Dashboard Data Shows Weekly Case Increases in Pennsylvania, Multiple Counties with High Percent-Positives

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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 10 – July 16 to the previous seven days, July 3 – July 9.

 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.

 “By looking at both statewide status and individual county status, and seeing cause for concern with case increases and percent-positivity above 5 percent in multiple counties, we took steps to stop increases before they become critical by implementing new mitigation efforts Wednesday,” Gov. Wolf said. “We continue to see cases rise and one thing we know for certain is that we must continue to wear masks and practice social distancing.

 “Risky behavior such as going out without a mask and congregating at a bar or in a crowded setting 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 16, the state has seen a seven-day case increase of 5,579, the previous seven-day increase was 4,914, alerting that cases are continuing to rise amid a lapse in following required mitigation efforts.

 While the statewide percent-positivity is 4.4%, counties with concerning percent-positivity include Beaver (8.2%), Allegheny (7.5%),  Washington (6.2%), Indiana (6.1%), Lawrence (6.1%), York (6.1%), Lebanon (6.0%), Philadelphia (5.5%), Dauphin (5.1%) and Westmoreland (5.0%). Each of these counties bear watching as the state continues to monitor all available data.

Pennsylvania Provides Update on SNAP Online Grocery Purchasing, Encourages Retailers to Join

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Pennsylvania Department of Human Services (DHS) Secretary Teresa Miller today reminded Pennsylvanians of the ability to use Supplemental Nutrition Assistance Program (SNAP) funds to purchase groceries online through select retailers. This flexibility allows SNAP recipients to purchase groceries from home, which can help limit trips out of the home as Pennsylvania sees rising cases of COVD-19. Last month, DHS launched the pilot program overseen by the United States Department of Agriculture (USDA) that allows SNAP recipients to purchase groceries online through participating retailers approved by the USDA.

 “We are pleased that Pennsylvanians have the ability to purchase groceries online using their SNAP benefits, and we encourage any SNAP recipients to use online purchasing when possible to support social distancing and help keep themselves and their family safe from COVID-19,” said Secretary Miller. “This pilot has been a success so far, and I would encourage retailers to reach out to Food and Nutrition Service to join this program to provide even more opportunities for Pennsylvanians to purchase groceries online using SNAP.” 

 The pilot program currently includes four approved retailers: Amazon, the Fresh Grocer, Shoprite, and Walmart, and since the program’s launch, these retailers saw about $6.5 million in online purchases by Pennsylvanians. Retailers that are interested in participating in this program must contact the USDA’s Food and Nutrition Service (FNS) and review the requirements. Retailers that do not wish to join the pilot program can still offer delivery or pick-up flexibility options for SNAP recipients by using mobile EBT processing equipment that would allow customers to pay with SNAP when groceries are delivered or picked up. Farmers’ markets may be able to receive this processing equipment at no cost through a grant opportunity provided by DHS. Online grocery transactions made up only 1.5 percent of total SNAP purchases during the month of June, equating to nearly 87,000 total online food transactions. Walmart (63 percent) and Amazon (29 percent) had the majority of the purchases, while ShopRite and Fresh Grocer experienced transaction activity of over half a million dollars combined.

Only eligible food items normally paid for by SNAP may be purchased from these retailers online with SNAP benefits. Delivery fees, driver tips, and other associated charges may not be paid for with SNAP benefits. This initiative does not include the ability to transact Cash Assistance benefits using the EBT card; therefore, individuals will need to use another method of payment, such as a pre-paid debit card, to cover non-allowable fees. More information on the online program, including a list of locations of participating retailers, can be found here.

Applications for SNAP and other public assistance programs can be submitted online at www.compass.state.pa.us. Those who prefer to submit paper documentation can print the application from the website or request an application by phone at 1-800-692-7462 and mail it to their local County Assistance Office (CAO) or place it in a CAO’s secure drop box, if available. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continues. Clients should use COMPASS or the MyCOMPASS PA mobile app to submit necessary updates to their case files while CAOs are closed.

National Health Policy Leaders Endorse Governor’s ‘Bold’ Action to Stop Another COVID Surge in Pennsylvania

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National health policy leaders endorsed Pennsylvania Governor Tom Wolf’s most recent mitigation efforts to stop another surge of COVID-19 cases in the commonwealth, reminding all Pennsylvanians that by taking these measures now we can stop further spread and end mitigation efforts sooner.

“In this pandemic, it is imperative to take bold action before cases rise exponentially—to get ahead of the curve,” said Ezekiel J. Emanuel, M.D., Ph.D., former special advisor for health policy to President Obama, and vice provost for Global Initiatives at the University of Pennsylvania. “Gov. Wolf is doing just that. We need to ensure physical distancing, the wearing of face masks, and limiting indoor activities. Gov. Wolf’s actions to implement these measures will save lives and allow continued reopening of the economy in a safe and smart way.”

