NIOSH Science Blogs

• Skin Irritation From Prolonged Use of Tight-Fitting Respirators
• How Collecting and Analyzing COVID-19 Case Job Information Can Make a Difference in Public Health

Case Investigation and Contact Tracing
CDC has published Case Investigation and Contact Tracing in Nonhealthcare Workplaces. This information will help employers understand how to collaborate with health departments during COVID-19 case investigation and contact tracing.

Carpooling Infographic

CDC has developed an infographic with suggestions for how to prevent the spread of COVID-19 when carpooling to and from work.

How and What to Communicate to Employees About COVID-19

CDC has published the COVID-19 Communication Plan for Select Non-healthcare Critical Infrastructure Employers. This document suggests how and what to communicate to employees, including communication channels and messages

According to the Center on Budget and Policy Priorities and the Campaign for Working Families (CWF), an estimated 350,000-450,000 Pennsylvanians may have missed their Economic Impact Payment (EIP), also known as the $1,200 stimulus payment. If people did not file taxes, they can still complete the non-filer form for the EIP until October 15, 2020. In addition, CWF is able to assist people with completing the non-filer form if needed. More information can be found in the press release below.

The Department of Human Services is asking for your help in getting this message out to people who may really need this financial support if they have not already received it.

You can find more information at the DHS website.

Pennsylvania Governor Tom Wolf and Pennsylvania Department of Health Secretary Dr. Rachel Levine today highlighted ongoing efforts to expand testing across Pennsylvania to ensure that every Pennsylvanian who wants a test can get one.

“If we want to mitigate the spread of this very contagious virus, we must continue to understand how it’s impacting Pennsylvania. Most importantly, improving access to testing helps Pennsylvanians who want and need to test for COVID-19,” Gov. Wolf said. “Testing also provides us with critical data to understand where the disease is in our communities so that we can take the necessary proactive measures to stop the spread and continue to protect the public.”

The Wolf Administration continues to work to further increase testing in Pennsylvania. This includes partnerships in place with Walmart and Quest Diagnostics, which provide direct access in many communities, including rural areas.

The administration also continues to work with laboratories across the state in order to enhance testing capacity in Pennsylvania, particularly as we see significant national delays in receiving test results due to other states experiencing major case increases.

“In Pennsylvania, we are committed to ensuring that testing is accessible, available and adaptable,” Secretary of Health Dr. Rachel Levine said. “Through working with our partners, including Walmart and Quest Diagnostics, we are helping to ensure that anyone who needs to get tested for COVID-19 in Pennsylvania can get tested. Testing, along with wearing a mask, washing your hands, maintaining social distancing and contact tracing are essential tools to reduce the spread of COVID-19 in Pennsylvania.”

Nine drive-thru Walmart testing sites launched on Aug. 5. These nine new sites are in addition to existing Walmart drive-thru sites in Clarion, State College, New Castle and Edinboro.

“Walmart is happy to assist Governor Wolf with reliable timely COVID-19 tests via a convenient drive thru,” said Jamie Reilly, Walmart regional health and wellness director.

Pennsylvania has conducted the ninth highest total number of tests for COVID-19 in the country, according to the Centers for Disease Control and Prevention. Since the beginning of the pandemic, more than 1.6 million tests have been completed, which equates to 13 percent of the Pennsylvania population.

At the height of the first wave in April, statewide testing capacity was limited to under 8,000 tests per day. Pennsylvania is now averaging more than 22,000 test results per day, as of Saturday, Aug. 1, and is testing about 4 percent of the population each month.

The most updated testing sites and information is available at the Department of Health. Testing sites continue to be added.

For the updated commonwealth map of testing sites, visit Pennsylvania COVID-19 Viral Testing Sites.

The current COVID-19 Public Health Emergency (PHE) does not waive any requirements related to Skilled Nursing Facility (SNF) Consolidated Billing (CB); however, CMS added CPT codes 99441, 99442, and 99443, to the list of telehealth codes coverable under the waiver during the COVID-19 PHE. These codes designate three different time increments of telephone evaluation and management service provided by a physician. You can bill for these physician services separately under Part B when furnished to a SNF’s Part A resident.

