Federal study: Routine health care for kids in low-income families dropped dangerously during COVID
A sharp decline in routine medical care for low-income children during the coronavirus shutdown could cause long-term harm if not reversed, federal officials warned Wednesday.
A data snapshot from the Centers for Medicare and Medicaid Services, or CMS, found that vaccinations, screening for childhood diseases, visits to the dentist and even mental health care dropped precipitously from March through May of this year, when doctors' offices and hospitals put elective services on hold to confront the coronavirus.
“The absence of these vital health care services may have lifelong consequences for these vulnerable children, and I call on states, pediatric providers, families, and schools to ensure children catch up,” CMS administrator Seema Verma said in a statement.
The data, based on an analysis of billing records, come from Medicaid and the Children’s Health Insurance Program, which together cover nearly 40 million low-income children.
Among the findings:
— Early childhood vaccinations declined by 22%, or 1.7 million fewer immunizations for kids up to age 2.
— Time-sensitive screenings for cognitive or developmental problems fell by 44%.
— Even after accounting for increased use of telehealth, there were 6.9 million fewer mental health visits.
— Visits to dentists plunged by 69%.
The changes mirror what happened with everyday health care services for adults. Many colonoscopies, mammograms and follow-up visits for chronic conditions were canceled or postponed during the strictest period of the shutdown, as were procedures like knee replacements and root canals. But with children, the consequences could be more profound if missed shots lead to outbreaks of preventable illnesses like measles and mumps later on.
CMS said more recent data has shown a pickup in childhood immunizations since May, but the agency stressed that needs to go into overdrive to make up for the missed services during the spring.
“The potential for increased outbreaks of infectious disease due to decreased vaccinations is real, and can result in decreased school attendance, decreased learning, and increased childhood illness in general,” the agency warned. “It is important for schools and families to catch up on well-child visits and ensure that children are up-to-date on their immunizations.”
Bill that would loosen bar, restaurant limits sent to Gov. Wolf
The Pennsylvania House and Senate have approved and sent to Gov. Tom Wolf a bill that would allow restaurants to operate at 50% capacity at the very least, and end the requirement for customers to buy food in order to purchase alcohol.
“Nearly 70% of our bars and restaurants will not be here in six months if we remain on the present course,” said State Rep. Craig Staats (R., Bucks). He said the bill “affords those who work in this industry some measure of stability and certainty in what has been a perpetually changing landscape.”
Wolf this week raised allowable capacity from 25%, to 50% for restaurants that can certify they meet state and federal standards for mask-wearing, social distancing and hours of operation. The bill would prevent him from lowering the limit beneath 50%.
Both the House and Senate approved the measure by overwhelming margins, but Wolf’s spokesperson had said after the Senate passed the bill that the governor would veto it.
Some Pa. schools opening the stands for sporting events
Some Pennsylvania school districts plan to allow more fans in the stands after a federal judge’s ruling last week that statewide pandemic limits on crowd sizes were unconstitutional.
The state Department of Education has asked schools to voluntarily comply with Democratic Gov. Tom Wolf’s gathering restrictions, which had been set at 25 indoors and 250 outside, and the administration is appealing the ruling.
But a number of districts already have opted to go their own ways. They include the Altoona Area School District, which will allow up to 3,400 spectators at Mansion Park Stadium — 33% of its capacity — for Friday’s game.
The district is taking safety precautions, including a requirement that people wear masks when entering the stadium or going to the restroom or concession stand, said Altoona spokesperson Paula Foreman. “Even when people get into those stands, there is certainly enough spacing in that stadium to keep everyone pretty well distanced,” she said.
The Pennsylvania Interscholastic Athletic Association, the governing body for school sports, told member schools that Wolf’s caps aren’t mandatory, “at least for the moment,” and that each school can make its own decision on crowds at games. But schools “should exercise caution and good judgment,” wrote the PIAA’s executive director, Robert Lombardi.
The elderly and ill were disproportionately affected by COVID-19 in the early months of the pandemic, but the average age of confirmed COVID-19 patients dropped from 46 to 38, in August, as a growing number of young adults contracted the virus, according to the newly released CDC data.