“Governor Wolf is making the very difficult and very necessary decision that will save lives in Pennsylvania,” said Andy Slavitt, former Acting CMS Administrator and United States of Care Board Chair. “Having reviewed the data, seeing Pennsylvania taking steps before this becomes a full-blown crisis is the only way to mitigate an out of control tragedy. I know the governor realizes the hardship caused by the pandemic on Pennsylvanians. These actions will help bring a quicker end to them.”

“Governor Wolf has shown throughout this crisis that he is doing what Washington refuses to do: let science and public health dictate decisions, and taking needed steps to protect the people of Pennsylvania from COVID,” Ron Klain, former chief of staff to Vice-President Biden, and President Obama’s ‘Ebola czar’ said. “That is the best plan to save lives, and, in the long run, promote a sustainable economic recovery.”

Gov. Wolf and Pennsylvania Secretary of Health Dr. Rachel Levine put in place additional mitigation efforts on July 15 when multiple data points indicated the state may be headed for another surge in COVID-19 cases. These health experts and the CDC have noted that limiting indoor activities and wearing masks can have a strong positive effect on curtailing another surge.

There is strong evidence to support the state’s mitigation efforts from several different data points. The state is seeing an increase in cases in the 19-24 and 25-49 age demographics, repeating the cycle experienced at the beginning of the outbreak. And as Dr. David Rubin from Children’s Hospital of Philadelphia and its PolicyLab has reported, we are seeing a dramatic increase in these age brackets throughout the state.

Data from Allegheny County indicate increases in these demographics and that exposure happened at bars and restaurants, particularly where alcohol was involved.

The Pennsylvania Department of Health also conducted analyses and case investigations in counties outside of Allegheny that demonstrate bars and restaurants as a nexus for the spread of COVID-19.

The CDC, on its website about restaurants and bars amidst COVID-19, lays out several different categories of risk. The highest risk is on-site dining with both indoor and outdoor seating, where seating capacity is not reduced, and tables not spread at least 6 feet apart.

The mitigation efforts Pennsylvania is taking in bars and restaurants are necessary to keep restaurants and bars at the CDC’s described lowest risk level possible, without completely curtailing indoor dining.

The governor’s most recent order on mitigation efforts can be found here.

The secretary’s order on mask-wearing can be found here.

FAQs on mask-wearing can be found here.

Pennsylvania Governor’s Administration Announces Partnership with National Nonprofit, Shatterproof, to End Substance Use Disorder Stigma

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Pennsylvania Governor Wolf’s Administration announced that Pennsylvania, through its Department of Drug and Alcohol Programs (DDAP), will be one of three founding partners and the first state partner with Shatterproof in supporting the nonprofit’s national strategy to end addiction stigma across the country. Other founding partners include The Hartford and the Brian Mendell Memorial Foundation.

“Pennsylvania has been a leader in efforts to combat substance use disorder and treat all people suffering fairly and with dignity,” Governor Tom Wolf said. “A big part of that is reducing stigma and helping people understand that substance use disorder is not a moral failing, but a disease, worthy of our efforts to combat, treat and cure.”

The strategy, titled The Movement to End Addiction Stigma, identifies nine commonly cited drivers of the opioid epidemic, seven of which are either partially or entirely driven by stigma. Also, the strategy addresses four key areas of stigma, including public stigma, structural stigma, self-stigma and stigma against medications for treatment.

“For decades stigma has cast a shadow over people battling substance use disorder and their families,” said DDAP Secretary Jen Smith. “So much so, that people don’t enter treatment for their disease for fear of public perception. That must change. The Wolf Administration is thrilled to partner with Shatterproof to help bring the strategic plan to life and break critical barriers to help people suffering get the help they deserve.”

Pennsylvania is the first state in the country to participate in the strategic plan and will be focusing on ending public stigma. The commonwealth’s slated project is a partnership between DDAP, Penn State University’s Douglas W. Pollock Center for Addiction Outreach and Research and The Public Goods Project set to launch in September 2020. More information about the project will be available once launched.

“Pennsylvania has stepped up as a leader by being the first and only state to be a founding partner of Shatterproof’s national strategy the Movement to End Addiction Stigma. We appreciate Pennsylvania’s commitment and dedication to implement evidence informed actions to address this underlying cause of this mounting public health crisis. Their leadership will undoubtedly lead other states to follow their example and join us to enable the millions of people suffering to stop feelings of shame, seek and receive access to quality treatment and ultimately find hope,” said Shatterproof founder & CEO, Gary Mendell.

