Governors form pacts to reopen economy; Michigan spearheads effort to create special enrollment period + 22 other updates from the 6 hardest-hit states

Below are 24 updates from the six states hit hardest by the COVID-19 pandemic:

New York (196,146 confirmed cases as of 9:25 a.m. CDT April 14)

1. In a White House media briefing April 13, President Donald Trump said that he had total authority over how and when states reopen and lift restrictions, but that is not an accurate statement, New York Gov. Andrew Cuomo said April 14. The state-federal partnership is central to America’s democracy. 

"We don't have a king in this country," Mr. Cuomo said. "We didn't want a king, so we have a constitution to elect a president."

Mr. Cuomo made it clear that he will not get into a fight with the federal government, as this is not a time for partisanship and division. The progress made so far during the coronavirus pandemic has been a result of people working together and doing the right thing, he said. 

"The president will have no fight with me — I will not engage in it," he said. "I put my hand out in total partnership and cooperation with the president."

2. The governor also said April 14 that total COVID-19 hospitalizations ticked down for the first time since the pandemic began. The three-day average for new COVID-19 hospitalizations is down, as is the net change in number of people intubated.

However, 778 people lost their lives yesterday. The curve is basically flat, but it is flat at a "devastating level of pain and grief," the governor said. There has also been an increase in nursing home deaths due to the new coronavirus, and this is an increasing issue for the state. 

Mr. Cuomo reiterated the fact that mitigation efforts, such as staying at home and practicing social distancing, led to the curve flattening. 

"Our actions determine our destiny," he said. "We are changing the curve every day." 

3. Mr. Cuomo said April 13 that the worst of the coronavirus pandemic in New York may be over "if we continue to be smart," The New York Times reports. When asked if he was confident that the worst was over, Mr. Cuomo said he was not and urged the state's residents to continue following stay-at-home orders and social distancing measures.

"The worst can be over, and it is over, unless we do something reckless," he said. Though there is still more suffering to come, as people continue to die from the virus, he added.

4. At a meeting April 13, the governors of New York, New Jersey, Connecticut, Pennsylvania, Delaware and Rhode Island created a multistate council to work on a coordinated strategy to reopen the economy and lift current restrictions.

The council will include one health expert, one economic development expert and the respective chief of staff from each state. They will work to establish a regional framework to gradually lift stay-at-home orders while limiting the spread of the new coronavirus.

5. Catholic Health in Buffalo, N.Y., plans to reopen the former AbsolutCare Nursing Home in Orchard Park, N.Y., and convert it into a dedicated continuing care facility for COVID-19 patients. The facility, the first of its kind in Western New York, will offer short-term rehabilitation and skilled nursing care for COVID-19 patients who are discharged from Catholic Health hospitals. Catholic Health will open the facility April 14 and rename it St. Joseph Post-Acute Center.

Read more about how New York is fighting the coronavirus here.

New Jersey (64,584 confirmed cases as of 9:25 a.m. CDT April 14)

1. A New Jersey bioethics panel has developed a report outlining guidelines for which patients get care and which do not if the state runs out of critical resources due to a spike in COVID-19 hospitalizations, New Jersey Department of Health Commissioner Judith Persichilli, BSN, RN, said during an April 13 media briefing.

The report provides guidance for healthcare workers if the state reaches a worst-case scenario where there are not enough ventilators or hospital beds to treat an influx of COVID-19 patients.

Patients will not be excluded from care based on age or health condition, and hospital triage teams will be asked to make individualized assessments of a patient's viability.

As of 9 p.m. CDT April 13, 8,185 patients in New Jersey had been hospitalized due to complications associated with COVID-19, with 1,626 ventilators in use.

2. New Jersey has joined a regional task force to develop a plan to reopen businesses and public life while trying to guard against a resurgence of the coronavirus, Patch reports. Led by Mr. Cuomo, governors from seven states, including New York, Connecticut, Pennsylvania and New Jersey, met April 13 to discuss a plan to reopen their states.