About 50,000 Pennsylvanians have downloaded new contact tracing app
About 50,000 Pennsylvanians downloaded the commonwealth’s new contract tracing app in the 24 hours since it was launched, officials said Wednesday.
Gov. Tom Wolf encouraged others to follow their lead to help mitigate the spread of the coronavirus in the commonwealth.
“The more people who download the app, the more effective it will be in helping to stop the spread of COVID,” the governor said in a statement. “Please download it today and make your phone part of the fight.”
Health officials have not said how many of Pennsylvania’s 12.7 million residents must download the app in order for it to be an effective contact tracing tool.
The free app uses Bluetooth wireless technology to gauge when users are within six feet of each other for 15 minutes or longer. If a user has been in close contact with someone who later tests positive for the coronavirus, they are alerted and provided with resources and information on testing.
At the app’s unveiling in Philadelphia on Tuesday, Gov. Tom Wolf and Health Secretary Rachel Levine stressed the app’s privacy settings, noting it tracks proximity to others, not one’s specific location, and protects the identity of users in part through encryption.
Lawmakers fail to override Wolf’s veto of school sports bill
The Pennsylvania House of Representatives failed to override Gov. Tom Wolf’s veto of a bill that would allow school districts to unilaterally decide how many spectators can attend sporting events amid the coronavirus pandemic. Therefore, the governor’s veto is sustained.
Voting Wednesday on the motion to override, the House failed to reach the needed two-thirds majority, or 134 votes in this case, by a vote of 130-71.
Philadelphia officials advise against large gatherings
Philadelphia officials are advising event organizers not to plan large events through the end of February.
The city announced Wednesday that large event permits will not be considered through Oct. 22, but advised that that guidance may be extended “based on current evidence regarding the status of the pandemic in Philadelphia and its unpredictability.”
Outdoor events of up to 150 people are now permitted in the city. Special event and demonstration permits will not be enforced for gatherings up to that size.
The city surpassed 36,000 confirmed cases of COVID-19 in residents Wednesday. Officials reported 103 new cases of the virus, bringing the total number of infected residents to 36,004.The city also announced two additional deaths; a total of 1,789 residents have died of the coronavirus.
Fauci hits back against herd immunity claims made by Republican senator
Anthony Fauci, the nation’s leading infectious disease expert, shot back at Sen. Rand Paul (R., Ky.) during a tense exchange during a coronavirus hearing on Capitol Hill Wednesday.
Fauci, a member of the White House coronavirus task force, took exception to Paul’s suggestion that new cases were on the decline in New York due to herd immunity.
“No, you’ve misconstrued that, senator, and you’ve done that repetitively in the past,” Fauci said.
Fauci pointed to testimony offered earlier in the hearing by Robert Redfield, the director of the Centers of Disease Control and Prevention, who estimated that about 22% of New Yorkers have been infected by the virus, far lower than the 60-70% that experts estimate would need antibodies to offer herd immunity to the virus.
“You are not listening to what the director of the CDC said, that in New York it’s about 22 percent. If you believe 22 percent is herd immunity, I believe you’re alone in that,” Fauci said.
Dr. Fauci has had just about enough of Rand Paul, basically calls him a moron.
"This happens with Senator Rand all the time... If you believe 22% is herd immunity, I believe you’re alone in that. pic.twitter.com/BdsuGsz8TI
“Adeline speaks for all of us in medicine and public health with her dedication, kindness, and heroic efforts to save lives even at the expense of her own,” Levine said. “She encompasses why we continue to fight to save lives with measures like restricting the attendance at large events. It isn’t to stop our way of life. It’s to save lives.”
”It’s why the legislature should stop wasting time trying to overturn vetoes of public health measures that are designed to save lives. I can’t stress this enough," she added. “We must be united in our efforts to stop the spread of COVID-19.”
Pa. new testing guidance casts doubt on possibility of widespread testing anytime soon
Pennsylvania health officials on Wednesday laid out their current guidance regarding patient prioritization in coronavirus testing. The guidance is another example of a marked change in Pennsylvania’s approach to testing, and casts even more doubt on the possibility of widespread, population-based testing anytime soon.
