COVID-19 Update: Tuesday, December 8

The following is the latest COVID-19 information from the state and federal governments as 2:30 p.m. on Tuesday, December 8.

Pennsylvania Update

Governor Wolf

At a press briefing on Monday, Governor Wolf expressed concern about the alarming rate at which new COVID-19 cases are being diagnosed in Pennsylvania, asked Pennsylvanians to wear masks, engage in recommended social distancing, and avoid mass gatherings, and warned that while he was not calling for any new mitigation requirements at this time, he and other state officials are reviewing their options and may recommend new measures later this week.

Department of Health

The Department of Health announced that beginning on Thursday, December 10, regional drive-through and indoor walk-in COVID-19 testing clinics will be held in Clinton, Delaware, Greene, Warren, and Wyoming counties. Counties with new, temporary state-sponsored testing sites will change each week over the next 11 weeks so that 61 counties will eventually be reached by these pop-up testing sites. Go here to learn more, including the testing schedule and site addresses.

Department of Health – by the numbers

Pennsylvania’s number of COVID-19 cases today surpassed 345,000.
In three of the past six days Pennsylvania has set a new single-day high for the number of new cases.
More than 11,500 Pennsylvanians have now died from COVID-19.
More than 40,000 residents of long-term-care facilities and more than 7000 people who work in those facilities have contracted COVID-19. Those figures encompass 1349 facilities in 66 of Pennsylvania’s 67 counties.
More than 18,000 health care workers in the state have contracted COVID-19.
The number of people currently hospitalized with COVID-19 has doubled in the past two weeks.
The number of COVID-19 patients currently breathing with the help of a ventilator has risen 50 percent in the past two weeks.
More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19; that is a 40 percent increase in the past two weeks.
14 percent of hospital adult ICU beds are currently unoccupied, as are 14 percent of medical/surgical beds, 37 percent of pediatric beds, 16 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.
The state-wide positivity rate on COVID-19 tests rose from 11.7 percent two weeks ago to 14.4 percent last week, according to the early warning dashboard released weekly by the governor and Department of Health.
A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.

Around the State

The web site northcentralpa.com reported late last week that “The 15-day average test positivity rate in Lycoming County is 43%, Pa. Department of Health data show. By comparison, the statewide 7-day average is 11%. A percent positivity rate of 5% is considered ‘too high’ by some experts.”
Westmoreland County has experienced an especially high rate of new COVID-19 cases in recent weeks. The Pittsburgh Tribune-Review reports that in response to increases in the number of hospitalized patients, Excela Health will convert a procedure room into a new space for about 12 new, temporary beds in one of its Westmoreland County hospitals. The newspaper notes that “On Monday, there were 133 patients hospitalized in the county with covid-19 – a 24% increase in a week and more than 138% since Nov. 1, according to state data. On Sunday, there were 137 patients — the highest since the pandemic started in March.”
One of that county’s commissioners has tested positive for COVID-19, the Tribune-Review reports.
And after being exposed to someone who tested positive for COVID-19, Philadelphia’s mayor has just entered into a quarantine period – for the second time, according to the Philadelphia Inquirer.
The Inquirer also reports that according to Philadelphia’s health commissioner, the city’s recent spike in COVID-19 cases was “likely caused by social gatherings that happened over Thanksgiving on top of already high case counts.” The Inquirer added that “The city on Tuesday reported 1,408 newly confirmed cases, for a total of 75,458 since the pandemic began. During the week that ended Saturday, the city reported about 910 new cases per day, with a positive rate of 12.7%.”

Department of State

To provide a greater number of people with convenient, limited-contact access to flu shots, the Department of State has suspended the age restriction that limits intern-administered flu shots to those ages nine and older. Instead, pharmacy interns may temporarily administer any age-appropriate influenza vaccination to children three years of age and older. Also, to increase access to COVID-19 vaccines as they become available, this waiver authorizes pharmacy interns to administer COVID-19 vaccinations to persons who are at least 18 years of age but only under the direct, immediate, and personal supervision of a licensed pharmacist who holds an active authorization to administer injectable medications. See the notice of this new, temporary policy.
The Department of State has extended previous waivers related to CPR training for massage therapists and CPR and basic life support training for dentists, dental hygienists, and expanded function dental assistants. See the notice of this new, temporary policy.
The Department of State has extended a waiver of the periodontal portion of the dental clinical exam because that exam involves a live patient. It also has extended the current waiver of the live patient aspect of the restorative exam and for its temporary replacement by a non-patient-based restorative dentistry examination administered by the Commission on Dental Competency Assessments and the Council of Interstate Testing Agencies Inc. See the notice describing these waivers.

Federal Update

Provider Relief Fund

HHS announced that the Provider Relief Fund will distribute $523 million in second-round performance payments to 9248 nursing homes as rewards for successfully reducing COVID-19-related infections and deaths between September and October. HHS concluded that between September and October, 69 percent of 13,251 eligible nursing homes met the incentive program’s infection control criteria. See HHS’s announcement of the nursing home distribution and a list of how much of this money HHS distributed to nursing homes in individual states.
HHS has updated its CARES Act Provider Relief Fund FAQ with nine new or modified questions and answers. Find the new items, all labeled “12/4/2020,” on pages 2, 6, 14, 15, 16-17, 25, 34, 47, and 55. Fund recipients should review this new information carefully, and in particular, the question on page 6 about erroneous payments, which reverses previous policy, and questions on audit terms and extensions on pages 14 and 15.

Centers for Medicare & Medicaid Services

CMS has posted information about how providers should code monoclonal antibody treatments and vaccine administration for Medicare beneficiaries and how much Medicare will pay for those activities.
CMS has sent a letter to the nation’s governors about steps they can take to ensure that their hospitals have sufficient capacity to handle the current surge in COVID-19 cases and their other patients as well. The letter stresses three steps states can take to maximize hospital capacity: ensure that no state-level licensure or scope of practice restrictions would impede health systems from leveraging flexibilities already granted by the federal government; ensure that state Medicaid agencies adapt payment and coverage policies appropriately; and foster coordination within their health care systems to create the partnerships necessary for effective community surge plans. See CMS’s letter to state governors.
CMS has updated its statement on how it will exercise its enforcement discretion for laboratories that perform COVID-19 molecular and antigen point-of-care tests.
CMS has posted new nursing home COVID-19 testing FAQs.

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.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In: 833-614-0820; Access Passcode: 3968359

Audio Webcast link: go here.

Hospitals Without Walls Call

On November 25, CMS announced the expansion of its Hospitals Without Walls program by introducing its Acute Hospital Care At Home program, giving eligible hospitals unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care that have succeeded in several hospitals and networks. A CMS Hospitals Without Walls stakeholder call will feature two organizations walking through their programs and a question and answer session. Slides/resources will be posted on CMS.gov prior to the call.

Wednesday, December 9 at 4:00-5:00 PM (eastern)

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1235939

Audio Webcast Link: go here.

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 past stakeholder calls, go here.

Department of Health and Human Services

HHS has released new hospital COVID-19 capacity data at the facility level. Previously released data about hospital capacity that had been released was aggregated at the state level but this new, more granular data release aggregates daily hospital reports into a “week at a time” picture while providing a view of how COVID-19 is affecting hospitals and communities. See HHS’s announcement about the new data and an FAQ about the data and go here for access to the data itself.