Pa. coronavirus update: Farley warns of growing infection, fatality rates in Philly; state sets contact-tracing priorities

Staff at a drive-thru COVID-19 testing site talk to people waiting in line in their cars at the PNC Bank Arts Center

In this March 24, 2020, file photo, staff at a drive-thru COVID-19 testing site talk to people waiting in line in their cars at the PNC Bank Arts Center in Holmdel, N.J. (AP Photo/Seth Wenig, File)

Ask us about COVID-19: What questions do you have about the current surge?

Updated 6:30 p.m.

The Pennsylvania Department of Health reported on Tuesday 6,669 additional positive cases of COVID-19 , bringing the statewide total to 321,070. It reported 81 new fatalities, for a total of 9,951 deaths attributed to COVID-19 statewide.

On Tuesday, Philadelphia reported 1,077 additional confirmed cases of COVID-19, for a total of 61,780 cases. Another 45 likely cases have also been identified. Seven new deaths were reported in Philadelphia, for a total of 1,960 since the start of the pandemic.

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Farley warns of growing infection and fatality rates

Philadelphia Health Commissioner Thomas Farley expressed concern over rising COVID-19 infection and fatality rates on Tuesday, which he said, unchecked, could strain hospital resources.

“We are still seeing very high case counts from the coronavirus here in Philadelphia,” Farley said. “And we are seeing increases in the severe consequences of this infection.”

Over the past week, Philadelphia averaged 765 new cases per day — lower than the previous week’s daily average of 888 cases, though Farley added the latest figure will likely rise as more data is reported. Pennsylvania is reporting more than 6,000 cases per day.

The number of people hospitalized with COVID is also growing on a city and state basis. According to the Pennsylvania state database, the number of hospitalized patients reached 3,400 yesterday compared with 2,900 last Thursday. “Both of those are new highs,” Farley said. “They’ve never been this high before.”

As of this morning, Philadelphia reported 672 hospitalizations, up from 542 last Thursday, with numbers continuing to rise.

“To put that in perspective, we peaked at about a thousand cases last spring,” Farley said. “So we can handle this now, but I’m still concerned that the hospitals may come under strain if we don’t get this particular epidemic wave under control.”

The city’s number of fatalities is also rising, from an average of 10 deaths per week in September, to 31 deaths the week of Nov. 8, and 17 deaths the week of Nov. 15.

However, Farley said, there have been some signs for hope — this past week, Philadelphia’s positive infection rate leveled off at 11.8% — same as the week before — after weeks of climbing numbers.

“A leveling trend could just be a pause before we see another increase; it could be the beginning of a reversal,” Farley said. “But even so, the number of daily cases we’re seeing is still extremely high.”

Pa. sets contact-tracing priorities

Pennsylvania has adopted a new prioritization scheme for its contact-tracing efforts in light of soaring cases. The state Health Department is focusing on people who were infected in the last six days before others, as well as those who may be at high risk of serious infection or high risk of infecting other people.

That includes those who work in a congregate-care setting or other dense environments. The new schematic also prioritizes contact tracing for contacts who live in the same household as positive cases over contacts that live elsewhere. If more than 14 days have lapsed since the infection was diagnosed, the contact-tracing team will no longer pursue the case for contact tracing.

Pennsylvania Director of Testing and Contact Tracing Michael Huff said the state has been working with a prioritization scheme for the past three weeks or so, but the Centers for Disease Control and Prevention released its recommendations Tuesday.

During the week of Nov. 8, case investigators in Pennsylvania reached less than a quarter of all 34,719 positive cases. In addition to the 8,332 people reached, the Health Department monitored 11,550 of their close contacts.

“People don’t want to answer the phone,” said Huff. “Public health controls are only as effective as the willingness of individuals to carry them out.”

Huff acknowledged that he does not often answer the phone when an unknown number calls, and said he understands that people may be wary of giving personal information to a stranger, or fear incriminating the business or restaurant they tell the Health Department they visited. He said that’s why the state is working on having a trusted and respected voice from the Health Department on the other end.

When asked if case counts could reach a case threshold where contact tracing is no longer a good use of resources, Huff noted that that’s what the prioritization scheme is for.

“We will continue to work through those lists,” said Huff. “We’re not going to stop.”

In Philadelphia, the city has asked many who test positive to call their own close contacts to warn them they may have been exposed. The case counts in the city have so far surpassed its ability to contact-trace that the department is no longer reporting weekly case investigation and contact-tracing numbers.

City officials defend new restrictions amid backlash

Mayor Kenney and Commissioner Farley reiterated the importance of following new city and state restrictions, despite pushback from some small businesses.

“I understand people being affected by this being unhappy about that, but I do think we need to recognize how many people are dying and potentially could be dying,” Farley said. “And that this kind of step, for a limited period of time, seems to me to be worth it.”

A group of gym owners, called the Philadelphia Fitness Coalition, protested outside City Hall earlier in the day, arguing that their own data had shown little evidence of new infections stemming from gyms.

“All due respect to them and their data and their tracing, they are not public health professionals, and our public health professionals tell us this is the best thing to do to keep people safe,” Kenney said. “I do understand their concern and their disappointment, but I’m following the public health professionals and their guidance.”

Farley added that the gym shutdown was only slated for six weeks.

