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PA COVID-19 Update – March 13, 2020

PA COVID-19 Update – March 13, 2020

Last updated 3:30 p.m.

To date, there are 27 presumptive positive cases and 6 confirmed cases of COVID-19 in Pennsylvania. Total cases = 33.

Counties impacted to date include: Bucks (2); Chester (1); Delaware (4); Monroe (3); Montgomery (17); Northampton (1); Philadelphia (3); Pike (1); Wayne (1)

 

DEPARTMENT OF HEALTH PROVIDES UPDATE ON COVID-19

By Sheri Melnick, Pennsylvania Legislative Services | March 13, 2020

Dr. Rachel Levine, secretary, Pennsylvania Department of Health (DOH), was joined by administration officials this afternoon to provide an update on the novel coronavirus, COVID-19.

Sec. Levine said that there are 33 Pennsylvanians who have tested positive for COVID-19. She explained that in addition to cases released in the DOH morning update today, there are two adults from Delaware County, two adults from Philadelphia County, and one pediatric case from Monroe County. To date, she noted, there have been over 300 Pennsylvanians tested, with over 140 negative tests and 33 presumptive positive tests. Sec. Levine stated that six of the positive tests have been confirmed by the Centers for Disease Control and Prevention (CDC) as positive. She said, “Nearly 130 tests are on the way to the lab or being processed at the lab now.” She made the distinction that “pending” means not just at the lab but on the way to the lab. Sec. Levine noted that there is also one patient who does not count towards Pennsylvania numbers because they reside in another state.

Sec. Levine commented that the situation is “rapidly changing” and that guidance from the CDC, especially about testing, changes daily. She noted that DOH is receiving calls from concerned people about whether or not they need to be tested. She said, “If you do not have any symptoms, you do not need to be tested at this time.” Sec. Levine explained that people with mild symptoms such as a cold or runny nose do not currently need to be tested. She emphasized that if someone has symptoms such as a temperature of over 100 degrees Fahrenheit, shortness of breath, or cough, they should call their health care provider. She asserted that if someone does not have a health care provider, they should call a hospital or emergency department before going there.

Sec. Levine stated that there have been questions from doctors about whom they can test and the permissions needed for testing. She noted that if a health care provider feels that a patient should be tested, they can order the test without consulting DOH. She asserted that currently there are at least two commercial labs that can conduct testing and that more will be able to test next week. Sec. Levine said that hospitals and health systems are also working on developing their own tests. She remarked that providers can consult with DOH by calling 1-877-PA-HEALTH (1-877-724-3258) and that if DOH does not recommend testing, a provider can order the test and have it sent to a commercial laboratory.

Sec. Levine emphasized that there are “simple steps” people can take to protect themselves from the spread of contagious diseases, including COVID-19. She noted that these steps involve washing hands with soap and water for at least 20 seconds, using hand sanitizer if soap and water are not available, covering coughs and sneezes with elbows, not touching one’s face, cleaning surfaces frequently, and staying home if sick. Sec. Levine offered the DOH website as a source for the most reliable information regarding COVID-19. She said, “We will continue to update Pennsylvanians through our website, Facebook, Twitter, and press releases.” She urged those with questions about their health to contact their health care providers. She said, “We have the networks in place to ensure that we will continue to strive for our vision, which is a healthy Pennsylvania for all.”

Sec. Levine opened the floor for questions.

Do you believe that Pennsylvanians who need testing are getting tested?

Sec. Levine said DOH is striving to ensure that everyone who needs to be tested is getting the tests. She reiterated that health care providers do not need DOH permission to send a test to a commercial lab. She noted that DOH has available tests and is working with county and municipal health departments to process tests. Sec. Levine emphasized that tests conducted at the state lab are free and will be covered by insurance if done at a commercial lab. She noted that all insurance companies in Pennsylvania and Medicaid will cover the COVID-19 test.

Is DOH going to give out more information about the locations of positive cases?

Sec. Levine stated that DOH is giving out information necessary to protect the public health. She asserted that people who have tested positive are either in isolation at home or in the hospital and noted that providing the municipality where they are located does not serve the public health.

How is DOH helping emergency medical services (EMS) providers to stop the spread?

Sec. Levine said DOH will work with EMS providers. Ray Barishansky, deputy secretary, Health Preparedness and Community Protection, DOH, stated that DOH has been in contact with the Emergency Management Council to ensure that EMS personnel are advised about personal protective equipment (PPE).

Since there is no community spread yet, do EMS personnel need to wear protective gear to every call?

Barishansky said that he would urge all EMS providers to take all necessary precautions.

Are you making sure that municipalities under DOH jurisdiction have information about where people who tested positive are living?

Barishansky stated that he cannot speak to specific location information. In regards to PPE, he said that DOH is in contact with county, municipal, and federal partners to make sure that DOH has stores of PPE and that the federal government is aware of the status of DOH stores.

Sec. Levine said that if EMS personnel have concerns, they should call DOH.

Can you provide a breakdown of the positive cases by county?

