COVID-19, Healthcare, and You — LCDC Issues Form

Editor’s Note:  LCDC will host an issues forum on COVID-19 on Wednesday, July 22nd at 7:00PM. The event will be live streamed on Facebook, and a Facebook account is not required to view.

What is it?

COVID-19 is a new respiratory virus that is highly contagious and causes a range of symptoms. It not only attacks the respiratory system, but also can impact the brain, heart, and digestive tract of its victims. COVID 19 emerges with typical flu symptoms, fevers, aches, sore throat, and cough. However, unlike with the common flu, this COVID can cause severe shortness of breath in certain people. In too many cases, this has led to hospitalization and death. It’s understood that senior citizens and people with immune deficiencies are most at risk but people of all ages and levels of health can be seriously affected. Details from Johns Hopkins Center for Health Security

So What?

Worldwide, almost 6 million people have contracted COVID-19 and more than 360,00 have died. The impact in the United States has been over 1.5 million confirmed cases and American deaths have surpassed 102,000. https://coronavirus.jhu.edu/map.html

COVID-19 Data for Pennsylvania from PA Dept of Health updates are available but as of this writing, there are over 68,000 confirmed cases and deaths number nearly 5,400 Pennsylvanians. And in Lancaster County, confirmed cases have exceeded 3,100, with more than 290 deaths. PA County-by-County

Clearly, with the number of cases and deaths worldwide as well as those in the United States, Pennsylvania, and Lancaster County, this critical development needs a uniform planned response to stop its spread. Yet after declaring the president’s “authority is total” the Trump Administration has abandoned a leadership role, leaving it to the states. This resulted in reliance on state actions, such as Gov. Wolf’s Stay-at-home Order. Still, COVID 19 creates a conflict that threatens both physical and economic health.

The business shutdown has slowed the spread and is “flattening the curve” of infections, keeping it to a level that hospitals can accommodate at any one time. However, the shutdown has also caused record numbers of job losses, as companies have had to lay off employees or have gone out of business entirely.

• Over 41 million people have filed for unemployment, bringing the estimated unemployment rate to over 20% and climbing.
• Worst jobless numbers the U.S. has ever seen, worse than the Great Depression numbers. https://www.cnbc.com/2020/05/14/weekly-jobless-claims.html
• In PA, almost two million people have filed for unemployment.
• Lancaster County has seen over 45,000 people have filed and the unemployment rate is over 19%.

PA Unemployment claims through May 14, 2020

As a result of unemployment and the resulting financial distress, food banks and many charities are seeing a dramatic increase in demand for their services.

The consequences of this disease are felt on personal and global levels. They include :

• Declining Physical and Mental Health
• Poverty/Unemployment
• School and Business Closures/Restructuring
• Supply Chain Disruptions
• Financial Market Performance

It is difficult to determine how much of COVID 19’s impact will be temporary or permanent.

The physical health of those who contract the disease are sickened with a range of symptoms from none (asymptomatic) to extreme (ICU admittance required).  However, data from the CDC shows that hospitalizations and deaths are not occurring equally across all racial demographics, with Black and Hispanic people making up a larger percentage of those experiencing the most dramatic outcomes.

A poll conducted by the Kaiser Family Foundation has found that nearly half of people in the United States reported that their mental health has been negatively impacted due to worry and stress over the virus.

The International Food Policy Research Institute estimates that Covid-19 could increase the global extreme poverty rate by 20%. The virus’ effect on poverty has been examined by the World Bank in the following document.  They focus these four main areas: Impact on Labor Income, Impact on Non-Labor Income, Direct Impact on Consumption, and Service Disruptions. Effective policy making is required to offset these issues for the short and long term.

Schools and businesses have shifted focus and activities online as much as possible, driving an increased dependence on online and phone services, and an increased reliance on computer knowledge. Businesses that are not able to be conducted while observing social distancing protocols (largely the service, retail, entertainment industries) may be required to make significant changes before reopening, and some challenges may threaten their viability. Businesses will potentially have to deal with involve issues including: employees in masks and gloves, equipment disinfection, space reconfiguration, and COVID-19 testing.