Based on recent case counts and the level of transmission across the commonwealth, officials are advising health care providers and labs to prioritize who gets a coronavirus test. The tiers are as follows:
Top priority: hospitalized patients with symptoms of the virus, symptomatic individuals, and people who have been in close contact with a positive individual and either have symptoms or suffer from underlying conditions
Second priority: people who have been in close contact with a positive individual but are asymptomatic; individuals who live in congregate care facilities; people who work in health care, corrections, child and adult protective services, or home health or hospice care
Third priority: essential workers, including those in retail, manufacturing, and food service, who are in areas with significant community spread and who cannot socially distance in their line of work
The last priority: asymptomatic people who don’t fall into any of the above categories
In early August, in contrast, Gov. Tom Wolf and Secretary of Health Rachel Levine said they wanted to improve the accessibility of testing so that “every Pennsylvanian who wants a test can get one.” But about two weeks later, Levine said the situation had changed due to nationwide shortages, which were exacerbated by outbreaks in other states, some of which have been more lax about coronavirus restrictions than Pennsylvania. She said then that the prioritization in testing was necessary, a sentiment she reiterated Wednesday at a brief news conference.
However, if someone is deemed eligible for a test, it should be free regardless of whether you are insured, officials said, and they urged Pennsylvanians to contest charges related to coronavirus testing with their insurance providers or the testing provider. If they run into issues, they said, residents can also contact the state Department of Health.
A spokesperson for Wolf told The Inquirer that the state is trying to guard against a possible fall surge and potential future shortage in testing materials. Tests remain available for anyone who needs one, she said, but are not “a commodity with a surplus.”
The Met cancels its entire upcoming season due to pandemic
The Metropolitan Opera in New York City has canceled its entire 2020-21 season, the latest shutdown forced by the continued longevity of the coronavirus pandemic.
The Met’s new season was originally scheduled to begin this week, but the company announced on Wednesday performances could not safely return “until a vaccine is widely in use, herd immunity is established and the wearing of masks and social distancing is no longer a medical requirement.”
The Met had previously announced it hoped to reopen in January 2021. The company has remained closed since March 12.
Amid a backlash from physicians and other health officials, the U.S. Centers for Disease Control and Prevention reversed itself last Friday — recommending a test for anyone who has been within six feet of an infected person for at least 15 minutes, whether or not they experience symptoms.
Then on Monday, the CDC changed its message on yet another piece of COVID science — taking down guidance that the coronavirus can spread beyond the much-touted 6-foot threshold. (Mounting evidence suggests that it can indeed be transmitted at greater distances, particularly in poorly ventilated indoor spaces. But for now, the agency’s web site is unclear.)
Public health experts, including two prominent specialists in the Philadelphia area, warn that the mixed messages can fuel public confusion and even mistrust of science.
“I don’t think it’s random what goes up and down on [the CDC] website,” said Esther Chernak, an associate professor at Drexel University’s Dornsife School of Public Health. “My concern is thatit is more controlled by people with more of a political orientation than a scientific orientation.”
Philadelphia residents can’t be kicked out of their homes for another two weeks, thanks to a order by the president judge of the city’s Municipal Court.
Residential evictions in Philadelphia are now banned until Oct. 7, according to an order Judge Patrick F. Dugan issued Tuesday. The order applies to all evictions in the city, not just evictions due to missed rent payments caused by the coronavirus pandemic.
Fourth large-scale COVID-19 vaccine trial begins in the U.S.
The first coronavirus vaccine that aims to protect people with a single shot has entered the final stages of testing in the United States in an international trial that will recruit up to 60,000 participants.
The experimental vaccine being developed by pharmaceutical giant Johnson & Johnson is the fourth vaccine to enter the large, Phase 3 trials in the United States that will determine whether they are effective and safe. Paul Stoffels, chief scientific officer of J&J, predicted that there may be enough data to have results by the end of the year and said the company plans to manufacture 1 billion doses next year.
Three other vaccine candidates have a head start, with U.S. trials that began earlier in the summer, but the vaccine being developed by Janssen Pharmaceutical Companies, a division of J&J, has several advantages that could make it logistically easier to administer and distribute if it is proved safe and effective.
