Friday, May 29, 2020

Updated: Gov. Tom Wolf: Proactive Testing to Begin at Pa.'s Nursing Homes

Lockdown-weary Pennsylvanians have been cheered by Governor Tom Wolf's recent decision to allow al fresco dining at area restaurants in yellow-phase counties. But I have even better news. In a telephone conversation with NorCo Executive Lamont McClure yesterday, Governor Wolf announced that the state Department of Health (DoH) plans to begin proactive and weekly testing of both residents and employees at the state's long-term care facilities (LTCFs). McClure asked that the DoH start at Gracedale as soon as possible.

Al Fresco Dining

This makes sense because the SARS-CoV-2 virus is far less contagious outdoors. As explained in a recent Vox video, the virus is destabilized outdoors. The airflow is much better. The corona, or crown, protecting the virus, is weakened by sunlight, wind, rain and humidity. But as the video also explains, it's still a good idea to maintain a 6' distance (the average droplets containing the virus travel) and limit duration of contact.

recent Chinese study (not peer reviewed) concludes transmission of Covid-19 is almost entirely an indoor phenomenon. This is corroborated by a Japanese study demonstrating that respiratory viruses like Covid-19 are less virulent in higher temperatures and humidity. Most recently, Homeland Security's Science and Technology Department has produced emerging research showing that sunlight, can seriously weaken Covid-19 in about two minutes. At lesser intensities, it takes a little longer. In addition to the ultra violet rays from sunlight, heat and humidity also play a role in weakening and killing Covid-19.

It is still possible to contract the virus outdoors, but less likely than indoors.

Proactive Testing at LTCFs

In Pennsylvania, about 2/3 of the Covid-19 deaths have been at LTCFs. Incredibly, the DoH nevertheless ordered nursing homes to accept stable Covid-19 patients once released from the hospital. Dr. Rachel Levine, Secretary at DoH, noted in a news conference Wednesday that this is still the CDC guidance. She defended the practice because, at least initially, there was a concern that hospitals would be overwhelmed. "In retrospect, I don't think there was any other choice," she said.

The decision to begin proactive testing at LTCFs appears to be a recognition that DoH should be doing far more to protect the residents and staff.

At Gracedale, the Northampton County owned nursing home, 209 residents and 49 staffers have tested positive for Covid-19. As of yesterday, 93 residents are actively positive, with 5 residents hospitalized. Fifty-six residents have died. Of the 49 staffers who've been infected, 37 have completed isolation and are back at work.

When the pandemic first hit, the US was hobbled by an inability to test. Slowly but surely, the US has caught up to other countries, but as explained in yet another excellent Vox video, testing has been reactive. It has been limited to those who show symptoms.  This prevents you from determining where the virus actually is and how many people have it.

Proactive testing, on the other hand, will help catch people who are asymptomatic. They can be isolated and prevented from unwittingly spreading the disease to others. This also means that many of those tested will come back as negative. Once you reach the point that only 10% of the tests are positive, you can say the virus is contained.

If you just cast the net wide, you'd need to perform 10 million tests per day in the US. A more targeted approach is through contact tracing. You identify the direct and proximate contacts of a person who has tested positive, and then test the contacts. This enables you to catch people who are asymptomatic or mildly symptomatic before they unknowingly spread the virus.

Dr. Levine indicated at her news conference on Wednesday that contacts have been very helpful.  "The vast majority of people understand the public health consequences and are very cooperative," she said.

Summer weather, combined with testing and tracing, should enable public health officials to get a jump on the virus before there';s a second wave. Testing and tracing will hopefully make a second lockdown unnecessary.

Updated 10:46 am to add information about Gracedale. Originally published at 12:00 am. 

11 comments:

Anonymous said...

Talking about closing the door after the horse is out of the barn. What have they been thinking?

Anonymous said...

Of course introducing infected patients upon the elderly in nursing homes was an obvious move. The elderly tend to be Republican and are more reliable voters. Eugenics has been a cornerstone of the progressive agenda for over a century.

Anonymous said...

Levine's mom is safe and sound at the Hershey Lodge. Levine and Wolf sentenced lots of elderly to death, but only after paroling mom from her death camp. A guy so twisted he'd lop off his privates can't be expected to make rational decisions regarding safety and health. This is why so many elderly Pennsylvanians are dead. Political correctness is awesome until your grandma has a funeral you couldn't attend after dying alone in a Wolf/Levine death camp. Nice work Tom and Dick.

Bernie O'Hare said...

"Of course introducing infected patients upon the elderly in nursing homes was an obvious move. The elderly tend to be Republican and are more reliable voters. Eugenics has been a cornerstone of the progressive agenda for over a century."

I have been a fairly harsh critic of the way this was handled by Wolf and Levine, but even I would never make this kind of ridiculous suggestion.

Anonymous said...

This is now announced after other counties and states had the foresight months ago to set up tent hospitals outside their infected nursing homes enlisting aid from the National Guard, and while other counties and states set up mobile testing vehicles outside their infected nursing homes to test all residents and workers and isolate as many as possible to minimize the potential deaths....we are way late to this party and we should have taken more initiative on our own as others did and should have focused on our largest nursing home in PA as a major Petri dish for this virus.....

Anonymous said...

The gang that runs proudly on 800K abortions per year are acting consistently re: regard for our most vulnerable. Those at the very beginning and very end of life are costly and expendable. Thus, our LTCF death camps - and the fight to keep abortion clinics open as essential businesses. The state stuck it to counties on nursing homes and county officials won't breathe a word of criticism because they're all on the same team. These weren't mistakes. This was done by design. Old people only have a few votes left in them, anyway, right? Disgusting.

Anonymous said...

Dunno, maybe I'm late to the dance, but for me, proactive would be taking these steps in late March or early April.

Anonymous said...

Impeccable timing.

Anonymous said...

" You identify the direct and proximate contacts of a person who has tested positive, and then test the contacts."
Unless your as republican in the legislature and you hide those who were exposed.
nothing like transparency

Anonymous said...

Chief Justice Roberts on 5/29/20 opinion in Calf. case, in which he was in the majority:

The precise question of when restrictions on particular social activities should be lifted during the pandemic is a dynamic and fact-intensive matter subject to reasonable disagreement. Our Constitution principally entrusts “[t]he safety and the health of the people” to the politically accountable officials of the States “to guard and protect.” …. When those officials “undertake[ ] to act in areas fraught with medical and scientific uncertainties,” their latitude “must be especially broad.” ... Where those broad limits are not exceeded, they should not be subject to second-guessing by an “unelected federal judiciary,” which lacks the background, competence, and expertise to assess public health and is not accountable to the people. ...

Anonymous said...

A little too late