“I’m sympathetic to the gym owners, but we do have human lives at stake here,” Farley said and encouraged people to continue paying their gym membership fees so that the gyms can stay afloat.

Philadelphia enacted new restrictions last Friday designed to combat the recent surge in infections that shut down indoor dining, gyms, museums, and libraries, and put limits on the number of people who could enter a store at one time.

Environmental health teams are currently circulating throughout Center City retail shops to ensure that the new restrictions are being followed.

“It’s been fairly common to find places that are not wearing masks and otherwise not following the rules,” Farley said.

Ahead of Black Friday, Kenney also warned potential shoppers to avoid long lines, wear their masks, and use curbside pickup when possible.

Farley added that some of the city’s restrictions — including those requiring people to work from home — are more stringent than statewide restrictions announced yesterday by Governor Wolf, and advised Philadelphians to play it safe.

“For people in the city of Philadelphia, they have to follow the more restrictive requirements – they have to follow the city rules,” he said.

Farley begs Philadelphians to ‘Please, please, please’ stay home on Thanksgiving

Commissioner Farley and Mayor Kenney doubled down on warnings to avoid traveling on Thanksgiving, advising Philadelphians to limit celebrations to their own households.

“I want to reiterate again, please, please celebrate Thanksgiving only with the members of your immediate household,” Farley said. “You don’t want to spread COVID to your elderly grandmother or to that cousin of yours that may have a chronic medical condition, might make him severely ill if he got the infection.”

Farley added that despite similar warnings ahead of Halloween, the city saw a spike in cases following a number of Halloween parties.

Mayor Kenney affirmed that he was putting his money where his mouth was when it comes to the holidays.

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“I had this situation with my mother, who’s 80,” Kenney said. “And I was trying to figure out how to tell her that I wasn’t going to be able to come over. I didn’t think it was good for her, and I have a nephew that has some issues with immune deficiency. And she texted me over the weekend instead, ‘I think it’s a better idea that you don’t come.’ She said, ‘It’s only a dinner. We could have dinner another time.”

Asked about his children, Kenney retorted, “Not that it’s your business, but my children spend, spend the Thanksgiving holiday with their mother and that’s been that way for awhile.”

Farley also responded to questions about whether small family gatherings could really increase infection rates.

“I would find it unlikely that any group of five people or 10 people doesn’t have one person who’s been out there exposed to somebody else,” Farley said. “And everyone should wear a mask, but even masks aren’t perfect. So if you’re out there interacting with other people, you’re at some level of risk, and getting people together over a big meal is a very high risk situation. So I would strongly request people don’t do that.”

Reasons not to get tested before Thanksgiving

Amid a spike in demand for testing, Commissioner Farley says some testing sites have had to prioritize symptomatic people.

“We’re hitting the limits at how many people they can test,” Farley said. “They’re doing what they can, they’re moving through the people that they can, but they are setting some priority. It’s a higher priority for the testing sites and for the city as a whole to test people who have symptoms and to test people who have been exposed to COVID. Those are the people who are more likely to be positive. We want to identify as quickly as possible to contain the spread from them.”

Farley speculated that the rise in demand was likely the result of people trying to get tested before traveling home for Thanksgiving — which he said the city doesn’t recommend.

“We’re concerned that there may be too much demand that we can’t meet,” he said. “And we do think the other people higher priority. If people are going to travel, there is some value to that, but I haven’t been enthusiastically reporting, uh, promoting that because of that concern, that there are lower priority and there’s only so much testing we can do.”

Another reason not to test ahead of the holiday, Farley said, is false negatives, which he said can provide “a false sense of security.”

“There’s an incubation period,” Farley said. “The time between when you catch the virus and when your test turns positive, there’s generally four to six days; it can be up to 14 days. And so if you test yourself during that period, you’ll get a negative test, even though you have the virus and you’ll turn positive a few days later. So if you happen to test negative now, then by Thanksgiving, you may be positive and you may be infecting your relatives. But just because you have a negative test, doesn’t mean that you are not risky to others.”

Montco to expand testing amid escalating rates of infection and hospitalization

Montgomery County is expanding its testing site hours to Monday through Friday, 9 a.m. to 5 p.m., at all six sites.

As neighboring Philadelphia struggles with its testing capacity, Montgomery County Commissioner Dr. Valerie Arkoosh urged “anyone who wants or needs to be tested, to get tested.”

Arkoosh said the county’s testing comes with few requirements: There’s no immediate cost to the patient (though their insurance will be billed); they don’t don’t need a health care provider’s order; and they can even approach the sites on foot (no car needed). But patients do need one thing: appointments.

“The one thing we require is an appointment because the sites have been so busy,” Arkoosh said. “We can no longer accommodate people who walk up. So please do make an appointment.”

That should be a lot easier starting this Monday, Arkoosh said, thanks to the sites’ expanded hours. (All appointments must be made on the day of.) Patients must also live, work or go to school in Montgomery County.

To make an appointment, visit montcopa.org/covid-19, or call (610) 970-2937. Appointment scheduling begins at 8:30am.

The expanded hours come as Montgomery County sees a continued rise in case numbers, hospitalizations and deaths. Montco’s 14-day positive rate increased to 8.17% as of November 19, compared with 7.04% the previous week. (Positive rates below 5% are considered suppression of the virus.)

Since November 19, Montco tallied an additional 1,733 cases of COVID-19 and seven deaths.

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