On November 11, the Pennsylvania Department of Health (DOH) released a new PAHAN notice, Notification of COVID-19 Test Results to Patients with guidance for healthcare providers who are evaluating patients for COVID-19. DOH is asking that clinicians provide the current guidance on isolation to patients being evaluated for COVID-19 to ensure that timely recommendations are provided to reduce spread of disease. Please report any confirmed cases of SARS COV-2, the virus that causes COVID-19, through the DOH electronic disease surveillance system, PA-NEDSS. There was also guidance for patients on developing a list of people with whom they have been in contact and a patient instruction handout.

Pennsylvania Governor Wolf’s Administration began distribution of the fifth allotment of COVID-19 antigen test kits provided by the federal government to Clinical Laboratory Improvement Amendments (CLIA)-certified institutions in Armstrong, Dauphin, Delaware and Indiana counties. Last week, 371,480 tests were distributed to 15 facilities in Elk, Lawrence, Mifflin and Philadelphia counties. Philadelphia distributed all 353,280 of their allotment during week four. Additional tests will be provided to healthcare providers in those counties in the coming weeks. Archived lists of distributions since week one can be found on the Department of Health’s Coronavirus Symptoms & Testing webpage under the Antigen Tests subhead. On Oct. 15, the Secretary of Health issued an Order to health care providers and facilities reinforcing that all antigen test results, both positive and negative, are required to be reported to DOH. For more information about the CLIA certificate and antigen test card reporting, reference the PA Health Advisory Network (HAN) Advisory: Guidance on Reporting Point of Care SARS-CoV-2 Test Results. For more information about the antigen tests, reference the PA HAN Advisory: Point of Care Antigen Test Use and Interpretation.

Following his reelection, Senate Majority Leader McConnell said, “I think we should do it (COVID-19 relief), and I think we should do it before the end of the year.” While Congress continues to debate the best way forward on COVID-19 relief, rural providers are experiencing the highest case load since the beginning of the pandemic.

The Centers for Disease Control and Prevention (CDC) confirmed that COVID-19 cases and deaths are highest in small cities and rural communities. This trend is underscored by the ongoing rural hospital closure crisis and rural communities being ill-equipped to deal with surges. In a Politico newsletter outlining the caseload facing rural America, NRHA CEO Alan Morgan said he thought that by the time the virus hit rural areas the country would be better prepared for the surge. Unfortunately, that isn’t the case.

The Centers for Disease Control and Prevention (CDC) added this easy-to-understand guide to their COVID-19 resources.  According to National Institutes of Health Director Dr. Francis Collins, face coverings could save 130,000 American lives by March.

The U.S. Department of Health & Human Services announced a new project to address the higher risk of severe illness from COVID-19 for people with kidney disease.  With encouragement to communities that face health disparities,  the Challenge invites new solutions from entities or individuals that can reduce the impact of pandemic without requiring significant time, expertise, money, or other resources from the patient.

Coverage Available at No Cost to Beneficiaries Across Variety of Settings in Health Care System

CMS announced that starting November 10, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat COVID-19 with no cost-sharing during the Public Health Emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an Emergency Use Authorization (EUA) from the FDA on November 9.

“Today, CMS is announcing a historic, first-of-its kind policy that drastically expands access to COVID-19 monoclonal antibodies to beneficiaries without cost sharing,” said CMS Administrator Seema Verma. “Our timely approach means beneficiaries can receive these potentially life-saving therapies in a range of settings – such as in a doctor’s office, nursing home, infusion centers, as long as safety precautions can be met. This aggressive action and innovative approach will undoubtedly save lives.”

CMS anticipates that this monoclonal antibody product will initially be given to health care providers at no charge. Medicare will not pay for the monoclonal antibody products that providers receive for free but this action provides for reimbursement for the infusion of the product. When health care providers begin to purchase monoclonal antibody products, Medicare anticipates setting the payment rate in the same way it set the payment rates for COVID-19 vaccines, such as based on 95% of the average wholesale price for COVID-19 vaccines in many provider settings. CMS will issue billing and coding instructions for health care providers in the coming days.

CMS anticipates the announcement will allow for a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract, to administer this treatment in accordance with the EUA, and bill Medicare to administer these infusions.

