The 2019 Novel Coronavirus (COVID-19) pandemic is an unprecedented event that has impacted every part of the globe. Pennsylvania has seen a similar unprecedented burden of COVID-19 and has taken equally unprecedented measures to save lives and reduce morbidity of the COVID-19 virus.

The commonwealth has responded aggressively to the spread of COVID-19, first by working to contain the virus through contact tracing and quarantines for residents who came in contact with someone who tested positive for the virus to slow sustained community spread. When sustained community spread was established, the commonwealth moved to mitigation efforts early in the response by issuing orders to close schools and non-life-sustaining businesses; and to restrict large gatherings. This decision to respond aggressively has proven to be an essential and effective measure to reduce the spread of COVID-19 and ultimately save an unrealized number of Pennsylvanians’ lives.

Mitigation efforts have helped to curtail the spread of COVID-19 so our hospitals can treat patients without overwhelming our limited supplies of personal protective equipment (PPE), ventilators, or beds. Throughout the pandemic, we have closely monitored our hospital system capacity through the creation of a public dashboard, and we have built and distributed millions of goods and materials to help our health care system manage the influx of patients.

PA DOH and PEMA have worked together to develop plans and stand up alternative care sites in the northeast and southeast so when our health care system becomes overwhelmed, we can load balance patients and supplies by keeping patient safety top of mind. At this point, alternative care sites have been identified in other areas of the commonwealth and can quickly stand up should there be a surge in other areas of the state.

As the situation stabilizes, we are planning a measured and strategic approach to allowing Pennsylvanians to return to work safely to prevent a resurgence of the virus. This must be done in the most effective, efficient, and risk-adverse method possible to balance our return to economic stability, while at the same time continuing to keep Pennsylvanians safe by controlling the spread of disease.

We are planning for the days and weeks ahead when we will not only safely return Pennsylvanians to work but return to a different and more resilient Pennsylvania. While we cannot be certain of the future path of this disease, our decisions will be driven first by prioritizing the health and safety of all Pennsylvanians.

To that end, the commonwealth is partnering with Carnegie Mellon University (CMU) to create a data-driven decision support tool that will enable a balance between maximizing the results of our economy while minimizing public health risks. This tool will help better understand the current health and economic status, as well as the inherent risks and benefits to easing restrictions by sector and region.

In consultation with Team PA, PA DOH, PEMA, the Department of Community and Economic Development, the Department of Labor & Industry, and others, the administration will develop guidance for businesses, local governments, workers, and customers with the goal of guiding a safe and iterative reopening process.

Pennsylvania plans to proceed with returning to work cautiously. Broad reopenings or reopenings that are not structured around ongoing social distancing, universal masking, or other public health guidance would likely result in a spike of cases and new stay-at-home and closure orders.

Throughout this process, the administration will have guidance in place to support best public health practices. This guidance will reinforce and build on existing worker and building safety orders. It will also be able to adapt to the changing nature of the pandemic, as well as lessons learned from communities that return to work strategically.

Discussed in greater detail below, the administration will utilize a three-phase matrix to determine when counties and/or regions are ready to begin easing some restrictions on work, congregate settings, and social interactions.

The red phase has the sole purpose of minimizing the spread of COVID-19 through strict social distancing, non-life sustaining business, school closures, and building safety protocols.

• Reiterate and reinforce safety guidance for businesses, workers, individuals, facilities, update if necessary
• Monitor public health indicators, adjust orders and restrictions as necessary

As regions or counties move into the yellow phase, some restrictions on work and social interaction will ease while others, such as closures of schools, gyms, and other indoor recreation centers, hair and nail salons, as well as limitations around large gatherings, remain in place. For example, retail locations will be able to open with forthcoming guidance in place that is substantially similar to the worker safety and building safety order. Otherwise retail will be able to allow for curbside pickup. The purpose of this phase is to begin to power back up the economy while keeping a close eye on the public health data to ensure the spread of disease remains contained to the greatest extent possible.

• All businesses must follow CDC and DOH guidance for social distancing and cleaning
• Monitor public health indicators, adjust orders and restrictions as necessary

After a county transitions to the yellow phase, we will closely monitor for increased risk, such as significant outbreaks. If overall risk remains mitigated for fourteen days, we will transition the county to the green phase.

The green phase eases most restrictions with the continued suspension of the stay at home and business closure orders to allow the economy to strategically reopen while continuing to prioritize public health.

While this phase will facilitate a return to a “new normal,” it will be equally important to continue to monitor public health indicators and adjust orders and restrictions as necessary to ensure the spread of disease remains at a minimum.

• All businesses must follow CDC and DOH guidance for social distancing and cleaning
• Monitor public health indicators, adjust orders and restrictions as necessary

History

The first confirmed case of the 2019 novel coronavirus in the United States was reported in Washington state on January 21; on January 30, the World Health Organization declared the virus a global health emergency.

The Pennsylvania Department of Health (PA DOH) began daily leadership meetings on January 26, to carefully track the disease, prepare a response, and coordinate with federal and hospital partners.