“A single-shot vaccine, if it’s safe and effective, will have substantial logistic advantages for global pandemic control,” said Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, who partnered with J&J to develop the vaccine.
Pennsylvania no longer has limits on crowd size, at least for now
There are no longer any limits on how many people can gather together indoors and outdoors in much of Pennsylvania, at least for the moment.
On Tuesday, U.S. District Judge William Stickman IV declined to stay a ruling that Gov. Tom Wolf’s restrictions on gatherings of 25 people indoors and 250 people outdoors in Pennsylvania are unconstitutional.
Stickman said the administration had failed to show “imminent and irreparable harm will occur” if the state can’t limit gatherings. State officials had sought a delay on his ruling while they appeal, which Wolf said Tuesday he will appeal to the 3rd U.S. Circuit Court of Appeals in Philadelphia. Wolf also plans on appealing Stickman’s denial.
“The actions taken by the administration were mirrored by governors across the country and saved, and continue to save lives in the absence of federal action,” spokeswoman Lyndsay Kensinger said in a statement. “This decision is especially worrying as Pennsylvania and the rest of the country are likely to face a challenging time with the possible resurgence of COVID-19 and the flu in the fall and winter.”
Other coronavirus restrictions put in place by the Wolf administration — including mask mandates and limits on indoor dining capacity — remain in effect.
While the ruling strikes down the statewide limits on gatherings, many counties and municipalities — including Philadelphia and Allegheny County — have their own local restrictions on crowd size. Health experts, including members of the White House coronavirus task force, urge people to avoid large crowds, where the virus can spread easily from person to person.
Pa. Senate passes bill to loosen virus limits on restaurants, bars
Legislation to loosen Gov. Tom Wolf’s pandemic restrictions on Pennsylvania’s bars and restaurants easily passed the state Senate on Tuesday.
The Republican-controlled Senate voted 43 to 6 for a bill that would end the requirement that customers buy food in order to purchase alcohol and would permit patrons to be served drinks at the bar.
It also would permit taverns and restaurants to operate at 50% capacity, or more if they can meet state and federal social distancing standards or erect appropriate barriers, and make it easier for restaurants to adapt adjacent outside areas to serve customers.
The bill will need another round of House approval before it can be sent to Wolf’s desk.
Wolf’s press secretary, Lyndsay Kensinger, said nearly every state currently has occupancy limits for bars and restaurants, and she said the Democratic governor will veto the bill if he gets it in its current form.
Lawmakers, Kensinger said, should among other measures provide financial help to the hospitality sector, funding for child care and hazard pay for frontline workers.
Radnor students to begin in-person learning next week
Radnor Township School District students will begin to return to the classroom next week in a hybrid plan approved by the school board Tuesday night.
According to the district, students in kindergarten and grades 1, 2, 6, 9, and 12 participating in the district’s modified in-person learning program will return to Radnor schools on Tuesday, Sept. 29.
Students in grades 3, 4, and 5 will return in-person on Thursday, Oct. 1, while students in grades 7,8,10, and 11 will return to the classroom on Friday, Oct. 2.
Coronavirus case numbers rising in 27 states, fueling fears of a fall surge
Progress in slowing the march of the novel coronavirus has stalled in much of the United States, and the pathogen is spreading at dangerous rates in many states as autumn arrives and colder weather — traditionally congenial to viruses — begins to settle across the nation, public health data shows.
Twenty-seven states and Puerto Rico have shown an increase in the seven-day average of new confirmed cases since the final week of August, according to The Post’s analysis of public health data. Minnesota, Montana, Oklahoma, Puerto Rico, Wisconsin, Wyoming and Utah set record highs Monday for seven-day averages.
Hospitalizations and deaths remain lower nationally than at their midsummer peak, but those numbers always lag several weeks behind trends in new infections.
“I think we’re just in the beginning of what’s going to be a marked increase in cases in the fall," said Michael T. Osterholm, a University of Minnesota epidemiologist. "And it won’t be just a testing artifact, either. This is real.”