World and US financial markets have had a decline due to the pandemic in the first quarter of 2020, with the World Economic Forum reporting the US GDP lost 4.8%. Penn State Professor Brent Moritz has outlined why the COVID-19 disruption to the supply chain is more serious than usual issues experienced with the supply chain.

COVID-19 is an all-consuming challenge to our modern way of life. We must be mindful of obstacles many of us face, and the resultant physical, economic, and emotional weight they impose.

Before we can reactivate our society and our economy we must determine that it is safe to do so; testing is required, either by the majority of the population or a controlled scientific study of random sampling and data extrapolation.

Now What?

Medical remedies are limited since no cure exists yet for coronavirus. Hospitals have been focused on doing all they can to save lives as we wait for a vaccine.  States have mandated sequestering of residents and shutdown of businesses leading to divisions between those who are afraid of contracting the coronavirus and those who are afraid their jobs will be lost seeing millions who have filed for unemployment.   In this time of uncertainty and stress, resources are available to help.  A pandemic must be met by a collective response from government, business, and the people.

Government:

• Health care plans
  • See Centers for Disease Control (CDC) website www.cdc.gov for recommendations
  • National Institute of Health (NIH): The NIH has extensive information on coronavirus including recommendations to stay safe.  Their website is www.nih.gov.
  • Testing and contact tracing:  States (and Lancaster County) have begun testing and contact tracing which will show the extent and spread of the virus. Ascertain that testing sites are accessible in all locations especially those most at risk such as minority communities.
  • Providing Medical equipment & Personal Protective supplies: The federal government gave strategies for states to manage PPE and medical equipment to avoid shortages but the responsibility is with the states to ensure the safety of health care workers and first responders.  Go to www.health.pa.gov to learn more.
  • Developing and providing vaccinations
• Economic recovery
  • CARES Act:  This Act contains $376 billion  for small businesses and the American people.  See www.home.treasury.gov.
    • Small Business Loans Paycheck Protection Program (PPP):  With the unprecedented number of  small businesses facing economic upheaval and potential ruin with COVID 19, Congress passed two rounds of Small Business Protection loans to help businesses and employees.  See www.sba.gov for more information.
    •  Assistance to State, Local and Tribal Governments:  A Relief Fund was created for the benefit of government entities to cover expenses related the pandemic such as testing and contact tracing. ($95 million for Lancaster County)
  • Unemployment:  For PA Unemployment information and claims, go to https://www.uc.pa.gov.
  • Tax deferments:  The due date for income tax was moved to July 15, 2020, without penalty
• Elections
  • Mail-In Ballots:  This year, PA is providing mail in voting for all citizens without a reason for absentee ballots, which has been promoted now for public safety.  Go to www.co.lancaster.pa.us to apply for a mail-in ballot.  Applications must be received at least one week prior to Election Day.

Loans

• Mortgage deferments/forgiveness:  Mortgage companies and banks are experiencing high call volumes with the number of consumers asking for deferments.  Federal law prohibits foreclosing on federally-backed mortgages for 60 days after March 18, 2020.  Also, if you are experiencing a financial hardship due to the coronavirus, you have the right to request a forbearance for up to 180 days and the right to request an extension for another 180 days.  Consumers must contact their financial institutions to ask for this forbearance.
• Student loans deferments/forgiveness: During this COVID-19 national emergency, student loan borrowers automatically suspended temporarily from making monthly payments on student loans.

Health Care: 

• Human Right:  With the outbreak of this pandemic, the weaknesses in the American health care system are visible. While we want everyone to be able to be tested and treated as necessary to ascertain that as few people as possible contract the virus, yet millions are now unemployed and lost health insurance.  Many millions more don’t have health insurance as they are unable to afford the high price for private insurance.  Health care should not be tied to employers but be available to all.
• Nursing Homes:  Sadly, the high percentages of residents in nursing homes who have contracted and died from the virus demonstrates that higher regulations and protocols in nursing homes are needed.
• Pharmaceutical companies and medical suppliers:  Personal Protection Equipment and supplies should be available to medical personnel according to need.  Price gouging should be illegal and federal leadership is needed so states aren’t vying for limited supplies.

