Department of Health Resources

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New Mitigation Efforts to Fight COVID-19

Updated November 23, 2020

New modeling from the Institute of Health Metrics and Evaluation (IHME) at the University of Washington projects upwards of 22,000 new COVID cases per day in Pennsylvania in early December, the same month we are projected to run out of intensive care beds. The modeling also projects that if mitigation efforts are not adhered to, Pennsylvania could have more than 32,000 deaths from COVID by Feb. 23, just three months from now. With universal mask-wearing, those deaths can be reduced by half.

As a result of these projections and with the number of COVID-19-attributable deaths quadrupling in the past week, yesterday the governor announced new mitigation efforts to reduce the spread of the virus.

Requiring Strict Safety Measures in Our Schools

Summary: The Wolf Administration is requiring Pre-K to 12 public schools in counties that have been in the substantial transmission level for at least two consecutive weeks to commit to safety measures to ensure the safety and well-being of students and educators. If they choose not to, they must move to fully remote learning without all extra-curricular activities. As of Friday, Nov. 20, there are 59 counties in the substantial transmission level for at least two consecutive weeks.

Requirements for Pre-K to 12 public schools in substantial counties for at least two consecutive weeks:

• Schools are mandated to comply with updated protocols if a COVID-19 case is identified in the school building.
• By 5 p.m. Monday, Nov. 30, chief school administrators and the governing body president/chair must sign an attestation form stating they have either transitioned to fully remote learning or are complying with the orders if they are conducting any in-person instruction while in the “substantial” range of transmission.
• Those schools that do not sign or comply with an attestation are required to provide only fully remote learning and suspend all extracurricular activities as long as the county remains in the substantial transmission level.

Keeping Businesses, Customers and Employees Safe

Summary: The administration is revising and reissuing its orders to protect businesses, customers, and employees. This order will consolidate previous orders and includes reiterating cleaning and social distancing requirements, mandatory telework requirements unless impossible, and other safety measures.

• Telework is mandatory unless impossible; safety measures required for businesses including cleaning, social distancing and masking.
• Online sales and curbside pickup for all shopping are encouraged.

Furthermore, to help with enforcement of existing masking orders in businesses, the administration is introducing liability protection for all businesses that maintain in person operations and are open to the public. Businesses will receive immunity from civil liability only as related to the Secretary’s masking order given that individuals and entities are engaged in essential emergency services activities and disaster services activities when enforcing the order.

Strengthening Gathering Limitations

Summary: As Pennsylvania sees an increase in cases, the commonwealth is strengthening gathering restrictions. All large events and gatherings are now reduced until further notice. In addition, the retail food services industry, including bars, restaurants, and private catered events must end alcohol sales for on-site consumption at 5 p.m. on Nov. 25, 2020 only.

• All indoor and outdoor events/ gatherings categories size limits will be reduced
• New limits are as follows:

Maximum Occupancy Calculator for indoor events:

Maximum Occupancy Calculator for outdoor events:

• Household gatherings are also advised against when attendees include non-household members as noted through the Secretary of Health’s Stay at Home Advisory.
• To specifically address large crowds, on Nov. 25, 2020 only, all sales or dispensing of alcoholic beverages for on-site consumption at businesses in the retail food services industry, including bars, restaurants, and private catered events must end at 5 p.m. Indoor dining may continue, takeout is encouraged.

Empowering local government

• The governor and Secretary of Health’s orders were issued pursuant to the authority granted to them under the law, and as such they have the force and effect of law. This authority extends to all local enforcement agencies in Pennsylvania. Local law enforcement received guidance on enforcement of the various COVID-19 orders in place from the Pennsylvania State Police through the PA Chiefs of Police Association.
• Given the importance of local engagement, the Department of Health has provided recommendations for local municipal leaders, as well as county-wide leadership. While statewide mitigation steps are necessary, local leaders can implement their own orders, ordinances, or directives in order to protect health and safety as long as they are stricter than those mandated by the state. Additionally, counties and municipalities are authorized to enforce state law, including orders from the Secretary of Health or Governor.
• Local leaders at all levels of government should exercise their authority and influence to support public health efforts that will protect residents and local economies. When local leaders engage, their constituents understand that they are supported in adopting and sustaining preventive behaviors.
• The Department of Health has established thresholds representing low, moderate, or substantial community transmission of COVID-19, and corresponding actions that can be taken by county and municipal leaders. A county’s threshold may change week-by-week as incidence and percent positivity rates rise and fall. Leaders should implement more public health actions rather than fewer if their county is between thresholds. To determine level of community transmission, counties should use the Department of Health’s COVID-19 Early Warning Monitoring System Dashboard. The Department of Health and the Department of Education use the same metrics to recommend instructional models for school leaders.
• Recommendations for each level of community transmission include increased communication, collaborative planning, stricter directives, and working with school leaders.

Ramping Up Enforcement

Summary: Orders already in place and those announced today are all enforceable, and law enforcement and state agencies will be stepping up enforcement efforts, issuing citations and fines, and possibly regulatory actions for repeat offenders.