Shatterproof is a national nonprofit organization dedicated to reversing the course of the addiction crisis in America. Shatterproof is focused on ensuring that American substance use disorder treatment is based upon proven research and ending the stigma of addiction. The organization advocates for changes to federal and state policy, payer reform, treatment quality assessment, and provides public education through online programs.

During the Wolf Administration’s second term, DDAP will place a heavy focus on reducing stigma associated with substance use disorder, intensifying primary prevention efforts, strengthening treatment systems and empowering sustained recovery. The aim of these efforts will be to positively influence the knowledge and behavior around the topic of addiction.

For more information about the work the Wolf Administration is doing to combat the opioid crisis, visit pa.gov/opioids.

View Shatterproof’s press release announcing the strategy, and learn more about their efforts to combat stigma.

MEDIA CONTACT:  Sara Goulet, Governor’s Office, 717-979-7462, Rachel Kostelac, DDAP, 717-547-3314

As Residents Get Better at Treating COVID-19, they May Become Worse at their Own Specialties

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This article presents concerns that, as COVID-19 continues to be an issue, residents will not be able to meet residency requirements. This follows the mid-March decision by the Accredited Council for Graduate Medical Education to allow hospitals to send residents to other specialties and suspend educational requirements. Thus, residents have been working as COVID-19 doctor’s, rather than practicing for their chosen specialties, which for residents that have chosen specialties like general surgery, acting like COVID-19 doctors has made it difficult to meet educational requirements. Many residents were sent to Emergency Departments and Intensive Care Units to act as medical interns, effectively stopping their specialties. Residents not changed to different specialties also experienced a shift in their education. Further, according to the Association of American Medical Colleges (AAMC), many medical students failed to match to residency programs.

Telehealth Can Improve Cancer Care in Rural Areas

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There are higher cancer related death rates in rural America due to poorer access to proper care, despite lower cancer-incidence rates. The article states that researchers have found that the telehealth infrastructure implemented in California mountain communities “enhanced the reach and quality of care as measured by volume, in-migration, clinical trial activity, and national quality accreditations.” Telehealth has become increasingly more important, especially during the COVID-19 pandemic. In June, the Federal Communications Commission announced that it would supply funding to rural health providers to establish necessary broadband connectivity for telehealth and virtual care services. However, in May, rural hospitals stated that necessary payments models must also be put in place help them control costs and weather the pandemic.

Fatal Overdoses Climbed to Record High in 2019, Reversing Historic Progress

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Drug overdose related deaths were at a record high in 2019, despite the Trump Administration using resources to combat the opioid crisis. This led to a 4.6% drop in 2018, but experts state progress was short-lived. This likely relates to the dramatic rise in synthetic opioid drug use and addiction experts note. Further, the 2019 data does not include racial and ethnic minorities, but the 2018 data notes an increase, particularly among black Americans. The situation is expected to get worse in 2020 because COVID-19 has exacerbated the situation after closing outpatient centers due to lockdowns in response to the virus. However, the Trump Administration has loosened restrictions on telehealth services, improving access issues that existed before the pandemic.

Boosting Oral Health Care in Rural Communities

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Both societal and geographical barriers make it difficult for rural communities to access oral care. Additionally, rural communities are more likely to experience poverty and regions with higher rates of poverty have significantly fewer dentists per 100,000 people. Due to this shortage, State and Federal legislators are working to improve access to oral health care for rural communities. Boosting the health care workforce, expanding teledentistry, and improving access to insurance are common approaches states are taking to increase oral health services. Teledentistry, which consists of a range of services from video consultations to patient monitoring, would be efficient in screening patients for diseases and connecting them with appropriate care from their homes. Federally, the Health Resources and Services Administration (HRSA) is working with states to attract providers to underserved rural areas, expand facilities, and establish teledentistry programs. Together, state and federal government officials are working to bring a greater oral care presence to underserved rural areas.

CDC Pregnancy Risk Assessment Monitoring System

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The Centers for Disease Control and Prevention (CDC) will make 57 awards of up to $175,000 each to support collection of population-based data on maternal and child health indicators that can be used to inform programs, research, and systems changes that influence maternal and infant health. Eligible applicants include state, local, and tribal governments, community-based organizations, and institutions of higher education. Extended to August 11th.

Committee Analysis Examines Longstanding Racial and Economic Disparities that Expose Inequities in the U.S. Health System

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The House Ways and Means Committee released a report that analyzed health care inequity among different U.S. residents. It found that although 97% of America is rural, only a small percentage of Americans live in these areas. This creates challenges in sustaining the health care workforce and capacity for service delivery in rural communities. Some of these issues include an aging infrastructure, economic disinvestment, workforce shortages, and environmental challenges to higher burdens of chronic conditions. The report also highlighted the disparities among minority groups in statistics such as infant mortality, life expectancy, language diversity, and access to mental health care.