Medicare Administrative Contractors (MACs) will reprocess claims for CPT codes 99441, 99442 and 99443 with dates of service on or after March 1, 2020, that were denied due to SNF CB edits. You do not have to do anything. If you already received payment from the SNF for these physician services, return that payment to the SNF once the MAC reprocesses your claim.

Pennsylvania Governor Tom Wolf released a weekly status update detailing the state’s mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard comparing the seven-day period of July 24 – July 30 to the previous seven days, July 17 – July 23.

The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.

“The mitigation efforts we took on July 15 were a proactive step to get in front of the rise of cases that we continue to see,” Gov. Wolf said. “Our percent positivity decreased this week, which is a positive sign, but in order to continue to see numbers decrease, we must continue to wear masks and practice social distancing.

“Going out without a mask and congregating at a bar or in a crowded backyard party where social distancing isn’t being practiced continues to lead to spikes in cases. We need to recommit to these simple measures to stop the spread and go back to more freedoms.”

As of Thursday, July 30, the state has seen a seven-day case increase of 6,228, the previous seven-day increase was 6,010, alerting that cases are continuing to rise throughout the state.

The statewide percent-positivity went down to 4.6% from 4.7% last week. Counties with concerning percent-positivity include Lawrence (7.4%), Franklin (7.2%), Indiana (7.2%), Fayette (7.1%), Armstrong (7.0%), Beaver (6.5%), Delaware (6.5%), Allegheny (6.4%), Lancaster (5.8%), Berks (5.6%), Philadelphia (5.4%) and Chester (5.3%). Each of these counties bear watching as the state continues to monitor all available data.

The Department of Health updated its travel recommendations, originally announced on July 2, to remove Wyoming to the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.

It is important that people understand that this recommendation is in place to prevent the spread of COVID-19 in Pennsylvania. A significant number of recent cases have been linked to travel, and if people are going to travel, we need them to take steps to protect themselves, their loved ones and their community, and that involves quarantining.

Gov. Wolf continues to prioritize the health and safety of Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of the status of their county. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.

The Pennsylvania Department of Health announced that beginning Wednesday, August 5, various Walmart locations across the state will begin providing drive-thru testing for residents living in areas where there is a need for testing sites.

“We appreciate the hard work done by health systems, pharmacies, Federally Qualified Health Centers (FQHCs), medical clinics and other entities that are providing testing for COVID-19 across Pennsylvania,” Secretary of Health Dr. Rachel Levine said. “When we established our testing strategy, we wanted testing to be accessible, available and adaptable and we are working to meet that challenge. Anyone who believes they are in need of a COVID-19 test and meet testing criteria can get tested today in Pennsylvania.”

Nine new drive-thru testing sites will launch on August 5. There is no testing in stores. These sites will be open weekly to test up to 50 registered patients. Registration is required one day in advance. The following drive-thru testing sites will be open Monday-Friday from 9:00 AM to 4:00 PM starting Wednesday, August 5th:

• Walmart Supercenter pharmacy drive-thru, 355 Walmart Drive, Uniontown, PA
• Walmart Supercenter pharmacy drive-thru, 2601 Macarthur Rd Relocation, Whitehall, PA
• Walmart Supercenter pharmacy drive-thru, 2010 Village Center Dr, Tarentum, PA
• Walmart Supercenter pharmacy drive-thru, 134 Daniel Kendall, West Brownsville, PA

The following drive-thru testing sites will be open Monday, Wednesday, Friday from 7:00 AM to 9:00 AM starting Wednesday, August 5th:

• Walmart Supercenter parking lot, 20245 Route 19, Cranberry Township, PA
• Walmart Supercenter parking lot, 200 Kocher Lane, Elizabethville, PA
• Walmart Supercenter parking lot, 50 Newberry Parkway, Etters, PA
• Walmart Supercenter parking lot, 1355 East Lehman St, Lebanon, PA
• Walmart Supercenter parking lot, 100 Chippewa Town Center, Beaver Falls, PA

These nine new sites are in addition to existing Walmart drive-thru sites in Clarion, State College, New Castle and Edinboro. The most updated testing sites and information is available on the Department of Health’s website.

