of adult ICU beds, six percent of pediatric ICU beds, 38 percent of pediatric beds, and 44 percent of airborne isolation rooms.
The number of health care workers who have contracted COVID-19 now exceeds 8500.
Pennsylvania has seen 40 confirmed cases of multisystem inflammatory syndrome in children (MIS-C). twelve suspected cases were found not to be MIS-C and another 16 are currently being investigated.

Department of Human Services

DHS has updated its interim guidance for personal care homes, assisted living residences, and private intermediate-care facilities during the COVID-19 emergency.
DHS has developed a suggested tool for personal care homes, assisted living residences, and private intermediate-care facilities to use when developing their implementation plan for reopening. It is designed not as a tool to submit to DHS but as a means of facilitating compliance with the interim guidance noted above. Find it here.

State Legislature

The Senate Republican Policy Committee held an informational meeting to discuss the challenges facing the state’s rural hospitals, and in particular, the challenges those hospitals have faced during the COVID-19 emergency. Go here to see a video of what the committee billed as a “workshop.”

Federal Update

White House: Executive Order

The White House issued an executive order directing the Department of Health and Human Services to extend permanently some of the Medicare telehealth waivers initiated during the COVID-19 public health emergency; to simplify Medicare billing codes and propose a payment model to improve health care in rural areas; and to encourage the Department of Agriculture and Federal Communications Commission to invest in technology that enhances access to telehealth services.

The administration’s plans for following through on this executive order are described in an HHS news release that summarizes the policy changes the administration seeks and a CMS news release that addresses several proposed regulations that would facilitate achieving these objectives.

Department of Health and Human Services

HHS’s Office of the Assistant Secretary for Preparedness and Response held a webinar in late July on the use of telemedicine in alternative care sites. Now available from that webinar are the presentation around which that webinar was conducted and an FAQ about the use of telemedicine in alternative sites.
The Office of the Assistant Secretary for Preparedness has created a new rural health information hub web page with current and key resources for rural health care systems preparing for and responding to a COVID-19 surge. The page includes links to resources by audience and topic.
HHS’s Office of the Inspector General has updated its guidance on the application of its administrative enforcement authorities to arrangements directly connected to the COVID-19 public health emergency with new guidance on the ability of clinical laboratories to offer free COVID-19 antibody testing to federal health care program beneficiaries who are contemporaneously receiving other medically necessary blood tests.

Centers for Medicare & Medicaid Services

CMS has posted three-year average hourly wages used for 2022 Medicare area wage index reclassifications. CMS usually publishes this data with its final inpatient prospective payment system regulation but is posting it separately this year.
CMS has updated its FAQs about COVID-19 testing in skilled nursing facilities.
CMS has posted a database detailing which nursing homes will receive point-of-care tests in its first wave of such shipments.

Food and Drug Administration

The FDA has issued guidance on the use of drugs frequently used to treat COVID-19 patients when those drugs go beyond their labeled “in-use time” limits.
The FDA has issued emergency use authorization (EUA) for a commercial device intended to provide temporary left ventricular support when treating critically ill COVID-19 patients who are undergoing ECMO treatment and suffer complications during that treatment.
The FDA has issued an EUA for a commercial device that is a patient interface intended for helmet-based non-invasive positive pressure ventilation used to treat acute respiratory distress symptoms among COVID-19 patients being treated in hospital intensive care units.
The FDA has issued an EUA for a commercial device that is a valve intended for use to deliver emergency, short term, constant-flow pressure-cycled ventilator support for COVID-19 with patients who weigh 10kg or more.
The FDA has issued an EUA for a commercial device that provides bi-level positive air pressure to support respiratory therapy of spontaneously breathing adults who weigh more than 30kg and who suffer from COVID-19.
The FDA has issued a surgical masks umbrella EUA in response to concerns about insufficient supply and availability of disposable, single-use surgical masks. Under this EUA, surgical masks that meet specific performance requirements are authorized for use in health care settings by health care personnel as personal protective equipment during surgical mask shortages resulting from the COVID-19 pandemic.
The FDA will host a virtual town hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19. The purpose of this town hall is to help answer technical questions about the development and validation of tests for COVID-19. This event will be held on Wednesday, August 12 at 12:15 p.m. (eastern). Go here for call-in information. Similar town hall meetings will be held on August 19 and August 26.