COVID-19 Update: Monday, October 26

The following is the latest COVID-19 information from the state and federal governments as of 3:45 p.m. on Monday, October 26.

Pennsylvania Update

Governor Wolf

Governor Wolf has written to President Trump asking him to work with Congress to provide funding to enable the state to continue its Regional Response Healthcare Collaborative Program (RRHCP) for which current funding expires on December 31. The RRHCP is a partnership between the state’s departments of Human Services and Health and the Pennsylvania Emergency Managemental Agency through which selected Pennsylvania health systems work with long-term-care facilities that are vulnerable to the COVID-19 pandemic by providing assistance with preparation, prevention, response, and education.

Department of Health

The Department of Health has published an executive summary of the state’s plan to distribute and administer COVID-19 vaccines in Pennsylvania once such vaccines become available. Among other matters, the plan identifies critical populations and addresses vaccine provider enrollment, storage and handling, communication, and safety concerns.
The Department of Health has issued a training PowerPoint to assist skilled nursing facilities with capacity and testing reporting requirements.
The Department of Health has updated its FAQ on drugs for treating COVID-19.
The Department of Health has issued a health advisory titled “Additional Factors to Determine Close Contacts of Persons with COVID-19” with recommendations for implementing new guidance from the CDC on the identification and quarantine of close contacts.
The state has begun distributing its second allotment of COVID-19 antigen test kits provided by the federal government to Clinical Laboratory Improvement Amendments (CLIA)-certified institutions in Berks, Huntingdon, Union, and Westmoreland counties.
During a Monday news conference, Secretary Levine called for an extension of the authorization for the Pennsylvania National Guard to help with the state’s COVID-19 response.

Department of Health – by the numbers

Pennsylvania’s COVID-19 case count has now surpassed 195,000. The daily total has been in four figures every day this month except for one, which has not happened since the early months of the pandemic. This includes the three highest single-day new case counts since the pandemic began.
With today’s latest figures, the death count now nears 8700. Daily death counts are now generally lower than they were in the spring.
Overall, more than 30,000 residents and employees of long-term-care facilities have contracted COVID-19. Those figures encompass 1049 facilities in 63 of Pennsylvania’s 67 counties.
More than 12,000 health care workers in the state have contracted COVID-19.
The state-wide positivity rate for COVID-19 tests is now five percent, up from 4.2 percent last week; 30 counties are currently above five percent. Counties with what the state calls “concerning” positivity rates including Huntingdon (12 percent), Bradford (11.2 percent), Lawrence (9.0 percent), Lebanon (8.7 percent), and Westmoreland (8.4 percent).
According to the state’s weekly data dashboard, Berks, Bradford, Centre, Elk, Huntingdon, Lackawanna, Lawrence, Lebanon, Luzerne, Mifflin, Montour, Northumberland, Philadelphia, Schuylkill, and Westmoreland counties are in a “substantial” level of community transmission. Allegheny County is now in a low level of community transmission.
The rate of response to contact tracing efforts is not very good, but Secretary Levine reports that among those who have recently been diagnosed with COVID-19 and who responded to inquiries about their recent whereabouts, 55 percent said they had visited a restaurant in the past two weeks and 13 percent said they had visited a bar.
Over the past two weeks more than 2000 cases have been diagnosed among school-aged children. This reflects a change in the nature of who is contracting COVID-19: while the numbers are up in all age groups, such cases are more common in people under the age of 50 than they were in the spring and early summer.
Labs are reporting an average of 34,000-35,000 test results a day.
The number of people currently hospitalized with COVID-19 is more than twice what it was on October 1.
Secretary Levine said that the number of hospitalized COVID-19 patients generally lags behind case count trends by about two weeks and can therefore be expected to continue rising in the coming weeks.
The number of COVID-19 patients currently breathing with the help of a ventilator also is up significantly this month.
But Secretary Levine explained that far fewer hospitalized COVID-19 patients are assisted by ventilators now than they were during the pandemic’s early days. Back in the spring, roughly 30 percent of hospitalized COVID-19 patients in Pennsylvania were assisted by ventilators; now, only about 10 percent are.
She attributed this decline to how much providers have learned over the past few months about how to care for COVID-19 patients. Both treatment and therapeutics have improved since the spring. Patients continue to get very sick but the health care delivery system is better equipped to treat them.
25 percent of hospital adult ICU beds are currently unoccupied, as are 22 percent of medical/surgical beds, 36 percent of pediatric beds, 13 percent of pediatric ICU beds, and 40 percent of airborne isolation unit beds. These figures are similar to what they were a week ago.

