Secretary Rachel Levine Press Conference

COVID-19 Update 5-7-2020

Today, Secretary Rachel Levine of the Department of Health held her daily press conference to provide an update on the COVID-19 crisis in Pennsylvania. As of this morning, there are 1,070 new positive cases of COVID-19 in Pennsylvania, which brings the total number of cases to 52,915 in all 67 counties. This includes 3,437 positive cases in healthcare workers, and 2,107 positive cases in workers within the food industry at 124 facilities statewide. Additionally, there have been 10,506 cases of COVID-19 among 514 long-term care living facilities, which includes nursing homes and personal care homes. As a result of the Department’s continued work to reconcile data from various sources, including the Philadelphia County Health Department, our NEDS system and our electronic death reporting system, we are reporting an increase of 310 deaths over the last several weeks. Tragically, that brings the statewide total to 3,416 patients who tested positive for COVID-19 and have passed away, and to date, all of those deaths have been in adult patients. As of 10:00 am this morning, hospitals are reporting that approximately 2,484 patients are currently hospitalized due to COVID-19, and 528 of those patients have required the use of a ventilator or a breathing machine. Across our healthcare system, approximately 45% of hospital beds, 39% of ICU beds, and 73% of our ventilators are still available in Pennsylvania.

Today, Secretary Levine stated the following:

• As the weather starts to get warmer and some parts of the state are able to go from red to yellow (to re-open), we know that individuals will be spending more time outdoors, which is great.
• It is essential that we remind all Pennsylvanians of another public health threat that can affect people of all ages, which is Lyme Disease.
• Lyme Disease is a serious health issue that can affect your overall health. It can affect your heart, the nervous system, joints and can lead to serious complications, if it is not diagnosed properly and treated promptly.
• Lyme Disease, as we know, is spread through tick bites. Each year the number of Lyme Disease cases in Pennsylvania is among one of the highest in the nation, which is why it is so important to protect yourself, your family, and even your pets, from tick bites when you are outside.
• People typically think that ticks only live in high grass, heavily wooded areas, and areas with a lot of leaf litter. However, ticks can be found in your backyard, around your neighborhood, and in urban areas, too.
• The best way to protect yourself from a tick bite is to cover your skin with light-weight clothing; use insect repellent containing 20% or more of DEET; and do a tick check immediately on yourself, your family, your pets, after being outdoors.
• Symptoms of Lyme Disease can include a bulls-eye shaped rash, but it doesn’t have to exactly be a bulls-eye, and not everyone gets a rash. It also includes fevers, chills, headache, tiredness and fatigue, muscle aches, joint aches and swollen lymph-nodes.
• If you think you have been bitten by a tick, you should contact your healthcare provider.
• Being proactive will help protect us against a number of diseases that can impact your overall health, including Lyme Disease.

 Below please find the questions and answers from today's press conference.

 Questions asked to and answered by Secretary Levine:

Are Pennsylvania residents that are still under a stay-at-home Order permitted to travel to the Jersey Shore beaches that are re-opening? Is it safe for them to do so and will there be any enforcement in regards to traveling to beaches?

• There is no enforcement against travel within Pennsylvania or between states, so there is no law or regulation that prevents travel within Pennsylvania or between Pennsylvania and New Jersey. My recommendation, however, is not to do that. I know it is tempting given the warm weather that will hopefully be coming soon, but going into New Jersey can have risks because New Jersey has had a very high incidence of COVID-19 and if you go to the Shore, I bet other people will be going to the Shore, which makes it almost impossible to practice social distancing. My recommendation is for people to stay home. 

• Regarding the proposed expansion of testing, if a person is asymptomatic, how likely is it that they would test positive? And, how likely is it that they are contagious to others?
• At the moment we are still prioritizing testing for symptomatic individuals. Previously we had actually been more stringent in that, but we have really recommended testing for all symptomatic individuals for COVID-19….those with fever, cough, shortness of breath. We are not pushing out population based testing at this time, we might in the future, and that would be wide-spread testing of asymptomatic people. We do know that asymptomatic individuals can have COVID-19 and can spread COVID-19, but we don’t really know how many asymptomatic people there are in Pennsylvania and what percentage or chance you have of having COVID-19 if you have no symptoms.

 If masks work, why do businesses need to close? Or, if they don’t work, why do people need to wear them inside businesses that are open?

• The issue is that masks work, but they don’t work 100 percent. As we have said, my mask protects you and your mask protects me. These are not the N-95 masks that healthcare workers use when taking care of individuals that have COVID-19….these are cloth masks. Cloth masks are not 100% preventative, which has led to the mitigation and prevention measures that the governor has taken. The goal of the masks was to bend and flatten the curve, and we were successful in doing that. We did not overwhelm our healthcare system, but we need to careful in the future because COVID-19 is not gone from Pennsylvania and can still resurge in the future and it is still very prevalent in the Southeast and Northeast region of the state. But, we are making significant strides, and tomorrow we have 24 counties that will go from the red zone to the yellow zone in the Governor’s phased reopening plan.

