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By Harrison Cann, Pennsylvania Legislative Services | March 10, 2020


Department of Health Secretary Dr. Rachel Levine today provided an update on Pennsylvania’s response to the novel coronavirus, known as COVID-19.


She stated that 11 Pennsylvanians have now tested presumptively positive for COVID-19 and that the latest case is a Montgomery County adult who is being treated at the University of Pennsylvania hospital. She noted that the individual had contact with another person who tested presumptively positive and that it brings the total number of cases in Montgomery County to eight.


Sec. Levine added that a patient from Monroe County has been released from the hospital and that the person is now in isolation at home. She continued that there are no other changes to other patients at this time. She then discussed the difference between self-isolation and quarantine.


“Isolation and quarantine help protect the public by preventing exposure to people that might have any contagious illness, in this case we are talking about COVID-19,” Sec. Levine stated. She noted that isolation separates individuals that are sick with a contagious illness from people who are not sick, and that isolation could be voluntary or mandatory in the event of an emergency. She added that the Department of Health (DOH) and secretary of health have the authority to isolate people that are sick.


“Quarantine is a little different. Quarantine separates and restricts the movement of people who have been exposed to a contagious illness…to see if they become sick,” Sec. Levine said. She clarified that someone in quarantine may not be sick or become sick but that it is important in separating those who have never been exposed in order to stop the potential spread of disease. She noted that quarantine can be voluntary but also can be mandatory during a public health emergency if they have come in contact with someone who was exposed to the disease.


Sec. Levine stressed that it is important to know that Pennsylvania is taking “every precaution” to ensure everyone is kept safe. She stated that if someone is sick with COVID-19 they are either in isolation at home or in a hospital receiving medical care. She added that if someone is in quarantine they are at home to limit exposure to the rest of the community.


She continued by affirming the most up-to-date information can be found at and that information will continue to be shared through the website, social media accounts, and press conferences. She said that DOH has been updating health care providers regularly on how to assess patients and how to obtain a test. She emphasized that it is important for Pennsylvanians to stay calm and that DOH, Governor Tom Wolf, and the Pennsylvania Emergency Management Agency (PEMA) have networks in place to ensure “a healthy Pennsylvania for all.”


Sec. Levine and Dr. Sharon Watkins, director, Bureau of Epidemiology, DOH, then answered questions from the audience.


Has there been any community spread?

Sec. Levine responded that there is not because the newest patient had known contact with someone who tested positive for COVID-19. She clarified that community spread is a specific public health term and that it occurs when there is spread within the community without knowledge of how they got it. She noted that community spread would only happen if someone presented symptoms for COVID-19 and got it without any known contact with someone who was exposed or without any travel outside of the area.


Dr. Watkins commented that Pennsylvania is currently in the containment phase and that it is investigating every case of COVID-19 to determine the person’s exposure through travel or close contact. She added that community exposure would mean that DOH would not be able to identify how a person got sick, which means they would have gotten it from the virus circulating somewhere in the community unknown to the public health or health care providers.


So the newest case is someone who got exposed to it in Pennsylvania but it is not considered community spread?

Dr. Watkins responded that is correct because they are aware of how the person got exposed.


Germantown Academy announced today that it had a student test positive for COVID-19. Is this the 11th case?

Sec. Levine responded that DOH is not going to disclose specific case information but that the newest case is an adult.


How much will public health response change in the case of community spread?

Sec. Levine responded that the state is currently in a containment phase so it continues to trace contacts and travel and quarantine those who have been exposed. She added that in the case of “significant community spread” they would shift to a mitigation phase. She stated that mitigation would include a lot of work in a specific area to enforce social isolation.


What do you mean by close contact?

Dr. Watkins responded that close contact means being a household member or sharing a small space with someone who has been exposed. She noted that this specifically means having sustained contact within six feet of an individual. She added that public health professionals are investigating close contact cases and assigning risk based on how long a person could have been exposed.


Can you talk about the difference between isolation and quarantine in your home? How do you know people that are self-isolated are following protocols?

Sec. Levine responded that someone in quarantine or isolation does not have to stay inside if they have a closed backyard but that they are supposed to stay at home and not go to the grocery store or pharmacy. She added that high-risk individuals are checked up on daily and that data from the 2014 Ebola situation showed that 98 to 99 percent of people that are isolated or quarantined do follow directions.


What information can you give on the setting of the person-to-person transmission?