Department of Human Services

DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) published a memorandum in August informing behavioral health managed care organizations, county mental health/intellectual disability offices, and behavioral health providers that specified state regulatory provisions have been temporarily suspended during the COVID-19 disaster emergency declaration period. OMHSAS has now re-issued this memorandum to update signature requirements for treatment and service plans. The notice applies to inpatient psychiatric services, outpatient psychiatric services, intensive behavioral health services, outpatient drug and alcohol services, mental health procedures, partial hospitalization, intensive case management, psychiatric rehabilitation services, community residential rehabilitation services, and long-term structured residences.

Federal Update

Provider Relief Fund: Webcast on Phase 3 General Distribution

Applications for the Provider Relief Fund Phase 3 general distribution are now being accepted by HHS. HHS will hold a webcast on Monday, November 2 at 3:00 p.m. (eastern) for interested parties. Go here to register for the webcast and to submit questions. Providers considering applying for Phase 3 general distribution funds that did not view the previous webcast should participate in this one in anticipation of the November 6 application deadline. Also available are a fact sheet and a presentation about the Phase 3 general distribution.

Provider Relief Fund: Financial Reporting

Last week we reported on HHS’s updating of its most recent Provider Relief Fund financial reporting instructions that broadened how fund recipients may use those funds. That report was accompanied by an HHS policy memorandum and amended reporting requirements. For providers interested in how HHS is defining parent entities in this update, the amended reporting requirements document includes the following explanation:

Reporting Entity: Entity (at the Tax Identification Number (TIN) level) that received one or more PRF [Provider Relief Fund] payments, or an entity that meets the following three criteria: 1) is the parent of one or more subsidiary billing TINs that received General Distribution payments, 2) has providers associated with it that were providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 2020, and 3) is an entity that can otherwise attest to the Terms and Conditions. If the entity has subsidiary TINs that received General Distribution payments, regardless of whether the subsidiary or Reporting Entity formally attested to accepting the payment within the provider portal, the Reporting Entity may report on and direct the use of General Distribution payments. However, if a subsidiary TIN received a Targeted Distribution payment, 1 the subsidiary TIN must report use of funds for that payment, and the parent organization that reports on a subsidiary’s General Distribution payment cannot also report on (or transfer) the subsidiary’s Targeted Distribution payment.

Department of Health and Human Services

Four weeks after HHS announced that it would distribute 150 million state-of-the-art Abbott BinaxNOW COVID-19 tests nationally to assist with states’ reopening efforts, states have begun to report back to HHS about how they are choosing to distribute the rapid, point-of-care tests. Of the states that have provided preliminary reports, the BinaxNOW allocations are largely being sent to local health departments, K-12 schools and institutes of higher education, nursing homes, hospitals, and correctional facilities. Learn more from this HHS announcement about the status of the distribution and states’ responses to it.
HHS’s Office of the Inspector General has updated its work plan for COVID-19-related audits, evaluations, and inspections.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about 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 participants an opportunity to ask questions of CMS and other subject matter experts. Two such calls remain this month.

CMS COVID-19 Office Hours Call

Tuesday, October 27 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2394789

Audio Webcast link: go here to register for the call

Nursing Homes Call

Wednesday, October 28 at 4:30 – 5:00 PM (eastern)

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5587022
Audio Webcast Link: go here to register for the call

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

Food and Drug Administration

The FDA has approved the antiviral drug Veklury (remdesivir) for treatment of COVID-19 requiring hospitalization for use in adult and pediatric patients 12 years of age and older and weighing at least 40 kilograms (about 88 pounds).
The FDA has consolidated its existing resources for stakeholders to easily find information about drug and biologics development and manufacturing, including for products to diagnose, cure, mitigate, treat, or prevent COVID-19 and for other critically needed products to treat symptoms of COVID-19 or to provide supportive care to those with COVID-19. Go here to find the consolidated guide to these resources.

Centers for Disease Control and Prevention