Sec. Levine stated it is on the website.

Is there a greater concern for those counties where people have tested positive?

Sec. Levine noted that DOH is going to monitor the situation throughout the state. She stated that DOH will help counties with their response.

Are there efforts to increase the testing at the state lab?

Sec. Levine said the lab has increased their processing and can now conduct 100 tests per day. She commented that DOH is dependent upon supplies from the U.S. Food and Drug Administration (FDA) and the CDC and is working to “test as many as we can.”

Is your testing limited by the number of kits and regions?

Sec. Levine noted that there are no backlogs of testing right now. She asserted that at the present time there are not enough resources to test every person in Pennsylvania.

Why not test more when you have the capacity?

Sec. Levine said that the CDC has not yet recommended population-based testing, which would be beyond the capacity of the state lab. She said, “We might have to do that in the future.” She explained that current CDC recommendations are to conduct symptom-based testing but added “it might come to a time to do population-based testing.”

Are you bound by CDC guidelines?

Sec. Levine responded that DOH is not but would not have the capacity to do population-based testing of every person in the southeastern part of the state. She remarked that a person cannot get tested by a private lab without going to a health care provider. Through her discussion of population-based testing, she noted that an asymptomatic person could test negative initially but could test positive at a later time. She remarked that a physician using a private lab for testing is not required to follow CDC criteria. Sec. Levine explained that DOH has relaxed testing guidelines by permitting health care providers to use private labs for testing without the approval of DOH.

How have the guidelines been relaxed?

Sec. Levine said that CDC guidelines have been focused on exposure with travel history or contact with someone who has COVID-19. She noted that if a rapid flu test is negative, physicians should consider COVID-19 testing, which is “completely different” from population-based testing.

Can you talk about social distancing with regards to EMS providers who have raised concerns about attending an upcoming funeral with a purported number of around 1,000 people in attendance?

Sec. Levine stated that there is no documented case of COVID-19 in Cumberland County where the deceased firefighter lived. She remarked on the importance of social distancing because the virus can travel up to six feet. She said, “We want people, if possible, to be six feet away and not touch a surface and then touch their face.” She reemphasized the need for people to wash their hands 10-20 times a day, use hand sanitizer, and stay home if they are sick.

Dr. Anthony Fauci, a member of the White House coronavirus task force, has said that there are not enough tests and that the shortage means that people needing the test may not have been tested. Has Pennsylvania avoided that situation?

Sec. Levine said that following CDC criteria gives Pennsylvania the capacity to conduct the testing, which has been aided by private lab testing and will be further assisted by hospitals having the capacity to test. She opined that what Dr. Fauci is talking about is that the U.S. does not have enough tests to conduct the type of population-based testing that was done in Singapore.

Is there a concern in Pennsylvania that people could have spread COVID-19 without knowing they have it?

Sec. Levine noted that testing in the state has only been available for less than two weeks. She asserted that for the first month or more, when addressing the spread of COVID-19, no states were able to conduct testing. She said that the capacity for testing has continued to improve when testing anyone who fits the criteria. Sec. Levine stated, “We are able to test anyone who has symptoms consistent with COVID-19.”

Does Pennsylvania have missed opportunities because of previous limitations?

Sec. Levine responded that the criteria have continued to change. She stated, “I cannot promise that there were not people who had COVID-19 somewhere in the U.S. that were not tested, but our ability to test has continued to improve.”

What is the number of test kits and how may do you have left?

Sec. Levine said she does not know the exact number. She asserted that DOH is getting new supplies from either the CDC or FDA. She remarked that the state’s lab director indicated that he can satisfy current testing needs and she reiterated, “The country is not at a place to conduct countrywide population-based testing.”

Is the pediatric case a school-aged child?

Sec. Levine responded that pediatric means a person who is under the age of 18 and that they would be in school.

Has there been communication with that school and parents?

Sec. Levine asserted that DOH is working on that today after recently receiving the test results.

Is that the first pediatric case?

Dr. Sharon Watkins, state epidemiologist, DOH, confirmed that it is and noted that the case is under investigation and DOH has no further details.

Will hospitals be conducting testing?

Sec. Levine responded that the Children’s Hospital of Philadelphia (CHOP) can do their own testing. She remarked that current procedures mean that a physician obtains a specimen, or calls the hospital to inform them that a patient will be coming there, and the sample is sent to a commercial lab.

How can doctors get in contact with a commercial lab?

Sec. Levine said doctors need to check with the hospital and then call the lab to pick up the specimen like any testing sample.

Dr. Watkins stated that DOH is working on providing guidance on how to access commercial labs and will provide that as soon as possible.

How many of the 33 cases positive for COVID-19 have a known source?

Dr. Watkins opined that 32 have a known source and that one is under investigation.

Does Pennsylvania have community spread?

Dr. Watkins asserted that Pennsylvania does not have community spread and has 32 cases with known risk factors and one under investigation.

Sec. Levine said, “One case is under investigation and under consideration for community spread.”

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