The City of Philadelphia announced on Friday its new plans for eventually moving into the yellow phase of Governor Wolf’s reopening plan. Jim Kenney announced “Safer at Home”, as the Philly area is expected to move into the yellow phase starting next Friday, June 5th.
The strategy combines 3 actions: containment, social distancing, and protecting vulnerable populations.
Containment involves Case identification, Case isolation, Contact tracing, Contact quarantine and monitoring.
From June through August, Philadelphia will implement large-scale, rapid testing (i.e. results in 24 hours or less) to quickly identify new "cases" (people with confirmed COVID-19 infection).
Testing is currently available at 47 sites across Philadelphia, including hospitals, Federally Qualified Health Centers, pharmacies, and urgent care centers, at no out-of-pocket cost to residents, and the number of sites will be expanded to under-served neighborhoods.
Testing will also be offered through outreach to populations suffering a disproportionate impact (e.g., African Americans) and vulnerable populations, such as individuals experiencing homelessness and those living in congregate settings.
Any resident with fever or respiratory symptoms or with exposure to a known or suspected case of COVID-19 infection will be actively encouraged to be tested.
People with the infection will be asked and provided with instructions to self-isolate for at least 10 days after the onset of symptoms to prevent the spread of the virus to others.
To prevent further spread, the Department of Public Health will work with testing sites and health care providers to quickly identify people who may have been in close contact to individuals with the infection ("contacts").
Following notification of a positive test in a person (the "case"), Department of Public Health representatives or designees will interview the case to identify their contacts, including asking questions about whom they live with, with whom they work, and what locations they have visited. Staff will also work with the employer and any locations visited while the case was able to spread the virus to identify additional contacts.
Medium- and high-risk contacts (those who have spent more than 10 minutes in proximity to the case during the case's infectious period) will be asked to quarantine at home and monitored daily for 14 days after the last known exposure; low-risk contacts (those who spent fewer than 10 minutes near the case) will be advised to monitor their symptoms without quarantine.
The risk of different businesses and activities will be assessed based on the potential for transmission of COVID-19, the number of people who could become infected, and the likelihood of fatalities, considering the following factors:
The number of people potentially or likely to be present in a setting or activity;
The feasibility of restricting or limiting access to reduce crowd sizes;
The frequency of face-to-face interactions conducted within six feet;
The number of prolonged (> 10 minutes) face-to-face interactions;
Whether interactions take place in a confined interior space;
The feasibility of installing barriers to prevent transmission;
The feasibility of use of face masks in the activity; and
The number of vulnerable (i.e. older or chronically ill) people potentially exposed.
As they restart, businesses and services will be asked, and in some instances required, to follow a Safe Mode of operations to prevent spread of COVID-19, which is detailed in a separate set of guidelines.
Safe Mode will include a Safety Checklist of precautions tailored to the specific activity and setting, but containing these common eight elements: Masks, Barriers, Isolate, Distance, Reduce Crowds, Handwashing, Clean, and Communicate.
While the governor's yellow phase calls for the suspension of stay-at-home orders, the Department of Public Health will continue to advise city residents that they are "safer at home," and should only leave to engage in essential activities.
Protecting Vulnerable Populations
Some residents of Philadelphia are at greater risk for infection or for severe disease than others. Members of racial and ethnic minorities have higher rates of recognized infection and severe infection than Caucasians, likely related to longstanding social disadvantage. People who live in congregate settings are at greater risk for infection, and those who are elderly or have chronic medical conditions are greater risk for severe disease if infected. In Phase 2, Philadelphia will emphasize protections for these disproportionately vulnerable populations.
In response, the Department of Public Health will develop and release a COVID-19 racial equity plan that will include actions to address:
Improving completeness of surveillance data;
Access to testing;
Addressing chronic health conditions that increase the severe COVID-19 disease;
Protecting essential workers;
Preventing community spread;
and Preventing spread in congregate settings
In order to mitigate risks at long-term care facilities, the following steps will be taken to prevent introduction of the virus and to prevent spread within the facilities if introduced:
Provision of ample personal protective equipment;
Requiring masking by staff at all times (universal masking);
Provision of COVID-19 testing supplies and rapid testing equipment to nursing homes for quick diagnosis of COVID-19 in residents or staff;
Enforcement of restrictions on visitors and on residents leaving the facilities;
Screening of nursing home staff at the beginning and end of each shift for fever (with temperature checks) and symptoms consistent with COVID-19;
Testing of all symptomatic staff and, if cases are detected, testing of asymptomatic staff;
Promotion of liberal, non-punitive sick leave policies for staff and strongly discouraging staff from working while ill;
Screening of residents every eight hours for fever and symptoms consistent with COVID-19;
Immediate isolation and testing of all symptomatic residents and their roommates and, if cases are detected, testing of asymptomatic residents;
Testing of all new admissions for COVID-19 prior to transfer from acute care hospitals, and isolation precautions for 14 days following admission;
Cohorting and other infection control actions to prevent spread when cases are detected; Use of serologic screening of residents and staff as appropriate to assess risk and guide cohorting;
Continued enforcement of restrictions on group activities, and strict enforcement of social distancing, universal masking, and enhanced hand and environmental hygiene as these activities are gradually allowed to resume
"To successfully navigate the next phase of our recovery, we need all Philadelphians to embrace the shared responsibility we all have at this critical moment in our city's history," the document reads.