Massachusetts releases care rationing guidelines, Pennsylvania launches $450M loan program for hospitals + 21 other updates from the 6 hardest-hit states

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Below are 23 updates from the six states hit hardest by the COVID-19 pandemic:

New York (190,288 confirmed cases as of 9:25 a.m. CDT April 13)

1. New York has reported 10,056 deaths, with 671 deaths occurring since April 12, New York Gov. Andrew Cumo said at a media briefing April 13. Though the net change in hospitalizations has plateaued, hospitals still are seeing about 2,000 new COVID-19 hospitalizations per day.

2. The New York state Department of Health is mandating that all hospitals suspend visitation, except for people supporting the patient or family members and/or legal representatives of patients in imminent end-of-life situations. Patient support people include a person at the bedside for patients in labor and delivery, pediatric patients and patients for whom a support person may be medically necessary, including patients with intellectual and/or developmental disabilities.

3. The New York City health department sent a memo to healthcare providers warning that the city soon may be out of swabs for COVID-19 tests, according to NBC New York. The health department told healthcare providers to "only test hospitalized patients in order to preserve resources that are needed to diagnose and appropriately manage patients with more severe illness."

4. In response to a question about news reports that New York hospitals are facing a lack of supplies, Mr. Cuomo said April 13 that there has not been a situation in which a hospital has had an urgent need for supplies that the state has been unable to fill. Hospitals are reporting their inventory to the state every night, and the state is deploying resources as needed, the governor said.

 "So far, we have not said no [to any hospital]," Mr. Cuomo said. 

5. The governor said that he will meet April 13 with governors from several states, including Connecticut, New Jersey, Delaware and Pennsylvania, to discuss a coordinated plan to reopen their states. 

6. At a media briefing April 12, Mr. Cuomo said he will issue an executive order directing employers to provide essential workers with free cloth or surgical masks to wear during direct interactions with the public.

7. New York City is opening new testing centers in minority communities especially hard hit by the coronavirus pandemic, Mayor Bill de Blasio said, according to The New York Times. Data shows that black and Latino New Yorkers are dying at a higher rate from COVID-19 than white residents. The city plans to open testing centers in East New York in Brooklyn; Morrisania in the Bronx; Harlem, Manhattan; Jamaica in Queens; and Clifton on Staten Island.

8. Mr. Cuomo returned 35 unsolicited ventilators donated by the Pathways Nursing Home and Rehabilitation Center in Niskayuna, N.Y. Mr. Cuomo didn't disclose specifics about why the ventilators were returned. 

"What an incredibly beautiful, generous gesture," he said April 12. "I want to say thank you on behalf of all of the people of the state. The family of New York we talk about. We talk about that we're a family, upstate, downstate, we're all one family."

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

New Jersey (61,850 confirmed cases as of 9:25 a.m. CDT April 13)

1. New Jersey is decreasing the capacity of all public transportation by half and expanding the requirement for wearing masks or face coverings, Gov. Phil Murphy said during an April 13 media briefing.

The order requires transit riders and customers picking up food from restaurants or bars to wear face coverings. All food places, as well as NJ Transit and private carriers, are required to provide employees with gloves and face coverings

The expanded order takes effect 7 p.m. CDT April 13.

2. The federal government provided 200 more ventilators to New Jersey, the governor tweeted on April 12.

"Ventilators are our No. 1 need right now," Mr. Murphy said. "We won't stop fighting to get the equipment we need to save every life we can."

As of 9 p.m. CDT April 12, 1,611 ventilators were in use, representing 54.9 percent of the state's capacity, according to the New Jersey Health Department.

3. More New Jersey hospitals are considering implementing do not attempt to resuscitate protocols for dying COVID-19 patients to protect front-line workers from contracting the illness NJ.com reports.

Hackensack Meridian Health, New Jersey's largest hospital network, and St. Joseph's University Medical Center in Paterson are among the state's healthcare facilities that have adopted DNAR protocols for dying COVID-19 patients.

DNAR policies seek to reduce the risk of contracting the illness during lifesaving measures, such as CPR and intubation, where front-line workers are particularly vulnerable to the virus.

4. The governor established a task force to acquire medications needed to address the pandemic, Politico reports.

Hospitals have been informing the state's health department about medications in short supply — such as the sedative and induction agent propofol — to prevent them from running out.

State officials are working to get the medications directly from pharmaceutical companies.

Read more about measures New Jersey is taking here.

Massachusetts (25,475 confirmed cases as of 9:25 a.m. CDT April 13)

1. Gov. Charlie Baker's administration released guidelines for how hospitals and providers can ration ventilators and intensive care beds if the COVID-19 crisis becomes unmanageable in the state, according to Boston.com. The guidelines advise hospitals to give patients a score, with a lower score meaning they would likely receive lifesaving access to a ventilator. Patients who are healthier, medical personnel and women further along in pregnancy would receive lower scores, and therefore are more likely to receive care. 

