FEMA Region 3 SITUATION REPORT - COVID-19€¦ · 04/05/2020 · 22XX-TRANSPORTION Total...

FOR OFFICAL USE ONLY (FOUO)

FEMA Region 3

SITUATION REPORT - COVID-19 Monday, May 4, 2020

❖ Regional Overview 1. FEMA Region 3 Force Laydown

2. DOD Force Laydown

3. External Affairs Summary

4. Regional Financial Summary

5. Alternate Care Site (ACS) Laydown

6. COVID-19 Regional Projections

❖ State Executive Brief (DC, DE, MD, PA, VA, WV) 1. Hot Issues

2. State Issues

3. COVID-19 Projections

4. Personnel Protective Equipment & Ventilators Report

5. Non-PPE Report

6. Hospital Capacity Report

7. Alternate Care Sites

8. Fatality Management

9. Testing Sites

10. Defense Coordination Element

11. External Affairs Report

12. Finance and Admin Report

13. Miscellaneous

❖ Appendixes 1. ASPR Situation Report

WARNING: This document is FOR OFFICIAL USE ONLY (FOUO). It contains information that may be exempt from

public release under the Freedom of Information Act (5 U.S.C 552). It is to be controlled, stored, handled,

transmitted, distributed, and disposed of in accordance with DHS policy relating to FOUO information and is not

to be release to the public or other personnel who do not have a valid “need-to-know” without prior approval of

an authorized DHS official.

May 4, 2020 R3-1 of 5


Situation Report

FEMA Region 3 1. Force Laydown (Source: R3 GIS COVID19Mapbook, R3 Force Laydown)

Regional 3 Situation Report

FOUO - FOR OFFICAL USE ONLY May 4, 2020 R3 2 of 5

2. DoD Force Laydown (Source: DCER3_COVID19_Storyboard_30APR20; received 04/30/2020 3:19 pm)* *No DoD Force Laydown Updates as of 05/03/2020.

3. External Affairs Summary (Source: R3 EA report, received 5/1/2020 2:00 pm)

IGA ➢ NSTR

Congressional ➢ Correspondence

• NSTR

➢ Letters and Requests for Information

• NSTR



4. Regional Financial Summary (Source: Financial SITREP Data as of 4-30-2020, received 05/01/2020 9:52am)

ALLOCATIONS OBLIGATIONS

416X-PUBLIC ASSISTANCE $8,176,733 $7,176,728

11XX-SALARIES & BENEFITS Total $1,290,553 $1,290,549

21XX-TRAVEL Total $537,300 $161,254

22XX-TRANSPORTION Total $5,108,100 $9,312

23XX-RENT, COMM, UTILITIES Total $864,125 $380,606

24XX-PRINT & REPRO Total $6,000 $0

2501-MISSIONS-FOS Total $1,550,000 $77,822

25XX-OTHER SERVICES Total $983,000 $376,284

26XX-SUPPLIES & MATERIALS Total $619,000 $137,000

41XX-GRANTS Total $0 $0

IMMEDIATE NEEDS ASSISTANCE Total $35,520,520 $15,268,843

2508-MISSIONS-DFA Total $558,033,740 $324,807,500

Total $612,689,071 $349,685,898



5. Alternate Care Site (ACS) Laydown (Source: R3 GIS COVID19Mapbook, FEMA RIII ACS Laydown)



6. COVID-19 Regional Projection (Source: (FOUO)_COVID19CaseAnalysisBI05022020, received 05/03/2020 10:48 am)

➢ Currently witnessing a doubling of confirmed cases every 21 (▲1) days. For the past 9(▲1) days we have only seen as high as a 6% growth in cases per day. Current mortality rate based off confirmed cases 4.67% (▲.02%). National mortality rate 5.8% (♦).