On February 1, PA DOH stood up its DOC, or Department Operations Center, on a 12 hour, 7 days a week activation status at the Pennsylvania Emergency Management Agency (PEMA). Staffed by PA DOH epidemiologists, public health nurses, physicians, logistical, planning and communication support, the Pennsylvania Department of Human Services and PEMA to closely monitor the spread of the disease, and begin containment strategies in furtherance of the state’s preparedness plans.

On March 4, due to the continued spread of the virus throughout the United States, PEMA partially activated its Commonwealth Response Coordination Center (CRCC) to provide planning and logistical support for PA DOH and to coordinate situational awareness across state agencies and all 67 counties within the commonwealth.

On March 6, Pennsylvania recorded its first two cases of COVID-19 and Governor Tom Wolf signed a Disaster Declaration to ensure the state had the resources and authority to plan the process of containment and mitigation in Pennsylvania, assuring Pennsylvanians that the commonwealth was prepared to face this crisis.

On March 7, PEMA elevated the activation level of its CRCC to a full activation during daylight hours to provide for additional support for PA DOH and to coordinate planning and response operations across state agencies and federal, state, and local jurisdictions.

From the beginning of the pandemic, the administration undertook a measured, regional strategy to mitigation and containment, and protecting Pennsylvanians with the assurance that they could receive testing and treatment for COVID-19 without any financial burden. Decisions and actions were taken on a state, county, and regional basis in coordination with local elected officials, public health experts, and other stakeholders.

On March 10, PEMA, with assistance from PA DOH, conducted a COVID-19 planning workshop and tabletop exercise for all state agencies to discuss preparations, potential impacts, and agency Continuity of Operations Plans (COOP) related to operations during a pandemic.

On March 12, with cases rising in Montgomery County, Governor Wolf closed schools and adult day centers there for 14 days, requesting that non-essential businesses close and county residents limit travel. He also imposed limited visitation in nursing homes and correctional facilities. The mitigations would prove to be vital as cases increased in the Southeast over the next week.

On March 13, Governor Wolf announced that mitigation efforts would be extended to Delaware County and all Pennsylvania schools would be closed for 10 days beginning March 16. Additionally, on March 13 the President of the United States issued a National Emergency, which included Emergency Disaster Declarations for all 50 states for emergency protective measures for COVID-19 response operations that was retroactive to January 20.

On March 14, with cases in Pennsylvania nearing 50, Governor Wolf announced additional closures in Bucks and Chester counties.

On March 16, because of the continued spread of the virus across the commonwealth and increasing case counts, PEMA began 24/7 operations of its CRCC in support of PA DOH and to maintain situational awareness, coordinate resource support, and provide planning support across the state agencies and federal, state, and local jurisdictions.

Under guidance from Health Secretary Dr. Rachel Levine, Governor Wolf ordered all Allegheny, Bucks, Chester, Delaware, and Montgomery county bars and restaurants to cease dine-in operations beginning March 16 for 14 days.

On March 18, PA DOH announced the first death from COVID-19 in the state.

On March 19, Governor Wolf ordered all non-life-sustaining businesses to close across the commonwealth to help stop the spread of the virus. The administration provided guidance, refined parameters, and designed an exemption process that could allow some businesses to remain open under strict guidance from the state. Additionally, on March 19 the governor received notification of approval of his request for a Small Business Administration (SBA) disaster declaration for the Economic Injury Disaster Loan (EIDL) program to provide much-needed aid to businesses impacted by the COVID-19 mitigation procedures.

On March 23, Governor Wolf and Dr. Levine began the process of issuing additional stay-at-home orders based on county cases and modeling of the possible spread.

Timeline of County Stay-at-Home Orders:

• March 23 Allegheny, Bucks, Chester, Delaware, Monroe, Montgomery, and Philadelphia counties;
• March 24 Erie County;
• March 25 Lehigh and Northampton counties;
• March 27 Berks, Butler, Lackawanna, Lancaster, Luzerne, Pike, Wayne, Westmoreland and York counties;
• March 28 Beaver, Centre, Washington counties;
• March 30 Carbon, Cumberland, Dauphin and Schuylkill counties;
• March 31 Cameron, Crawford, Forest, Franklin, Lawrence, Lebanon, Somerset counties; and
• April 1 Statewide Stay-at-Home Order.

As the administration issued stay-at-home orders, it also moved to make more materials available to health care systems by working with the legislature to invest $50 million in support for hospitals and health systems. The administration also worked with the legislature to move the primary election from April 28 to June 2.

Federal support and aid have been critical in the state’s response. On March 29, to seek all available aid, Governor Wolf requested a federal major disaster declaration. On March 31, the federal government granted approval. Beginning with early assurances that COVID-19 testing and treatment would be covered for all Pennsylvanians at no cost, Governor Wolf took additional steps to ensure everyone in the state was treated fairly and without discrimination amid the pandemic.

On April 3, to reinforce mitigation and safety surrounding the COVID-19 pandemic, Governor Wolf called for universal masking and requested that religious leaders consider alternate forms of worship.