 Currently, SCI Huntington is reporting 109 total cases of COVID-19. The Department of Corrections is reporting 108 inmates and 32 staffers have testing positive. Does this mean that virtually all of Huntington County’s COVID-19 cases can be attributed to the prison, and if so, how would this impact Huntington and surrounding counties, especially with chances of moving into the yellow phase of re-opening?

• We are looking at all of that data and we will see how all of the numbers look….I don’t have the numbers in front of me. What we have always said is that long-term care living facilities, correctional institutions, and other areas that have COVID-19, such as food processing and manufacturing processing, etc., do count in the county’s general count of COVID-19 patients. 

• Citizens in Wyoming County today protested their ongoing red phase status. They point out that they have only had 27 cases, remain well below the 50 cases per 100,000 people in a two week threshold, and should be held to the same standards as their neighboring counties of Sullivan and Bradford, which go into yellow tomorrow. Meanwhile, Clinton County, which will also go into yellow tomorrow, has never dropped below the 50 case threshold.
• We are going to be looking at all of that data and then presenting that data to the Governor, who will be making those decisions.

 Like past reconciliations, can you say how many deaths would have been reported today without the reconciliation, and how many were due to the reconciliation? Again, this question can be answered after the press conference, if you do not have that granularity.

• I do not have that granularity, but we can send that reconciliation to the reporter after the press conference. I want to emphasize that we are all spending a lot of time working to reconcile that data. Our Department is working daily with the Philadelphia Health Department in terms of reconciliation. We are working on personnel and IT fixes in terms of other reconciliations and we want to make sure we have the absolute, most accurate data available for Pennsylvania. 

• The percentage of population being testing in Montour County far exceeds that of any other county, even though the county only has 50 cases. Is it simply because of the presence of Geisinger Health System, or is it because of another reason? And, if it is, is Geisinger testing people multiple times and reporting them?
• I don’t have granularity about Geisinger’s testing system, but I think it is fair to say that with a large academic medical center, there is more testing. 

• Rite Aid just announced it would begin testing asymptomatic people at its testing sites in Pennsylvania and elsewhere. When will the state do the same at its testing sites and when should hospitals do the same at theirs?
• Rite aid is part of our testing sites, so we are building an eclectic array of different testing possibilities for Pennsylvania. We want to make sure that it is accessible and it is available to people to get tested, so that is going to include the testing that we do. For example, we still have the two mass testing sites in Montgomery and Luzerne County, who’s tests go right to our lab in Exton. Exton is still doing samples that we have prioritized for health workers and long-term care living facilities and hospitals, etc. But, actually, hospitals and health systems are doing a majority of the testing in the state. They are either performing these laboratory tests in their own hospitals or they are sending them out to Lab Corp and Quest, who are still doing a large number of tests. Then we have Rite Aid, which will be obtaining the tests and then sending them to a commercial laboratory, so we are actually looking to partner with other companies and pharmacies as well, so we are going to have an eclectic group where people can get testing. 

• Do you have any advice for people who might be considering visiting their mom despite the restrictions? What if they think it is no big deal and no reason to forgo the visit? What guidelines can you give to visit mom safely?
• I know that Mother’s Day is coming up, but my recommendation for the red zones is to do that virtually. The safest thing that you can do for yourself, your mother, your family and your community is to do that visit virtually. In the yellow zones, I think that people could do visits, but not to a nursing home or a long-term living care facility. I mean if you are going to go to their home. We are not allowing visitors in any type of nursing home, long-term care living facility or personal care home. They still have to be locked down because of the severe risk of spread in those settings. 

• Can somebody be transferred from a nursing home where their roommate has testing positive for COVID-19 to a family home or another nursing home? If so, what guidelines are given to family members accepting the nursing home resident?
• If a family accepted a nursing home resident, if there were cases of COVID-19 in that facility, then everybody would need to be quarantined for 2 weeks. If your loved one was in a facility where there was COVID-19 and that person tests negative but they have been in that facility and you plan to bring that person home to take care of them, then the entire household should be quarantined for 2 weeks. 

• We have learned that the CDC detailed guide to re-opening the country has been shelved by the Trump Administration. What are your thoughts on that and does it mean that businesses will have fewer guidelines to concern themselves with as they re-open?
• I am not really going to comment on the Trump Administration’s actions. I want to say that we collaborate very closely with the CDC. We have been looking at their guidelines and when they meet with our guidelines and our expectations, we often use them. Occasionally we might go in a different direction. It is kind of hard to comment on what the Federal government and what the White House is going to do.

 We know the Department wants to expand testing to get more accurate accounting of the virus, but if only the sickest people are currently being tested, how does the state factor in those decisions now?

• We want more than just the sickest people to be tested. Previously, even a little more than two weeks ago, when laboratory testing was still a little more rigid and we didn’t have enough supplies, we were prioritizing that testing to long-term care living facilities, hospitals, seniors with symptoms over 65 years old. However now that we have more testing capability and we have more reagents and swabs, and it is not just us and our laboratory in Exton…..the hospitals and health systems and commercial laboratories are also able to do testing…..we want to expand testing to all symptomatic individuals to get a better idea of how many patients have COVID-19.

