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State at nearly 50,000 Cases as 24 Counties Prepare to Reopen; Monroe County Far Above Reopen Target

Updated: May 4, 2020

The two week rolling average of new cases in Monroe County, as of May 3. (Chart by The Boro* from PA DOH data)

HARRISBURG (MAY 3 2020) - The Pennsylvania Department of Health today confirmed as of 12:00 a.m., May 3, that there are 962 additional positive cases of COVID-19, bringing the statewide total to 49,267. All 67 counties in Pennsylvania have cases of COVID-19.

Today, the department reported 26 new deaths, bringing the statewide total to 2,444 in Pennsylvania. County-specific information and a statewide map are available here

“As we see the number of new COVID-19 cases continuously change across the state that does not mean we can stop practicing social distancing,” Secretary of Health Dr. Rachel Levine said. “We must continue to stay home to protect ourselves, our families and our community. If you must go out, please make as few trips as possible and wear a mask to protect not only yourself, but others. We need all Pennsylvanians to continue to heed these efforts to protect our vulnerable Pennsylvanians, our health care workers and frontline responders.”

There are 191,374 patients who have tested negative to date. Of the patients who have tested positive to date the age breakdown is as follows:

  • Nearly 1% are aged 0-4;

  • Nearly 1% are aged 5-12;

  • 1% are aged 13-18;

  • Nearly 6% are aged 19-24; 

  • Nearly 38% are aged 25-49; 

  • Nearly 27% are aged 50-64; and

  • Nearly 27% are aged 65 or older.

Most of the patients hospitalized are aged 65 or older, and most of the deaths have occurred in patients 65 or older. There have been no pediatric deaths to date. More data is available here.

In nursing and personal care homes, there are 9,122 resident cases of COVID-19, and 1,194 cases among employees, for a total of 10,316 at 492 distinct facilities in 44 counties. Out of our total deaths, 1,635 have occurred in residents from nursing or personal care facilities. In Monroe County's eight long-term care facilities, there have been 125 resident cases, 28 health care workers testing positive, and 22 deaths. A county breakdown can be found here.

Approximately 3,031 of our total cases are in health care workers.

Monroe County Still in Red Phase

Governor Tom Wolf last week set forth a three-stage plan for reopening Pennsylvania businesses. The phases are labeled "Red", "Yellow", and "Green". Currently, the entire state is in the "Red Phase", with only life-sustaining businesses open, with some particular amendments made as of May 1 which permit most construction activities, golf courses, and other activities to resume, subject to physical distances and other guidance.

The next phase is the "Yellow Phase" in which most businesses will be permitted to resume operations provided they adhere to state and federal guidance on physical distancing and cleaning practices. On Friday, the governor announced 24 northcentral and northwest counties that would be permitted to move into the yellow phase this coming Friday, May 8.

The first 24 counties to move to the yellow phase, on May 8, placed over the PADOH Health Region map. The remainder of the state will remain in the red phase.

Monroe County, with one of the highest concentration of cases per capita in the state, was not considered for reopening. In order to be considered for movement into the yellow phase, a county and it's associated region, must have two weeks in which their total new cases are below 50 cases per 100,000 residents. For the county, that is a total of about 85 cases in a two-week period. The county currently has 209 new cases over the last 14 days.

The county is in the Northeast Health Region (Carbon, Lehigh, Northampton, Lackawanna, Luzerne, Pike, Susquehanna, Wayne, and Wyoming). Five of the counties in this region are also among the states top ten counties in cases per capita (Monroe, along with, Lehigh, Northampton, Luzerne, and Lackawanna). The Northeast Region total of new cases in a two-week period must fall below 804 to be considered for moving from the red to the yellow phase. Currently, the region has 2,709 cases in the 14-day period ending today, nearly 3 1/2 times the target numbers.

The Northeast Health Region rolling total of new cases in a 14-day period, as of May 3. (Chart by The Boro* from PADOH data)

The two-week period approximates the average time to recovery for infected persons. That figure therefore provides an estimate of the number of active infections in the region. The goal of 50 cases per 100,000 is the epidemiological metric of an "interepidemic" infection rate, the measurement used to mark the period between epidemic. During the interepidemic period testing capacity is important to monitor and react to potential flare-ups to prevent resurgence of the virus to epidemic levels.