Additionally, on April 3, Pennsylvania was one of the first states to receive statewide approval from the Federal Emergency Management Agency (FEMA) to conduct non-congregate sheltering in response to the COVID-19 emergency in the commonwealth.

On April 5, Governor Wolf announced that Dr. Levine issued an Order to make the buildings Pennsylvanians work in safer.

To successfully mitigate a surge that could overwhelm the state’s health care system, the administration sought information, capabilities, and needs from manufacturers that could ramp up to supply necessary personal protective equipment (PPE) and others supplies. In addition, health care facilities began the process of transferring supplies to help secure preparedness for those areas with greater needs. The state issued an order for the ability to transfer supplies around the commonwealth, as necessary to load balance the system.

On April 9, Governor Wolf announced the closure of schools through the end of the academic year and a temporary reprieve program for non-violent state correctional facility inmates amid Department of Corrections plans to keep inmates safe while incarcerated.

Communication and collaboration with other states have been vital as people typically travel between neighboring states for work, to visit family, and to vacation under non-pandemic circumstances. On April 13, Governor Wolf joined six other governors (NY, NJ, CT, RI, DE, MA) in a council to plan how states can work together to safely reopen and begin the process of recovery.

On April 15, the Secretary of Health issued an Order requiring safety measures in all businesses permitted to maintain in-person, physical operations except for health care providers. These measures included standards for cleaning and disinfecting high-touch areas, establishing protocols for businesses exposed to a probable or confirmed case of COVID-19, limiting the numbers of employees and customers on the premises, ensuring that employees have access to soap, sanitizer, and face masks, and that patrons wear face masks.

On April 17, Pennsylvania was the first state to have a Memorandum of Understanding (MOU) accepted by FEMA for purchasing and distributing food through established Food Banks in the commonwealth.

Also, on April 17, Governor Wolf outlined the standards the administration will use for reopening and on April 20, Governor Wolf announced a target date of May 8 for the beginning of phased reopening and easing of restrictions.

Standards

• Our approach will be data driven and reliant upon quantifiable criteria to drive a targeted, evidence-based, regional approach to reopenings in Pennsylvania.
• We will put forth guidance and recommendations for employers, individuals, and health care facilities and providers for assured accountability as we reopen.
• Reopening necessitates that adequate personal protective equipment and diagnostic testing are available.
• Reopening requires a monitoring and surveillance program that allows the commonwealth to deploy swift actions for containment or mitigation.
• Protections for vulnerable populations must remain steadfast throughout the reopening process, such as limitations on visitors to congregate care facilities and prisons.
• Limitations on large gatherings unrelated to occupations should remain in place for the duration of the reopening process.

Our approach will be data driven and reliant upon quantifiable criteria to drive a targeted, evidence-based, regional approach to reopenings in Pennsylvania.

To help inform decisions about what regions to reopen, and on what timeline, the commonwealth has partnered with Carnegie Mellon University and other institutions of higher education, to develop a data dashboard. This dashboard, as well as demographic and health criteria described further below, such as population density, mobility, availability of testing, and health care resources will inform formal recommendations made jointly by the Secretary of Health, the PEMA Director, and the Secretary of the Department of Community and Economic Development to the governor regarding when a region may safely move from one phase of reopening to the next. In preparing recommendations, the secretaries and PEMA director will meet to review the data sources described more fully below, balance risks to public health, and benefits to the economy, and agree unanimously as to the phase in which each region should safely be categorized.

First, DOH, in coordination with PEMA, other commonwealth agencies, and stakeholders in the areas of public health, economics, and emergency management, has developed criteria that will help guide decisions about reopenings and the easing of restrictions.

A target goal for reopening was initially set at having fewer than 50 new confirmed cases per 100,000 population reported to DOH in the previous 14 days.

So, for example, an area with a population of 800,000 people would need to have fewer than 400 new confirmed cases reported in the past 14 days to meet the target. An assessment then determines if the target goal has been met, and the administration works closely with county and local governments to enable the communities to reopen and transition back to work.

With the commonwealth dramatically increasing its testing capacity, as of May 22, the fewer-than-50 new cases per 100,000 population measure will be considered, but it will be reviewed in the context of various other factors that are indicative of risk.

Additionally, the commonwealth must ensure there is:

• Enough testing available for individuals with symptoms and target populations, such as those at high risk, health care personnel, and first responders.
• Robust case investigation and contact tracing infrastructure is in place to facilitate early identification of any cluster outbreaks and to issue proper isolation and quarantine orders.
• Identification of area’s high-risk settings, including correctional institutions, personal care homes, skilled nursing facilities, and other congregate care settings, and assurance that facilities have adequate safeguards in place such as staff training, employee screening, visitor procedures and screening, and adequate supplies of PPE to support continued operations.

The Pennsylvania COVID-19 Dashboard shows up-to-date data on case counts and demographics, hospital preparedness, and testing. ​Having trouble viewing the dashboard? View the full screen version.