1. Miscellaneous ➢ NSTR

Date R3 Cumulative R3 Actuals R3 %

4/19/2020 61518 2887 5%

4/20/2020 62486 966 2%

4/21/2020 65130 2644 4%

4/22/2020 67141 2011 3%

4/23/2020 70661 3520 5%

4/24/2020 74820 4159 6%

4/25/2020 78012 3192 4%

4/26/2020 81153 3141 4%

4/27/2020 84189 3036 4%

4/28/2020 86819 2630 3%

4/29/2020 90032 3213 4%

4/30/2020 93526 4401 4%

5/01/2020 98056 4563 5%

5/02/2020 101513 4741 4%

May 4, 2020 DC-1 of 10


REGION 3 Situation Report

DISTRICT OF COLUMBIA

1. Hot Issues ➢ NSTR

2. State Issues

EOC Status: Full Activation Total Cases: 5,016 (▲693) ▲= Difference since May 1 SitRep

DPH EOC Status: Activated Total Fatalities (Confirmed):

251 (▲27) ▲= Difference since May 1 SitRep

FEMA Declaration:

FEMA-4502-DR Individual Assistance limited to the Crisis Counseling Program for all areas in the District of Columbia on 4/30

Community Based Test Sites (CBTS)

LNO: No (0) Federally supported, Locally managed: 0 (♦0)

IMAT-A: Onsite Federally supported, Privately managed: 0 (♦0)

NG 502(f) Status: Approved

Stay-at-Home Order Stay-at-Home Order for the entire district until May 15, except essential activities.

K-12 Schools Public schools and charter schools closed for the remainder of the 2019-2020 academic year.

Brick-and-Mortar Business

Non-essential businesses closed until May 15, except telework. Workers and customers of food sellers must wear face masks.

Restaurants and Bars

Restaurants and bars restricted delivery and take-out only. Workers and customers must wear face masks.

Restrictions on Gatherings

Gatherings restricted to fewer than 10 people.

Region 3 Situation Report for District of Columbia

FOUO- FOR OFFICAL USE ONLY

May 4, 2020 DC-2 of 10

Travel Restrictions

• Hotel workers, guests, and visitors, as well as individuals using taxis, ride shares, private transportation providers must wear face masks.

• Public transit workers and riders are strongly encouraged to wear face masks while traveling aboard all buses, trains, and MetroAccess vehicles, as well as in rail stations, bus terminals and other transit facilities.

➢ IMAT-A EA: tracking VIP visits to Convention Center for the week of 5/4 to 5/8. ➢ IMAT-A Logistics: assisted DC with tightening up their warehouse inventory system on

5/1. o Reefer truck maintenance took place 5/1 AM. o Routine maintenance needs to be scheduled; Log tracking with LMD

➢ IMAT-A Planning is working on PPE data and possible gown RRF as of 5/1, also

assisting DC with a transition and demobilization template for 5/1, and working on an

internal Incident Strategic Approach to be updated every Sunday.

➢ IMAT-A Ops: attended discussions with DC Clinical Staffing Group and USACE regarding changes to the statement of work/freight elevator use 5/1, coordinated and facilitated Feeding Task Force meeting between RRCC and the District today (5/1) at 1500.

➢ A Tabletop Exercise (TTX) is in the development phase by the Hospital Task Force and tentatively planned for Monday 5/4. (IMAT-A)

(IMAT-A Inputs, retrieved 4:00 pm on 05/03/2020; Mayor’s Office retrieved 9:00 pm on 04/30/2020)

3. COVID-19 Projections (Source: (FOUO)_COVID19CaseAnalysisBI05022020, received 05/03/2020 10:48 am)

➢ Currently witnessing a doubling of confirmed cases every 20 (♦) days (Stay-at-Home Order was issued on March 30). Percent of cases per day seem to be trending down as the effects of social distancing take place. Current mortality rate based off confirmed cases is 5.00% (▲.04%).