According to Levine and Wolf, when a county and it's region meet the initial target for new infections, the decision whether to move to the next, yellow, phase, will be based on a number of other factors. Included in those factors are the capacities of the region to engage in testing sufficient to reasonably monitor the extent of the infections, and the availability of health care assets to respond to flare-ups, as well as the ability to enact containment and mitigation measures to prevent return to epidemic rates of infection.

They stressed, as they have since the beginning of the discussion of a plan to reopen Pennsylvania, that the regional approach would be subject to decisions made on a county-by-county basis depending on the situation in that county. Thus in the initial yellow phase are all counties in the two re-opened regions, except for Columbia County. These decisions are made based on the numbers of cases, as well as the other factors, evaluated in conjunction with the Carnegie Mellon University decision support tool, developed for the state.

There is not currently any timeline for moving any other county into the yellow phase. The governor last week denied that they were looking at the June 2 primary, or any other date, as a "target" or "deadline" for making decisions or moving other counties into the yellow phase. Levine and Wolf each repeated the comment that "the virus will determine the timeline."

Levine said that all reopening decisions follow the six standards outlined in the governor’s plan to reopen Pennsylvania. These include adhering to:

  • Data-driven and quantifiable criteria to drive a targeted, evidence-based, regional approach to reopening.

  • Clear guidance and recommendations for employers, individuals, and health care facilities and providers for assured accountability.

  • Adequate and available personal protective equipment and diagnostic testing.

  • A monitoring and surveillance program that allows the commonwealth to deploy swift actions for containment or mitigation.

  • Protections for vulnerable populations such as limitations on visitors to congregate care facilities and prisons.

  • Limitations on large gatherings unrelated to occupations.

“Our goal since this pandemic was first identified in Pennsylvania has been to save lives while ensuring that the public health system does not become overwhelmed with people suffering from COVID-19,” Levine said. “Our contact tracing and testing plans will ensure that as we begin to resume our daily activities, we can do so safely and without fear.”

Outline of the phases for reopening Pennsylvania. (PA Chart)

Defining the Yellow Phase

As regions or counties move into the yellow phase, some restrictions on work and social interaction will ease while others, such as closures of schools, gyms, and other indoor recreation centers, hair and nail salons, as well as limitations around large gatherings, remain in place.

On Monday, May 4, the administration said it will release further guidance for businesses permitted to reopen on May 8 in the 24 northcentral and northwestern counties. The guidance is being developed through collaboration with the affected counties, Team PA, the Department of Health, the Pennsylvania Emergency Management Agency, the Department of Community and Economic Development and the Department of Labor & Industry, among others.

Wolf said the guidance will build on existing safety and building safety orders released in April. Overall characteristics of the yellow phase include,

Work & Congregate Setting Restrictions

  • Telework Must Continue Where Feasible

  • Businesses with In-Person Operations Must Follow Business and Building Safety Orders

  • Child Care Open Complying with Guidance

  • Congregate Care and Prison Restrictions in Place

  • Schools Remain Closed for In-Person Instruction

Social Restrictions

  • Stay at Home Order Lifted for Aggressive Mitigation

  • Large Gatherings of More than 25 Prohibited

  • In-Person Retail Allowable, Curbside and Delivery Preferable

  • Indoor Recreation, Health and Wellness Facilities and Personal Care Services (such as gyms, spas, hair salons, nail salons and other entities that provide massage therapy), and all Entertainment (such as casinos, theaters) Remain Closed

  • Restaurants and Bars Limited to Carry-Out and Delivery Only

Wolf said that any businesses not specifically mentioned as restricted from reopening will be permitted to resume operations of they follow the forthcoming guidance.

Moving Forward

Wolf stressed the need for all Pennsylvanians to now, more than ever, take personal responsibility for their actions.

“Every human-to-human contact is a chance for the virus to spread, so more contacts mean a higher likelihood of an outbreak,” Wolf said. “If we see an outbreak occur in one of the communities that has been moved to yellow, we will need to take swift action, and revert to the red category until the new case count falls again. So, Pennsylvanians living in a county that has been moved to the yellow category should continue to strongly consider the impact of their actions.” The full reopening plan is available here.

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