The council will be tasked with gradually lifting the stay-at-home orders of each state and organizing the reopening of businesses and schools.

The states will work together to ease social distancing guidelines without renewing the spread of the new coronavirus.

3. New Jersey has received 100,000 masks from Taiwan, with another 200,000 to come, Gov. Phil Murphy tweeted April 13.

The federal government provided an additional 200 ventilators to the state on April 13, taking the number of ventilators New Jersey has received to 1,550.

The state is currently running at 55.4 percent of its ventilator capacity, but the devices are still New Jersey's top priority, according to Mr. Murphy.

4. The New Jersey Pandemic Relief Fund has raised more than $18 million from over 2,000 donors in less than three weeks, reports.

Founded by the state's first lady Tammy Murphy, the relief fund's goal is to support the healthcare community, provide help for the vulnerable and rebuild the economy.

The fund has awarded grants between $5,000 and $25,000 to 110 service organizations throughout the state.

Read more about how New Jersey is fighting the coronavirus here.

Massachusetts (26,867 confirmed cases as of 9:25 a.m. CDT April 14)

1. Massachusetts has approved hazard pay increases for some licensed nurses and caregivers on the front lines of the coronavirus pandemic, according to MassLive. A Boston-based labor union, the American Federation of State, County and Municipal Employees Council 93, said workers on the front line will receive temporary pay increases of $5 to $10 per hour. Under the agreement, workers holding licenses related to their occupation will receive a $10 per hour increase, and other workers will receive the $5 per hour increase. The increases will affect about 6,500 union workers. The increases are effective immediately and will remain in place until May 30. 

In addition, workers who have not missed a shift since Gov. Charlie Baker declared a state of emergency in March will receive a $500 one-time bonus.

2. Mr. Baker announced a program to boost state-made personal protective equipment, according to NBC Boston. The program would fund local manufacturers to adjust their business models to produce protective gear like gowns, face shields or shoe coverings. The program would also support making ventilators and swabs for testing. 

3. Massachusetts has launched a contact tracing initiative to reach everyone in the state who may have COVID-19 in an effort to slow the spread of the virus, according to NPR. Massachusetts has teamed up with Partners in Health, a Boston nonprofit, to help with the initiative. The state also began hiring and training some of the 1,000 people who will call everyone with a positive case and conduct the tracing, according to the report.

4. Massachusetts has joined six other states in the Northeast to coordinate a plan to reopen businesses, according to The New York Times. Governors and state health officials from the seven states plan to work together to develop strategies for easing restrictions. Shortly after the pact was made, President Trump declared that he has complete authority about when and how to reopen the country, the Times reported. 

Read more about how Massachusetts is fighting the coronavirus here.

Michigan (25,635 confirmed cases as of 9:25 a.m. CDT April 14)

1. Michigan Gov. Gretchen Whitmer is spearheading a group of 12 governors who are calling on the Trump administration to expand access to affordable healthcare by opening a special enrollment period during the COVID-19 pandemic.

The coalition, including governors from New Jersey, Illinois, Pennsylvania and Wisconsin, is advocating for an enrollment period of at least 30 days on the federal healthcare exchange to allow uninsured or underinsured individuals to access the care they need.

"Far too many of our residents are choosing to forgo coronavirus testing and treatment out of fear of the potential costs to themselves and their families," the governors wrote in a letter to HHS and CMS officials. "It is essential that we remove every barrier as quickly as possible to ensure those in our states and across the country are able to access the treatment they need."

2. The Michigan Department of Health and Human Services on April 13 launched a peer-run "warmline" to help Michigan residents with mental health conditions and alleviate the burden on first responders during the pandemic.

Certified peer support specialists who have experienced behavioral health issues, trauma or personal crises, will provide support to individuals in need of assistance.

"The warmline will help individuals with long-term mental health challenges find someone to talk to — someone who has lived these challenges themselves — and do it while staying safe and staying home," said Robert Gordon, MDHHS director.