Date DC

Cumulative DC

Actuals DC %

4/18/2020 2793 127 5%

4/19/2020 2927 134 5%

4/20/2020 3098 171 6%

4/21/2020 3206 108 3%

4/22/2020 3361 155 5%

4/23/2020 3528 167 5%

4/24/2020 3699 171 5%

4/25/2020 3841 142 4%

4/26/2020 3892 51 1%

4/27/2020 3994 102 3%

4/28/2020 4106 112 3%

4/29/2020 4323 217 5%

4/30/2020 4658 335 8%

5/1/2020 4797 139 3%

5/2/2020 5016 219 5%



May 4, 2020 DC-3 of 10

4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A, HHS LNO, DC: Mayor's Press Briefing as of 5/3/2020 4:00 pm)

ITEM Total in

State

Total Daily

Usage

Total anticipated

need for next 14-

days

Delta (In State - 14-

day supply)

State Provided

(non-federally sourced)

Total actual

federally requested

Total actual federal

received

Gloves 606,461 27,865 390,110 (216,351) 606,461 280,000 2,277,600

Gowns 6 2,171 30,394 30,388 6 168,200 455,656

Surgical Masks 2,068,200 44,525 623,350 (1,444,850) 2,068,200 250,000 693,390

N-95 Masks 405,807 2,960 41,440 (364,367) 405,807 1,000,000 771,445

Face Shields 180,950 3,408 47,712 (133,238) 180,950 500,000 164,256

Goggles 15,798 - - - 15,798 500,000

-

Coveralls 9,900 - - - 9,900 44 12,545

Resource Allocation Strategy Tiered approach (1. First Responders; 2. Medical Staff; 3. Clean Workplace (city essential staff) – as of April 15.

* No current burn rate for coveralls and goggles available. ➢ DC received 400,000 "reusable cloth masks". DC also received 3,615,160 "non-surgical

disposable masks". These have not been added to the surgical mask total. Total in the state equals total amount of inventory on hand across all DC warehouses. We are working with DC to get burn rates for googles and coveralls.

5. Non-Personal Protective Equipment (Source: R3 Ops: NONPPE Report, received 5/3/2020 4:00 pm)

Request Date/Time Submitted RRF# Locations Item Status

ACS Medical Personnel 04/07/2020 2664-178873 NRCC Approved/Ordered

Battelle Decon System - NCR 04/05/2020 2664-170509 NRCC Complete

Body Bags - 4,000 03/25/2020 2664-126332 NRCC Complete

Fatality Management Personnel 04/20/2020 2664-224253 NRCC Assigned to R3 for Action

FMS - DC (250) 03/28/2020 2664-134265 NRCC Complete

FMS - DC (50) 03/28/2020 2664-134251 R3 Complete

Medical Cots 04/01/2020 2664-151727 NRCC Complete

Medical/Test Supplies 03/21/2020 2664-113915 R3 Complete

Medical/Test Supplies 04/16/2020 2664-211897 NRCC Complete



May 4, 2020 DC-4 of 10

6. Hospital Capacity & Ventilators (Source: Hospital Data 5/3, received 05/03/2020 6:58 pm)

BEDS Total Inpatient

Beds Total Available Inpatient Beds

Total ICU Beds Total ICU Beds

Available

Actuals 2,430♦ 484 (▼31) 351♦ 68 (▲2)

(Source: Hospital Data 5/3, received 05/03/2020 6:58 pm)

VENTILATORS Total

Ventilators

Total Ventilators Available

Ventilators from EMAC

Ventilators from SNS

Ventilators Requested

Actuals 440♦ 196 (▼3) 50♦ 200♦ 300♦

➢ Data on ventilators from EMAC is provided by HHS; data on ventilators from SNS is provided by Ventilators Shipped to States email; data on ventilators requested is provided by the Region 3 NONPPE Report

➢ Ventilators requested are currently on hold (Region 3 NONPPE Report). Battelle Unit Location

➢ 2215 Adams Pl NE, Washington, DC 20018-3622 POC: David Foust, 202-412-3460

o Status: Operational and accepting PPE o Unit is only authorized under the Emergency Use Agreement to decontaminate N95

Respirators that are not cellulose based; face shields, goggles and safety glasses are also being decontaminated

o MedStar dropped off 10,000 masks to be cleaned on 05/01/2020 o DC IMAT-A visited the site on 05/01/2020 (IMAT-A)