Pennsylvania Governor Tom Wolf visited the Susquehanna Township Police headquarters to discuss the important roles education and understanding play in the enforcement of the various COVID-19 mitigation orders in place across the state.

“We have to do everything we can to keep our communities safe and healthy, including wearing a mask and following mitigation orders so our business operate safely,” Gov. Wolf said. “We have the ability to enforce these rules, and we are going to continue to work closely with commonwealth agencies and local officials to enforce public safety orders.”

The governor was joined by representatives of commonwealth agencies and local law enforcement involved in mitigation order enforcement, including Secretary of Heath Dr. Rachel Levine, Secretary of Agriculture Russell Redding, Pennsylvania State Police Lt. Col. Scott Price, and Susquehanna Township Chief of Police Rob Martin.

Each representative focused on the role their agency plays in education and enforcement of the various orders in place to keep Pennsylvanians safe and stop the spread of COVID-19.

“Wearing a mask is so important to protecting each other. I implore all Pennsylvanians to do right thing,” Dr. Levine said. “When you wear a mask you are not only telling that person you pass on the street that you care about their safety, you are telling police and other first responders that you care about their safety, too.”

“Pennsylvania’s restaurant owners and staff and have delivered for us, putting safe, healthy food on our tables,” Redding said. “We can all deliver for them by wearing a mask and following the COVID-19 measures to keep them safe and healthy.”

“As some of the most visible public servants in the commonwealth, the state police will continue working collaboratively with the Department of Health and local police departments to remain at the forefront of law enforcement pandemic response efforts,” said Lieutenant Colonel Price.  “We are grateful to the majority of Pennsylvanians who have stepped up to follow mitigation requirements and for all the support our troopers and liquor control enforcement officers have received during the past several months.”

Local law enforcement’s role is a collaborative one with state agencies and local officials, and Chief Martin stressed his department’s work to educate businesses and residents, and to refer any suspected violations of the governor and Dr. Levine’s orders to the proper state agency if necessary.

“Our citizens in Susquehanna Township have been inspiring. On many occasions they have contacted our police department and our government center for advice, guidance, and our assistance. We wish to meet our citizens where they are and be an educational voice of gentle persuasion,” Martin said. “Of the times that we have had to make referrals to our commonwealth partners, we have been met with cooperation and understanding. I want to thank the commonwealth for being a valued partner, and thank Governor Wolf for his always civil mannered discourse, as what our country needs right now is civility.”

The governor also asked local elected officials and business owners to work with local law enforcement to protect their communities and constituents.

“I’m calling upon every Pennsylvanian to do their part to help us get as close as we can to 100 percent compliance on masking,” Gov. Wolf said. “We need the help of our business owners to get workers masking. We need the help of our local elected officials to emphasize the importance of masking on keeping the community safe.”

According to a recent poll by Franklin & Marshall College, two-thirds of registered voters in Pennsylvania believe it is “extremely important” to wear a mask whenever they leave home.

“We need to come together, unified, against COVID-19,” Gov. Wolf said. “I’m calling upon every Pennsylvanian to do their part to help us get as close as we can to 100 percent compliance on masking.”

Appalachia’s first COVID-19 cases were confirmed in early March. 143 days later, on July 26, Doddridge County, West Virginia became the final of Appalachia’s 420 counties to report a confirmed COVID-19 case. Drawing on data from the Johns Hopkins University, COVID-19 Cases in Appalachia maps COVID-19’s spread in the region in relation to the rests of the country.  

More county-level information regarding COVID-19 cases can be found using the searchable database offering demographic data snapshots of confirmed cases and deaths in relation to hospital bed counts, population and businesses, and categories of people at risk for COVID-19. By hovering over each statistical icon, users can learn more about the supporting data. COVID-19 related data is updated daily.

Trump’s announcement comes as his administration has rolled out multiple health care announcements in recent weeks.

