Last week, while Governor Tom Wolf asked the state assembly to pass legislation protecting Pennsylvanians from eviction, State Secretary of Health Dr. Rachel Levine announced revised virus guidelines for nursing homes.

The revisions are practical changes to caregiving and testing scheduling given what we’ve learned of COVID-19 transmission over the past months. In particular, she stressed the importance of compassionate caregivers when many are as concerned with COVID’s impact on the emotional health of residents of nursing homes and longer-term care facilities as they are physical safety.

Levine described wide collaboration to protect Pennsylvania’s most vulnerable residents.

These new testing recommendations are:

In a county with low COVID-19 activity, defined as less than 5 percent positivity rate within seven days according to federal data:

• Routine testing of asymptomatic residents is not recommended.

• Routine testing of asymptomatic staff is recommended every four weeks.

In a county with moderate COVID-19 activity, defined as a seven day percent positivity between 5 and 10 percent according to federal data:

• Routine testing of asymptomatic residents is encouraged of all residents with outside contact in the last 14 days, if they have not otherwise been tested during that period.

• Routine testing of asymptomatic staff is recommended once a week.

In a county with substantial COVID-19 activity, defined as a percent positivity greater than 10 percent according to federal data:

• Weekly testing is recommended of all asymptomatic residents with outside contact in the last 14-days, if they have not been otherwise tested during the period.

• Routine testing of all asymptomatic staff twice a week.

Facilities experiencing an outbreak should immediately begin universal testing, ideally of all staff and residents.

The complete guidelines are available on the Department of Health website at https://www.health.pa.gov/topics/disease/coronavirus/Pages/Guidance/SNF-Guidance.aspx

Levine also described various testing methods, saying new antigen tests will be distributed among care facilities statewide. Though each type of common test – PCR, antigen and antibody – has its particular tradeoff in sensitivity and specificity, she said, the antigen tests will be less expensive and far easier to administer, requiring only a sort of card, rather than a whole kids or machines, and can be distributed faster and more broadly.

During the Q&A with reporters, Levine offered no opinion on rumors of a vaccine arriving soon, or how it will be administered or distributed, saying there are far too few facts to answer any questions specifically. For instance, she said, even the number of times a vaccine must be administered to a patient and the temperature it must be stored at will both vastly change procedures.

As yet, any such details may be months away, so while departments and states are developing plans, which plan to initiate and how cannot reasonably be answered.

As of Monday, the state has 135,826 confirmed COVID-19 cases and 7,780 deaths. Lehigh County has 5,308 confirmed and 345 deaths; Northampton County has 4,173 confirmed and 301 deaths; the city of Bethlehem has 1,240 confirmed cases and 82 deaths.