COVID-19 Update: Tuesday, November 17

The following is the latest COVID-19 information from the state and federal governments as of 3:45 p.m. on Tuesday, November 17.

Pennsylvania Update

The Wolf Administration/Department of Health

The Wolf administration and Department of Health announced new COVID-19 mitigation efforts in the face of growing numbers of new cases. See their announcement here. The new effort consists of four components.

A memorandum to acute-care hospitals presenting projections that the state could run out of ICU beds in December. It urges hospitals to act now, on their own, to address capacity planning and elective procedures matters.
An order requiring anyone who visits from another state to have a negative COVID-19 test within 72 hours prior to entering Pennsylvania. If someone cannot get a test or chooses not to, they must quarantine for 14 days upon arrival in Pennsylvania. Pennsylvanians visiting other states are required to have a negative COVID-19 test within 72 hours prior to returning to the state or to quarantine for 14 days upon return to Pennsylvania. The order does not apply to those who cross state boundaries for work or to receive medical care. It takes effect on Friday, November 20.
A strengthened order addressing the wearing of masks stating that masks must be worn indoors and outdoors when people are away from their home. When outdoors, they must wear masks if they are not able to remain at least six feet away from anyone not in their household the entire time they are outdoors. When indoors, masks are required even if people are physically distant from individuals not in their household. This means that even if people are able to be six feet apart, they will need to wear a mask while inside if with people other than members of their household. This order applies to every indoor facility, including homes, retail establishments, gyms, doctors’ offices, public transportation, and anywhere food is prepared, packaged, or served.
The departments of Health and Education issued recommendations for colleges and universities to implement a testing plan for when students return to campus following breaks and holidays.

Department of Health

The Department of Health has updated its FAQ directing long-term-care facilities to implement measures for the use and distribution of personal protective equipment. The update includes new information about the extended use of respirators.
The Department of Health updated its COVID-19 guidance to hospitals to clarify the requirement to test patients prior to discharge to another facility. These tests must be administered during the 72-hour period prior to discharge. If the patient was tested upon admission and the discharge occurs within 72 hours, a second test is not required. Patients who are exhibiting symptoms at the time of discharge and had a positive test result within the last 90 days do not need to be tested again prior to discharge.
The Department of Health issued a health advisory with guidance for patients after a known exposure to COVID-19, including instructions for positive patients isolating at home to stay in a private room when possible and using a private bathroom during the period of isolation. Household contacts who cannot separate from the positive patient will need to quarantine for 14 days after that individual’s infectious period ends, which may be a minimum of 24 days after the first individual’s exposure.

Department of Health – by the numbers

Pennsylvania’s number of COVID-19 cases today surpassed 275,000.
In 11 of the past 15 days, Pennsylvania has surpassed its previous high for the number of new cases in a single day.
More than 9300 Pennsylvanians have now died from COVID-19. Daily death figures are now generally higher than they have been since May.
More than 30,000 residents of long-term-care facilities and more than 6100 people who work in those facilities have contracted COVID-19. Those figures encompass 1162 facilities in 63 of Pennsylvania’s 67 counties.
More than 13,600 health care workers in the state have contracted COVID-19.
The number of people currently hospitalized with COVID-19 has nearly doubled since November 1.
The number of COVID-19 patients currently breathing with the help of a ventilator has more than doubled since November 1.
Nearly 600 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
19 percent of hospital adult ICU beds are currently unoccupied, as are 17 percent of medical/surgical beds, 38 percent of pediatric beds, 12 percent of pediatric ICU beds, and 35 percent of airborne isolation unit beds. These numbers have barely changed since the last update. The percentages translate into 782 available adult ICU beds, 3412 available medical/surgical beds, 316 available pediatric beds, 41 available pediatric ICU beds, and 943 airborne isolation beds.
The state-wide positivity rate on COVID-19 tests rose from 6.9 percent last week to 9.6 percent this week, according to the state’s early warning monitoring dashboard.
A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.
All but five Pennsylvania counties now have positivity rates greater than five percent.
59 of the state’s 67 counties are considered to be in “substantial transmission status.”
Of the confirmed cases reported between November 1 and November 7, 16 percent responded to contact tracers’ questions about whether they spent time at a business establishment. Of those who answered, 18 percent said they visited a business establishment 14 days prior to onset of symptoms. Among them:
- 53 percent reported going to a restaurant
- 26 percent reported going to some other business establishment
- 11 percent reported going to a bar
- 12 percent reported going to a gym/fitness center
- seven percent (reported going to a salon/barbershop
- 9 percent said they had attended a mass gathering or other large event 14 days prior to onset of symptoms.