Under section 6008 of the Families First Coronavirus Response Act (FFCRA), state and territorial Medicaid programs may receive a temporary 6.2 percentage point increase in the Federal Medical Assistance Percentage (FMAP), through the end of the quarter in which the COVID-19 PHE ends. A condition for receipt of this enhanced federal match is that a state or territory must cover COVID-19 testing services and treatments, including vaccines and their administration, specialized equipment, and therapies for Medicaid enrollees without cost sharing. This means that this monoclonal antibody infusion is expected to be covered when furnished to Medicaid beneficiaries, in accordance with the EUA, during this period, with limited exceptions.

View the Monoclonal Antibody COVID-19 Infusion Program Instruction.

The presidential election offers plenty of evidence that ignoring the coronavirus won’t make it go away.

Last week, while most of us focused on the race for the White House, the number of Covid-19 infections in rural counties grew by 30% and set a record for the number of new cases for the seventh consecutive week. There were 144,043 new infections in rural counties last week, up from about 110,000 the week before.

Also last week, another 97 rural counties were added to the red-zone list, bringing the total to 1,599, or four out of five of all nonmetropolitan counties. (This article using nonmetropolitan counties as synonymous with rural.)

Red-zone counties have a new infection rate of 100 or more cases in one week per 100,000 residents. The Trump administration’s White House Coronavirus Task Force says that red-zone counties need to enact tougher measures to control the virus.

The current surge originated in rural areas two months ago and more recently has spread into metropolitan counties. Previously, metropolitan counties had their worst new infection rates in July. But those counties surpassed those summer peaks for the past two weeks.

Here are other facts from last week’s analysis, which covers Sunday to Saturday, November 1 to 7.

• Rural counties had 1,873 Covid-19 related deaths last week, an increase of 20% from the previous week, and a new record. About 29% of new U.S. deaths occurred among rural residents, who constitute about 14% of the U.S. population.
• This fall’s surge has created a new class of rural hotspots. One quarter of rural counties (479) have one-week infection rates of at least 500 new cases per 100,000 residents — five times the red-zone infection level. Fourteen percent of metropolitan counties (141) meet that criterion. As the map below shows, these hotspot counties are primarily in the Upper Midwest, Great Plains, and the Intermountain region of that includes Montana, Wyoming, and Idaho.

Read more.

As Pennsylvania continues to combat COVID-19 and we enter cold and flu season, the most important step in preventing sickness is following healthy habits. These best practices limit the spread of germs for yourself and others.

Download the COVID Alert PA App

The COVID Alert PA app notifies you if you have had a potential exposure to someone who has tested positive for COVID-19. The app works by using anonymous Bluetooth technology that identifies other devices with the app in your proximity. When an app user who was near you reports they have a positive COVID-19 diagnosis, you may receive an alert, depending on the date, how long you were exposed and how close you were to the other person. It does not track your location or store your personal information.

The app also includes an interactive COVID-19 symptom checker, updates on the latest public health data about COVID-19 in PA and advice for what to do if you have a potential exposure to COVID-19.

Learn more and download now. The more Pennsylvanians that download the app, the more successful we will be in stopping the spread of the virus.

Mask Up

In Pennsylvania, masks must be worn whenever anyone leaves home. Masks are mandatory in all public spaces. Members of the public should wear homemade cloth or fabric masks and save surgical masks and N95 respirators for health care workers and first responders.

Remember this saying: “My mask protects you, your mask protects me.” 

Social Distance

It’s important to keep a safe space between yourself and other people who are not from your household. To practice social or physical distancing, stay at least 6 feet from other people who are not from your household in both indoor and outdoor spaces.

Washing your hands is one of the most important steps you can take in staying healthy. When you wash, make sure you:

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them.

Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.

Avoid Touching Your Face

Avoid touching your face with unwashed hands. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Clean Surfaces

Clean and disinfect frequently touched surfaces at home, work, or school — especially when someone is ill.

Make sure your child’s school, child care program, or college routinely cleans frequently touched objects and surfaces, and that they have a good supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.

At work, routinely clean frequently touched objects and surfaces including doorknobs, keyboards, and phones to help remove germs. Learn more about effective steps for cleaning from the CDC.

Stay Home When Sick

Stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others. It’s a good idea to build an at-home kit so you have all the items you need (food, medication, etc.) to stay inside and focus on feeling better.

Practice the healthy habits above and also do your best to get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

For the most up to date information on COVID-19 in Pennsylvania, visit the Pennsylvania Department of Health or PA Unites Against COVID and download the COVID Alert PA App.