Mental Health:

• Stress:  People are experiencing inordinate degrees of stress worried not only about contracting the virus but about their livelihood.  Isolation can be a problem for many including those experiencing domestic violence and those with depression.  Mental health help is available through Mental Health America of Lancaster Countywww.mhalancaster.org. For domestic violence concerns, please contact Community Action Program Domestic Violence Services of Lancaster County, www.caplanc.org.
• Mental Illlness:  Assure those with mental illness get the services they need.  Contact Behavioral Health and Developmental Services www.lancastercountybhds.org.
• First Responders and Medical Staff:  Lancaster County Critical Incident Stress Management (CISM) provides post traumatic stress counseling to first responders and medical staff.  Go to www.lancems.us.
• Social Communications:  Contact through social media to lessen anxiety and isolation during quarantine and economic shutdown.  Call loved ones when feeling down or stressed.  Plan virtual events such as dinners and concerts together.
• Loss of Jobs:  Dial 211 or go to 211.org for information on outreach and possible financial help to employers and employees stressed over loss of businesses and jobs.

Business

• Socially responsible openings: Businesses must make sure that employees, customers and vendors all stay safe from COVID-19.  See Occupational Safety and Health Act has Workers Rights and guidance for employers on its website at www.osha.gov.

Community Resources

• Food:  Please see Food Bank Directory for a list of food banks available throughout Lancaster County.
• Rent:  For those needing help with rent, please see Need Help Paying Bills.
• Education:  See SDOL COVID-19 Updates for information and aids to students who cannot attend schools at this time.  For examples of help:
  • Computers for students
  • Learning guides

Special Populations

• Mandatory Testing of All Prison and Jail Populations is needed:  Not only nursing homes but prisons and jails such as at Lancaster County Prison have occupants at close proximity and need to be tested and carefully quarantine each inmate who tests positive and send prison staff home until they are deemed recovered from the coronavirus.
• Immigration detention facilities, both detainees and facility staff need to be tested and carefully quarantine each inmate who tests positive and send facility staff home until they are deemed recovered from the coronavirus.
• Provide interpreters for COVID-19 plans and resources for those for whom English is not a first language
• Advocate for the elderly through the Department of Aging
• Prosecute hate crimes against Asian Americans through the State Police.
• Houses of worship, and any place that humans must visit physically.

How should we respond safely?

• Our Federal Government should ensure economic solvency through stimulus packages and should provide healthcare until the medical community declares we are safe!
• Lack of Federal economic support is creating a rush to re-open the economy before safeguards are in place
• If a vaccine can be developed, the earliest timing is 7-18 months. Facts on COVID-19 vaccine. Until a vaccine is developed and approved, scientific protocols must be followed

• How to protect yourself and others
  • Masks:  Employers should be providing masks and other safety equipment such as gloves demonstrated to protect against the coronavirus.
  • Social Distancing:  Distancing of at least 6 feet should be kept per protection protocols.
  • Cleanliness/Disinfecting:  Employers must regularly disinfect.
  • Illness:  Any employees who have a fever or are feeling ill need to report to employers and be sent home as appropriate.

• Widespread and accurate testing and tracing are vital before re-opening to avoid a second and possibly worse wave of infection
• Work with state agencies and academic resources to monitor the disease spread.
• Economic concerns are valid and deserve our attention but they should be weighed against any health risks.
• A slow, medically-sound method is better than a rush to reopen that could potentially set the economy back even more if a second wave of infections do occur.

Governor Wolf developed a plan to reopen Pennsylvania that was based on science. He has a created a team among the PA Dept. of Health, PA Emergency Medical Association, Dept. of Community and Economic Development, and the Dept. of Labor and Industry to develop guidelines for businesses.  He is also partnering with advisors from Carnegie Mellon University to monitor the virus’ spread and impact so that reopening the state can be done as safely as possible. Gov. Wolf’s Process to Reopen

What is Needed to Open

A critical component to any state’s reopening is widespread testing and contact tracing so that virus outbreaks can be identified and contained quickly. Also, businesses will need proper personal protective equipment to keep themselves safe at all times. This equipment includes masks, gloves, face shields, and deep cleaning protocols for disinfecting premises.

The impact of COVID-19 is so vast that almost every facet of human life has been affected. A review of the number of cases and subsequent deaths indicates its impact cannot be overstated. We must stand united in our effort to overcome this very grave and legitimate existential threat.