Overall, these numbers are slightly better than those from the previous week.

City of Philadelphia

In the face of growing numbers of new local COVID-19 cases, the city of Philadelphia has announced new mitigation efforts addressing businesses and business activities, recreational facilities and activities, retail and other consumer businesses, and more. The announcement also details enterprises that will continue under current guidelines. See the city’s announcement here and find further information here. The new guidelines take effect on November 20 and continue until at least through January 1, 2021.

Federal Update

Provider Relief Fund

The Provider Relief Fund web page has been updated with the following notice:

The application deadline for the Provider Relief Fund Phase 3 General Distribution was Nov. 6, 2020. You must have submitted your Taxpayer Identification Number (TIN) for validation by 11:59 p.m. ET on Nov. 6, 2020 for Phase 3 relief funds. If you submitted your TIN for validation by the deadline and your TIN is validated by Nov. 13, you will be able to proceed with submitting your revenue documentation to complete your application by 11:59 p.m. ET on Nov. 27, 2020.

Department of Health and Human Services

HHS’s Office of the Assistant Secretary for Preparedness and Response has posted information about high-flow nasal cannulation, an oxygen therapy that is a non-invasive resuscitation therapy for COVID-19 patients. HHS has purchased kits to use when administering this therapy and health care facilities can work through their local and state health departments to secure a supply. Go here to learn more about the therapy and how to acquire supplies.
HHS’s Office of the Assistant Secretary for Preparedness and Response presents a speaker series focused on how the COVID-19 pandemic can affect health care professional stress and resilience. Topics in this series include acute and chronic stressors, identifying at-risk employees, and fostering resilience. Go here for further information.
HHS has entered into partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains to improve access to eventual COVID-19 vaccines. Participating pharmacies will counsel customers about vaccines and order and administer vaccines at no cost to those customers. Learn more in this HHS announcement.

CMS COVID-19 Stakeholder Calls

CMS hosts varied 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.

Nursing Homes

Wednesday, November 18 at 4:30 – 5:00 PM (eastern)

Toll Free Attendee Dial-In: 833-614-0820

Access Passcode: 1335116

Audio Webcast link: go here

Centers for Disease Control and Prevention

The CDC has published a scientific brief that for the first time states that wearing masks can protect the wearer, and not just those with whom mask wearers come into contact, from the spread of COVID-19.
The CDC has updated its COVID-19 guidance for in-home social service providers such as caregivers and aides, teachers and tutors, social workers, and resettlement agency personnel who visit the homes of their clients. Find the updated guidance here.
The CDC has updated its guidance on point-of-care COVID-19 testing.
The CDC has updated its FAQs about the spread, diagnosis, and treatment of patients with COVID-19.
The CDC has updated its FAQs for laboratories that perform COVID-19 tests.
The CDC has posted information about current research on the impact of COVID-19 on pregnancy.

Food and Drug Administration

The FDA has updated its guidance on investigational COVID-19 convalescent plasma. The updated guidance extends the period of enforcement discretion through the end of February 2021. This extension will permit continued access to convalescent plasma for the treatment of hospitalized COVID-19 patients while blood establishments develop the necessary operating procedures to manufacture the plasma consistent with the emergency use authorization. The guidance also includes a new recommendation that authorized COVID-19 convalescent plasma not be collected from individuals who have received an investigational COVID-19 vaccine.
The FDA has updated its FAQs on the development of COVID-19 tests.
The FDA has established a new webpage, A Closer Look at COVID-19 Diagnostic Testing, to provide health care providers and other public health professionals, including those who might purchase COVID-19 tests, with more technical information and resources.