President Donald Trump is expected to sign an executive order on August 3, 2020 aimed at boosting health care in rural areas, where struggling hospitals have faced worsening economic conditions during the pandemic, according to five individuals familiar with the planned announcement.

The order will focus on an administration effort to create new ways of financing rural health care, as well as propose a permanent extension for some telehealth policies that helped fuel virtual care’s explosive growth amid stay-at-home orders.

Trump’s announcement comes as his administration has rolled out multiple health care announcements in recent weeks, in a pre-election effort to bolster the president’s record on an important issue to voters. These actions have included executive orders aimed at slashing drug prices, though the ambitious plans have limitations and are not expected to take effect before Election Day. Last week, the administration also released a report on surprise medical bills, as it urged Congress to revive bipartisan efforts to pass consumer protections.

Pressed about his lack of a replacement for Obamacare, Trump also has spent days promising to unveil a health plan of his own, though he declined to detail exactly what that plan would do.

“We’re signing a health-care plan within two weeks, a full and complete health-care plan,” Trump said on “Fox News Sunday” on July 19 — just over two weeks ago.

One federal health official said the rural health changes are limited and should not be viewed as a replacement for the health care law. Three officials also said the administration does not have plans to imminently produce an Obamacare alternative.

Some elements of the rural health plan have been under consideration for more than two years, but the White House budget office balked at proposals to reform hospital payments, fearing that they would be unworkable in practice. Federal health officials retooled the proposals to demonstrate they would save the federal government money.

Under the new plan, the federal Medicare agency will leverage its authority to test new pilot projects that offer financial incentives for providers who deliver higher-quality care to patients. Administration officials believe its new financial model will help keep rural hospitals open, after about 130 have closed in the past decade. The program will be optional, according to three sources.

However, officials have debated the risks of overhauling rural hospital payments, given that the industry is already are under considerable financial pressure and the administration could face political backlash if more hospitals shutter after the White House’s plan takes effect. It’s unclear if any of the changes could be finalized before the election.

On telehealth, the administration will issue a proposed rule to make permanent Medicare payment of the technology for certain health care providers, in an effort to ensure the expansion of virtual care outlasts the pandemic, said two officials. However, a more sweeping extension of pandemic telehealth policies would likely have to come from Congress, which is just beginning to review the issue.

During the height of nationwide shutdowns, Medicare telehealth visits grew from just a few thousand per week to more than 1 million. Trump himself has often remarked about the technology’s rapid rise during the pandemic.

The White House and HHS declined to comment. A CMS spokesperson did not immediately respond to a request for comment. A White House announcement is expected at 5 p.m., two sources said.

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 healthcare 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.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, August 11^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3498643

Audio Webcast link: https://protect2.fireeye.com/url?k=6f7db93e-3329a042-6f7d8801-0cc47adc5fa2-ed718e46a02e4dc1&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2361

Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)

Tuesday, August 11^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5097566
Audio Webcast Link: https://protect2.fireeye.com/url?k=b4723cca-e827351a-b4720df5-0cc47a6a52de-e4916e2be973d447&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2386

Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)

Wednesday, August 12^th 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618
Audio Webcast Link: https://protect2.fireeye.com/url?k=2884bdb1-74d1b4a2-28848c8e-0cc47adb5650-5b54c104cb155c28&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2411

Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)

Wednesday, August 12^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088
Audio Webcast Link: https://protect2.fireeye.com/url?k=6b0af8ba-375ff16a-6b0ac985-0cc47a6a52de-6400b78b7f9a7c65&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2401

Nurses (twice a month on Thursday at 3:00 PM Eastern)

Thursday, August 13^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289
Audio Webcast Link: https://protect2.fireeye.com/url?k=666e39a3-3a3b30b0-666e089c-0cc47adb5650-9c83dad655df67f4&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2421

 Lessons from the Front Lines: COVID-19 (twice a month on Friday at 12:30 – 2:00 PM Eastern)

 Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

This week’s Lessons from the Front Lines:

Friday, August 7^th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4695240

Audio Webcast Link: https://protect2.fireeye.com/url?k=c441afa6-9814a6b5-c4419e99-0cc47adb5650-c14a30d0298b73f0&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2376

 For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.