Delco and Bucks challenge state on including long-term care cases in the formula to reopen. State refuses and Montco is somewhere in the middle

Elected officials in Bucks and Delaware counties have challenged the inclusion of all positive cases of Coronavirus in the formula to reopen as outlined by Governor Tom Wolf. Yesterday, Bucks County released a letter dated April 29th that outlines its reasoning, and Delaware County Commissioner Kevin Madden outlined Delaware County’s position in a video.

While Bucks County doesn’t come out and say it doesn’t want the data from long-term care facilities included, the letter stresses that its view is that testing data should be analyzed beyond just a mere number.

In Delaware County’s video, Commissioner Kevin Madden is more direct (his response is included in the video below). He asks for the state to no longer count positive cases in long-term care facilities within the number used to calculate when the county can take a step towards reopening. He states that the long-term care facilities and the general public are two different issues and should be addressed as such.

From the letter from Bucks County’s Board of Commissioners:

As of today, we are able to report the positive news that the levels of pure community spread, defined as those residents not knowing where they were infected, has consistently dropped over time to approximately 10% or less of our daily cases, along with the more negative news that our
businesses and residents are growing increasingly frustrated with the imposed restrictions.

We believe a regional or even county-wide assessment goal of an average of less than 50 cases per 100,000 individuals over the course of 14 days will have a detrimental effect on our effort to maintain Bucks County’s infrastructure of business, tourism and community support. In our
efforts to increase access to testing in the community and long-term care facilities, we will see an uptick in cases, possibly in those who are mildly symptomatic, asymptomatic, or untested who were sick in the recent past but continue to test positive. That could easily drive up the numbers well beyond the threshold without actually increasing community risk, and permanently keep Bucks County in the “red zone.” As we have maintained a unique and robust contact tracing process throughout this crisis, we believe it is far more important to see and analyze the kinds of positives we are getting, more so than simply the numbers themselves. Additionally, it is important to note a growing decline in cooperation from the public in identifying information integral to this process as there is now a possible disincentive for infected individuals to provide data, thinking it might prolong the economic shutdown or have other personal and family consequences.

Yesterday, Pennsylvania’s Secretary of Health Dr. Rachel Levine was asked about these requests during a press briefing (you can view her response in the video below). She stated that the state would not change how it counts positive test results from long-term care facilities and they would continue to be included. Her reasoning was that the staff travel between the facilities and the community and everything within the community is interconnected.

Montgomery County Commissioner Dr. Val Arkoosh was also asked to address the requests made by two neighboring counties (her response is included in the video below). Montgomery County has been breaking out the number of cases from long-term care facilities in its data and this week started including it on its COVID-19 portal. She stated that she believes they should be counted because they have an impact on the healthcare system when residents of long-term care facilities require hospitalization. However, she believes breaking out the data from long-term care facilities should be done and it could be useful to look at the infection rates separately and address them differently. She does not call for the state to stop using long-term care data in the formula to reopen.

In the below video, we have tied together three of the responses outlined above. The video opens with Delaware County’s request and is followed by Dr. Levine’s response. It ends with the response from Dr. Arkoosh.

One thing to note, the difference of opinion on this issue is not partisan. The governments of Delaware, Bucks, Montgomery counties are all controlled by a Democratic Party majority. Governor Tom Wolf is a Democrat.

Photo: Commonwealth of PA