Healthcare workers argue that the guidelines would leave disadvantaged groups to die. 

About 250 physicians, nurses and other medical professionals wrote an open letter to the Crisis Standards of Care Advisory Committee, urging them to reconsider the guidelines. 

"The scoring system does not reference or account for structural racism, economic injustice or poverty, ableism, ageism, or the resultant major health disparities that harm black communities, Latinx communities, indigenous communities and other communities of color, low-income communities, disabled communities, incarcerated individuals and elders. These factors will make it statistically less likely that people from these communities will be allocated lifesaving resources in a crisis," the letter stated. 

2. A COVID-19 fund launched by the governor and his wife, Lauren Baker, has raised $4 million in one week, according to NBC Boston. The fund will be used to help communities hit hard by the pandemic. 

Read more about how Massachusetts is fighting the coronavirus here.

Michigan (24,244 confirmed cases as of 9:25 a.m. CDT April 13)

1. On April 12, Michigan recorded its lowest one-day increase in the number of COVID-19 cases since March 26, Click On Detroit reports.

An additional 645 coronavirus cases and 95 deaths due to complications associated with the virus were reported by the Michigan Department of Health and Human Services.

State officials warned that while a decrease in the number of cases are being reported, they cannot confirm that the data represents a statewide decline in the number of cases and deaths.

2. Michigan Gov. Gretchen Whitmer's extended stay-at-home order went into effect April 12 and prohibits residents from visiting friends or relatives, as well as second homes within the state, The Washington Times reports.

The order allows residents to return to their homes from outside the state and leave for residences outside of the state.

Exceptions to the order include those caring for a relative, visiting a nursing home and attending a funeral with no more than 10 people.

The extended order expires May 1.

3. The governor directed all U.S. and Michigan flags to be lowered to half-staff throughout the state indefinitely, according to an April 10 executive order.

The order will honor and mourn Michigan residents who lost their lives to the new coronavirus.

"The flags lowered will serve to remind us all that every life lost is a story and legacy of a loved one gone too soon," the governor said. "As we continue on, we will carry their memories."

Read more about measures Michigan is taking here.

California (23,311 confirmed cases as of 9:25 a.m. CDT April 13)

1. California will send 600 nurses to nursing homes or assisted living facilities grappling with a surge in COVID-19 cases, Gov. Gavin Newsom said April 10, according to local news station KTLA. The nurses will help local facilities identify and quarantine COVID-19 patients. State health officials are monitoring 191 nursing homes and assisted-living facilities across the state where patients and staff have tested positive. As of April 10, 1,266 infections in the state have been linked to the facilities. 

2. St. Vincent Medical Center in Los Angeles reopened April 13 as a COVID-19 treatment center. The state is reopening the 266-bed facility through a partnership with Los Angeles County, Oakland, California-based Kaiser Permanente and San Francisco-based Dignity Health. The facility is now called the Los Angeles Surge Hospital. 

3. California's strict and early stay-at-home measures have made a big difference in the projected death count attributed to COVID-19, according to local news station KRON 4. 

A projection by Seattle-based University of Washington researchers originally projected the state to have 6,109 deaths by Aug. 4. However, as of April 12, the number of deaths expected by Aug. 4 dropped significantly, to 1,616. 

Read more about how California is fighting the coronavirus here.

Pennsylvania (23,036 confirmed cases as of 9:25 a.m. CDT April 13)

1. On April 10, Gov. Tom Wolf announced a new $450 million loan program to provide short-term financial relief to Pennsylvania's hospitals. The Hospital Emergency Loan Program aims to provide immediate financial support to ensure hospitals have the resources they need, including staff and personal protective equipment.

The maximum loan size is $10 million per hospital at an interest rate of 0.5 percent.

"We must support our hospitals through this unprecedented time," the governor said. "When this pandemic finally ends, we’re going to need hospitals to care for our regular medical needs, like heart attacks and broken bones. This new loan program will provide immediate relief to our hospitals, which are on the front lines of this pandemic."

Applications will be available from April 13-20.

2. On April 11, Pennsylvania's Secretary of Health Rachel Levine, MD, said that the state expects to see a surge of cases this week, "but it won't be a tidal wave," CBS Philly reports.

"There will be a wave of new cases that will come up and come down, but it won’t be a tidal wave that would completely overwhelm our health care system," she said.

She also said that hospitals still had space for new patients, and about 70 percent of ventilators were available.

3. The Pennsylvania Department of Labor and Industry is implementing new federal unemployment compensation benefits provided by the Coronavirus Aid, Relief, and Economic Security Act. Those eligible will receive an additional $600 a week, beginning this week.

The CARES Act also makes self-employed, independent contractors, gig economy workers and others not normally eligible for unemployment pay benefits temporarily eligible.

Read more about how Pennsylvania is fighting the coronavirus here.

 

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