Sec. Levine responded that there was close contact with the person. She added that people want specific details and she will always share significant public health information, but individuals are entitled to their privacy and confidentiality.


Do you know about the woman in central Pennsylvania that traveled to Italy and was taken to the hospital after falling ill?

Sec. Levine responded that she will not talk about a specific case but that DOH is in contact with county and municipal health departments. She added that if a hospital has a potential case, it would contact its health department or DOH and DOH would recommend a course of action.


A lot of initial reports were using the word ‘quarantine,’ but should they have been referring to initial cases as being in isolation?

Sec. Levine responded that the correct term for patients who are positive is isolation and the correct term for patients who have been exposed is quarantine. She clarified that everyone needs to be on the same page when it comes to the use of public health terms.


How many people are being isolated and quarantined?

Sec. Levine responded that there are 11 positive cases right now and that individuals are either isolated at home or in a hospital. She added that anyone who had close contact with any of the 11 patients is being quarantined. She said that there is a sensitive balance between releasing information to the public and maintaining the privacy of patients.


How do people go about their daily lives without knowing if their neighbors are quarantined?

Sec. Levine responded that if a neighbor was quarantined they would not answer the door or welcome someone into their home.


Do you recommend that people who are self-quarantining reach out to DOH?

Sec. Levine responded that most people in quarantine are there based on DOH’s orders. She added that travelers coming from specific countries should notify DOH and self-quarantine.


Dr. Watkins commented that there is a list of individuals who are quarantined based on their risk and that they would have traveled from either Iran or China. She added that any close contacts are also in quarantine. She said that those individuals should be calling their health department and health care provider if they are feeling sick. She continued that travelers from Italy and South Korea should let DOH know if they become sick while self-isolating and that they should call their health department prior to going to their health provider.

Schools in the eastern part of the state are closing due to possible exposure, so how do students and teachers there know if they were exposed?

Sec. Levine responded that there is no known community spread and that DOH would contact an individual if it determined that they had close contact with a patient. She added that DOH is working closely with the Department of Education (PDE) and school districts but that closure decisions will ultimately be up to superintendents.


At what point would it make sense to have schools cancel sporting and public events and hold online classes?

Sec. Levine responded that DOH is continually assessing the situation and working with the county and municipal health departments. She added that PDE will work with superintendents on all school closure decisions. She said that mitigation efforts in the case of community spread would be much more significant, but that as of now the schools should work with DOH, PDE and health departments regarding quarantines.


Is it fair to say that a case of community spread would be the watermark for state-recommended closure in a region?

Sec. Levine responded that it might not be one case of community spread but that assertive mitigation efforts would take place in the event of significant community spread. She noted that mitigation would not be statewide but that efforts would be concentrated on certain affected areas.


The Pennsylvania Interscholastic Athletic Association (PIAA) has a lot of basketball games coming up. At what point do you have the conversation about not allowing fans at games?

Sec. Levine responded that it is hard to tell how close Pennsylvania is to mitigation. She added that there has not been any community spread at this time and that different schools are taking their own precautions. She noted that the state will take significant mitigation efforts in areas if significant community spread occurs.


Could you shed light on what it would take to close schools and how it would impact children?

Sec. Levine responded that she is not going to guess about the future but that all things are being considered with PDE, counties, and superintendents. She stressed that any significant decisions will only be done if it is absolutely necessary to protect public health.


Some districts have closed down in an extreme abundance of caution. Are we going to start seeing this happen all over?

Sec. Levine responded that she is in favor of abundance of caution and that DOH will incorporate all factors when making informed decisions.


Where is that fine line between abundance of caution and telling people not to panic?

Sec. Levine responded that the situation is around that fine line right now and that there are local, state and federal collaborations knowing there are ramifications for all decisions. She added that there is a balance for everything and that they are making the most informed decisions to protect public health.


Would a case of community spread be a tipping point then?

Sec. Levine responded that one case of community spread might not be a tipping point but that a significant number of cases would be.


Do you know how the $3 billion federal emergency fund is going to actually extend to individual people?

Sec. Levine responded that there was a press release about insurance coverage yesterday and that insurance companies would be covering all testing. She noted that Pennsylvania has one of the lowest uninsured rates in the country and that testing at DOH will be free regardless of insurance. She added that she does not know how much federal funding will be given to Pennsylvania or when it will come, but that there are ongoing discussions about utilizing all resources for this public health response.


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