3. Michigan aims to accelerate daily COVID-19 testing through a new commercial laboratory and is implementing 13 new or expanded COVID-19 drive-thru facilities throughout the state to slow the spread of the new coronavirus.

The new Grand Rapids lab hopes to boost the state's COVID-19 testing capacity by 40 percent to about 3,000 tests per day.

MDHSS, the Michigan Primary Care Association, NxGen MDx Laboratory and 11 health facilities are collaborating to ramp up testing across Michigan.

"More testing will save lives," Ms. Whitmer said.

4. New data has suggested that Michigan could be beginning to flatten its curve, Ms. Whitmer said, according to Click On Detroit.

The rate of COVID-19 growth in Southwest Michigan has seen a particular decline, but there are still many areas of the state recording increases in the number of coronavirus cases and deaths, according to Joneigh Khaldun, MD, CMO and chief deputy director of MDHHS.  

"Easing up on social distancing measures too early would be devastating. More people will die and our hospitals will be overwhelmed," Dr. Khaldun said. "Health and economy are related, and we must put the health of the public first."

Read more about how Michigan is fighting the coronavirus here.

California (24,372 confirmed cases as of 9:25 a.m. CDT April 14)

1. California has made a pact with two other West Coast states, Oregon and Washington, to coordinate the reopening of their economies. 

California Gov. Gavin Newsom, Washington Gov. Jay Inslee and Oregon Gov. Kate Brown agreed that the reopening plan will be based on science and not politics. In addition, the governors said they will prioritize residents' health.

"COVID-19 has preyed upon our interconnectedness. In the coming weeks, the West Coast will flip the script on COVID-19 — with our states acting in close coordination and collaboration to ensure the virus can never spread wildly in our communities," the governors said in a joint statement.

2. In California, 2,501 healthcare workers have tested positive for COVID-19 as of April 12. The confirmed case number includes individuals who tested positive after on-the-job exposure, as well as travel and close family contact, according to data from the California Department of Public Health. 

3. California Insurance Commissioner Ricardo Lara ordered insurers to refund premiums for the months of March and April to some insurance policyholders. The order applies to medical malpractice insurance, car insurance, workers' compensation, commercial multiple peril insurance and commercial liability insurance. Insurers must give the refunds within 120 days.

"Insurers may comply with the premium refund order by providing a premium credit, reduction, return of premium, or other appropriate premium adjustment," the order states.

Read more about how California is fighting the coronavirus here.

Pennsylvania (24,336 confirmed cases as of 7:25 a.m. CDT April 14)

1. Pennsylvania Gov. Tom Wolf is joining a coalition of governors on the East Coast to coordinate plans to reopen the economy and gradually lift stay-at-home orders. Mr. Wolf is joining six governors, from New York, New Jersey, Connecticut, Pennsylvania, Delaware, Rhode Island and Massachusetts, to create a multistate council to establish the regional approach.

2. Pennsylvania's case count is plateauing and the curve of the new coronavirus infection in the state is flattening, health officials said, according to The Philadelphia Inquirer. Social distancing has worked and has helped the state avoid a "much, much worse" death toll, state Secretary of Health Rachel Levine, MD, said.

"The closures are saving lives in Pennsylvania. If we stop those efforts now, our health systems will become overwhelmed, and then more will be lost to this dangerous virus," she said, the Inquirer reports.

3. Pennsylvania will receive 2 million N95 masks from the federal government, Vice President Mike Pence said at the White House coronavirus briefing April 13, The Philadelphia Inquirer reports. The masks will arrive next week.

Previously, the state had requested nearly 500,000 masks from the Federal Emergency Management Agency, but only received a quarter of that number as of early April.

4. Pennsylvania has not been able to collect important information about the new coronavirus' spread and effect, in part due to the fact that the state's data collection system was in the middle of an update when the pandemic began, Penn Live reports. The state needs key demographic information, including data on age, gender, race and primary residence of those tested as it looks to reopen the economy and slowly roll back mitigation efforts, such as social distancing.

Read more about how Pennsylvania is fighting the coronavirus here.


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