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COVID-19: State unveils cautious reopening plan

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With status as red, yellow and green Bucks County remains red
 
A three-phase matrix plan called “Process to Reopen Pennsylvania,” developed by the Pennsylvania Department of Health and the Pennsylvania Emergency Management Agency (PEMA), was released by Gov. Tom Wolf on May 1. And while some counties are poised to start, Bucks County will not be among them.
 
The red phase, which is the most restrictive of the three – and currently in effect for all counties – will move through a yellow phase, which eases stay-at-home restrictions. The yellow phase also limits public gatherings to 25 or less and allows some in-person retail business operations. Restaurants would remain closed to in-house dining, schools would remain closed, and fitness, personal care and entertainment facilities would remain shut down.
 
The green phase would lift all state restrictions beyond Pennsylvania Department of Health guidelines and those guidelines by of the Center for Disease Control (CDC).
 
The decisional algorithm would be “data driven and reliant upon quantifiable criteria to drive a targeted, evidence-based, regional approach,” according to the publication. In addition, testing capability targets would also need to be met, a contact tracing infrastructure put in place, personal protective gear supplies in place, and personnel training would be conducted at identified high-risk facilities (such as correctional and nursing care facilities).
 
In partnership with Carnegie Melon University, a multi-axis data matrix involving several parameters will be used to inform any decision to transit to a different phase of reopening. The current target is the generation of fewer than 50 new cases per 100,000 people consistently over a 14-day period.
 
Currently, all counties across the state remain under a stay-at-home order until May 8, when 24 of Pennsylvania’s 67 counties – most in the less-densely populated central region of the state – will move into the yellow phase, having met the criteria to do so.
 
Bucks County COVID-19 cases, however, are climbing significantly, despite declining cases in the state as a whole. There were (as of Tuesday, May 5) 3,445 confirmed COVID-19 cases, an almost 30 percent increase from last week’s number of 2,675. Mortality figures over the past week have climbed as well, reflecting a significant 68 percent increase to 283 COVID-19 fatalities in the county, including 115 deaths over the past week alone.
 
In contrast, the number of hospitalized COVID-19 patients in Pennsylvania has decreased to 2,575 as of May 5, down from 2,781 at the same time last week. And 554 were on life support, down from 616 last week. Those included 534 COVID-19 patients on ventilators and 20 on the more critical ECMO (extracorporeal membrane oxygenation) life support.
 
Favorable trends in new cases and a slight decrease in ventilatory support cases, however, were offset by a decrease in hospital bed capacity across the state. Medical/surgical bed availability had decreased to 6,188 throughout the commonwealth, down from 7,427 last week and reflecting a 45 percent capacity. ICU bed capacity also decreased to 1,247, down from 1,473 last week.
 
In Bucks County, as of Tuesday, there were 306 available medical/surgical beds and 25 available ICU beds. Across the county, 45 of 126 ventilators are in use, reflecting a larger portion of in-use ventilators in Bucks County than across the state as a whole. By comparison, Montgomery County, with 4,687 confirmed case and 443 deaths, had 166 of its 249 ventilators in use, equating to using two-thirds of its capacity compared to Bucks County’s use of one third of its stockpile.
 
Pennsylvania is the sixth state most affected by COVID-19 cases in the United States, with 53,434 confirmed cases and 3,165 deaths. Of the 3007 counties across the 50 states, Bucks ranks 60th in number of cases, placing the county in the top 2 percent.
 
As other states are moving more aggressively to opening up, the SARS-CoV-2 virus, which causes COVID-19, may be demonstrating an increased ability to claim the easier victims who relax social distancing and masking, according to a study released by researchers at Los Alamos Laboratory.
 
The pre-release study, which has yet to pass peer review and official publication, asserts that epidemiological data indicates a more transmissible strain of the virus has rapidly dominated U.S. infection rates in a “selective sweep.” If true, the study reflects an unsettling propensity of the virus to mutate quickly, causing a potential double-whammy of increased virulence and a more complicated vaccine development effort.
 
Other concerning developments involve children showing a multisystem inflammatory syndrome (associated with toxic shock or Kawasaki disease) that seems associated with past exposure to COVID-19. Of 15 children identified in New York City – all between the ages of 2 and 15 – 5 have required ventilatory life support.
 
The possible enhanced ability of the virus to mutate and its pathogenic reach to every age group defines a hidden enemy that remains unpredictable and likely underestimated.
 
 

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