Given that this is a critical time for mitigation efforts and orders to be followed, the Wolf Administration is stepping up enforcement on the following orders:

• Out of State Travel
• Mask-wearing
• Business Safety, including telework, occupancy, cleaning, social distancing
• Restaurant Mitigation, including occupancy, masking, social distancing, self-certification
• Gathering Limits
• School Attestation and Mitigation
• Orders are enforceable as a disease control measure under the Disease Prevention and Control Law. Citations may be written under the Administrative Code of 1929 71 P. S. § 1409 and/or the Disease Prevention and Control Law of 1955 35 P.S. § 521.20(a). The decision whether to issue a warning or a citation is made on a case-by-case basis and determined by the unique circumstances of each encounter.
• Persons who fail to comply with an order may be fined between $25 and $300 dollars.
• Enforcement agencies include the Pennsylvania State Police, local law enforcement, personnel from the departments of Agriculture and State, and PA Liquor Control Board stores who interact with visitors.

Because a component of enforcement is investigating complaints, the Department of Health, with assistance from other agencies, is bolstering its ability to receive and respond to complaints from customers and employees. The department will continue to investigate complaints provided via its webform and plans to use additional staff from other state agencies under the governor’s jurisdiction to process complaints.

Following a complaint about a business, the Department of Health will send a warning letter informing the business of the potential consequences, including fines and closure if the business is not compliant with the mitigation orders. If a business continues to receive complaints, it risks referral to the Pennsylvania State Police or regulatory agencies, further fines and possible closure. 

Last week, Pennsylvania Secretary of Health, Dr. Rachel Levine, announced new mitigation efforts as Pennsylvania has seen a resurgence of COVID-19 cases.  The efforts announced include:

Strengthened Making Order

This new order strengthens the initial masking order from April 15, 2020 with the following inclusions:

• Masks are required to be worn indoors and outdoors if you are away from your home.
• When outdoors, a mask must be worn if you are not able to remain physically distant (at least 6 feet away) from someone not in your household the entire time you are outdoors.
• When indoors, masks will now be required even if you are physically distant from members not in your household. This means that even if you are able to be 6 feet apart, you will need to wear a mask while inside if with people other than members of your household.
• This order applies to every indoor facility, including homes, retail establishments, gyms, doctors’ offices, public transportation, and anywhere food is prepared, packaged or served.

Protecting Our Health Care System 

Dr. Levine issued a memorandum to acute care hospitals outlining expectations to care for Pennsylvanians who need care during the pandemic.

Hospitals are to work through the established health care coalitions and other partnerships to prepare for how they will support one another in the event that a hospital becomes overwhelmed during the pandemic. Hospitals should also be working to move up elective procedures necessary to protect a person’s health and prepare to suspend them if our health care system becomes strained.

Restrictions on elective surgeries put into effect in March and lifted in April were to help with both PPE and bed capacity and were considered successful.

Hospitalizations are increasing, as are ICU patients, and according to modeling from the Institute of Health Metrics and Evaluation, which does not take into account hospitalizations from influenza, Pennsylvania will run out of intensive care beds in December if ICU admissions continue at the current rate.

The same modeling indicates we will have sufficient medical-surgical beds with some uncertainty as to capacity from region to region.

Traveler Testing

Dr. Levine issued an order requiring anyone who visits from another state to have a negative COVID-19 test within 72 hours prior to entering the commonwealth.

If someone cannot get a test or chooses not to, they must quarantine for 14 days upon arrival in Pennsylvania.

Pennsylvanians visiting other states are required to have a negative COVID-19 test within 72 hours prior to their return to the commonwealth or to quarantine for 14 days upon return to Pennsylvania.

This order, which took effect on Friday, November 20, does not apply to people who commute to and from another state for work or medical treatment

Colleges and Universities

The departments of Health and Education issued recommendations for colleges and universities to implement a testing plan for when students return to campus following the holidays.

These recommendations include establishing routine protocols for testing.

Colleges and universities should have adequate capacity for isolation and quarantine and should be prepared to enforce violations of established policies such as mask wearing and physical distancing.

Every college and university should test all students at the beginning of each term, when returning to campus after a break and to have regular screening testing throughout the semester/term.

Housing Assistance

The U.S. Department of Housing and Urban Development is suspending foreclosures and evictions for mortgages insured by the Federal Housing Administration until the end of April 2020.

The Pennsylvania Public Utility Commission (PUC) has issued an emergency order prohibiting electric, natural gas, water, wastewater, telecommunication, and steam utility terminations.  This will remain in place for as long as the disaster proclamation of Disaster, signed by Governor Wolf on March 6, is in effect.

Food Assistance for Seniors

Many grocery stores are offering special shopping timeslots for seniors and individuals with compromised immune systems. Please check with your local grocer before heading to the store. Order online if possible.

Delaware County seniors who need a grab-and-go meal can contact Senior Community Services’ senior centers. Visit scsdelco.org/centers/centers.shtml for contact information. Centers are open from 8:30 AM to 2:00 PM.