 How long as the PA Department of Health been using the MITAR Sara Alert contact monitoring application and how has it been working thus far?

• Well, we actually have started using it in the last day or so, and I believe we have our first two patients that are part of the system and, in its first or second day, it is going great.

How far along is the Health Department when it comes to examining Bluetooth notification technology and is the Department using the Google/Apple, API, some other vendor, or are they developing their own technology?

• We are looking at the different types of Bluetooth technology now and I believe we are getting very ready to work out a contract with them and then we will announce it.

 Yesterday you provided legislative leaders details regarding COVID-19 cases, including 84.4% of the 3,106 deaths had at least one, and as many as four, comorbid conditions at the time of death. Is it fair to say that those people died of something else and tested positive, or were probable for COVID-19?

• No, what we are saying in terms of that data that we provided to the legislative leaders upon their request, is that it is very clear that seniors are most at risk for having COVID-19 and have a very serious case of COVID-19, possibly leading to death. Those with comorbid conditions are even more at risk of contracting COVID-19 or having very serious case and tragically passing away. Those comorbid conditions can include heart disease, which can lead to congestive heart failure. It can include uncontrolled hypertension, and chronic lung disease, such as chronic obstructive pulmonary disease, which includes chronic bronchitis and chronic emphysema. Some seniors might have one of those conditions. It is not uncommon for them to have multiple of those conditions, and that is the basis of the data that we shared with the legislature. 

• The number of new cases is up….what is your reaction? Is the trend over?
• One of the reasons that the number is up, is that we had a “data dump” and we had a bunch of results come back from Lab Corp, and that tends to skew things. We are going to see what the numbers are tomorrow and over the weekend and into next week, to follow the trends. Overall, the number of new cases, over time, continues to go down. We know today’s was a little over 1,000, but we will see how tomorrow’s is.

While we know that the virus sets the timeline, what is your outlook as we look forward to the fall in terms of social distancing?

• I am a positive and optimistic person and I think that we are going to be successful in our fight against COVID-19 in Pennsylvania and in the United States. That being said, it is very hard for me to predict what the fall is going to look like. There are a number of public health officials that are very concerned about a significant increase of the virus in the fall as the weather starts to get colder. That will be the same time that we start to see influenza, so we are going to make sure that Pennsylvania is ready.

Over the last couple of days, the Department has given us numbers of the COVID-19 cases among healthcare workers. You have also provided COVID-19 cases numbers in nursing homes and long-term care, and their employees? Are those two separate numbers or are the nursing home employee case numbers included in the overall healthcare worker case numbers?

• The nursing home staff cases are included in the larger healthcare worker statistics.

Some parts of the country, such as Kentucky and some counties in Florida, have opened up drive thru testing sites to anyone who wants a test. Why is this not more wide-spread and why isn’t Pennsylvania doing this?

• We are considering all of our testing criteria, but we want to make sure we test people who have symptoms. If we are going to be testing large amounts of asymptomatic people, we want to do that in a systematic surveillance, data-driven way, to get a sense of the total burden of COVID-19 among people in Pennsylvania, but we want to do that in a scientific way.

Earlier this week, the Monroe County Coroner expressed frustration with you and the Department in a letter to Governor Wolf. The letter sought your resignation. What is your reaction to the letter?

• I haven’t seen that specific letter, but we are actually working with the County Coroners. We had a phone call last week and we are going to be arranging another phone call, to try to make sure that, with the Coroners Association President, Executive Director and with other Coroners, that we work closely with these excellent professionals. In terms of asking for my resignation, I always serve at the pleasure of the Governor and will continue to serve under his leadership as Secretary of Health.

 Is Rite Aid testing somehow getting counted in the state numbers?

• Yes, Rite Aid will be doing the tests. The don’t perform the laboratory analysis in the store. They actually obtain the specimen and send them to a commercial laboratory and all of those results are imported into our data system, NEDS. 

• Would places such as auto racing and dirt tracks, like Selinsgrove Speedway in Snyder County, and horse racing tracks, like Presque Isle in Erie County, be able to operate in counties that reach the yellow stage?
• I don’t have specific information about those facilities. I know that guidance is coming out from the Governor’s office so we will wait to see what the guidance is.

Given that Governor Wolf said today that he will announce the next round of openings tomorrow, can you say when the next opening will occur, and in the next round, will there be counties opening independently of the health district groupings?

• All of that information will be released tomorrow during the Governor’s press conference.

We have heard from several dentists regarding when they will be allowed to re-open for routine procedures. If the state says its okay to open dental offices, does that decision also reflect what CDC and OSHA are recommending?

• We have reviewed the CDC guidance and OSHA guidance and we putting that all together. We hope to have that released by the end of the week, which should be tomorrow or Saturday.