Pharmaceuticals 04/20/2020 2664-225003-001 NRCC Complete

Pharmacy Cache - 1 04/08/2020 2664-183676 NRCC Complete

Refrigerated Trailers 03/25/2020 2664-125659 NRCC Complete

Refrigerated Trailers - 2 04/04/2020 2664-163940 NRCC Complete

USACE Site Assessments 04/06/2020 2664-152257 R3 Approved/Ordered

https://goo.gl/maps/j2YySyWkqsGeBN3i6

https://goo.gl/maps/j2YySyWkqsGeBN3i6



May 4, 2020 DC-5 of 10

7. Alternate Care Site (ACS) (Source: R3 ACS Ops Tracker, retrieved 05/03/2020 7:29 pm; DC IMAT-A Inputs, retrieved 05/03/2020 7:30 pm)

Site Address/BLDG Number Site Status Operational

Date Max # Bed Spaces

(Non-COVID-19)

Walter E. Washington Convention Center

801 Mt Vernon Place NW Washington, DC 20001

Pending Buildout Goal:

May 10, 2020 1,910

United Medical Center (UMC)

1310 Southern Ave SE Washington, DC 20032

“Pods” - Buildout TBD TBD

➢ The DC Convention Center ACS: o Construction is 53% complete as of May 1. (IMAT-A)

o Working on a freight elevator contract modification. The freight elevator is a potential issue because it can slow down construction; it is unclear who will be paying for the contract modification. (IMAT-A)

o DC aiming to open Hall A for patients on May 10 (pushed from May 8 due to delay in delivery of oxygen tanks); Halls B and C can be opened later if needed. (IMAT-A)

o MedStar will staff first 100 beds. A 10-person team from HHS Public Health Service will conduct a dry-run validation exercise, arriving May 7; remainder of team (70-80 pax) to arrive on May 17 only if bed count is over 100. (IMAT-A)

o IMAT-A Ops looking at how patients will be transported to the Convention Center. (IMAT-A)

o IMAT-A EA tracking VIP visits to the Convention Center, including FEMA Administrator and DC Senior Level Staff (IMAT-A)

➢ 6 Containerized Medical Solution (CMS) “pods” delivered to United Medical Center on April 22; United Medical Center housing and staffing the pods. (IMAT-A)

8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – DC (May 1).docx, received 05/01/2020 7:22 pm)

District of Columbia

Item Amount Procured

by State

Amount Procured by Feds

Amount in Use

Total in State

Anticipated Shortage

Human Remains Pouches

Unknown 4,000 on site (RRF 2664-126332)

Varies

OCME has over 5k, UNK how many hospitals, nursing facilities, funeral homes, etc. have on hand

N/A

Refrigerated Storage, Including Trailers

Equip. needed to make 53’ refrigerated trailers useable submitted (lift, racks, flooring, etc). This order has been processed by DC. Est. 3

6 53’ Trailers on site, 60 pax each (RRF 2664-163940, 2664-125659). Received

Opened a Western Shelter (Blue Plains) due to delay in funeral

Now available: 746 4 Mobile Storage Units – 28 capacity each – Total 112

None (Daily sitrep tracks open morgue space)



May 4, 2020 DC-6 of 10



by State


Amount in Use

Total in State


weeks for complete delivery; but, as equip. for rack system is completed manufacturer will ship so they can begin outfitting one trailer at a time. Multiple requests in progress for field morgue set up – most have been fulfilled. See Notes section below for report on hospital morgue availability as of April 30.

maintenance support for broken reefer.

services. Multiple requests in progress for field morgue set up – some have already been fulfilled.

Blue Plains – 20 Crematorium Contractor – 45 UDC Mortuary Dept – 9 Georgetown Univ – 200 2 Mobile Storage Units from Air Guard FSAR Team 12 each for total of 24 (Transport only, not for LT storage – not included in total capacity)

Additional Staffing *Medical Examiners *Funeral Directors

Fatality Mgmt Medical Reserve Corps applications being processed by DC Health. First group of vetted volunteers attended orientation April 20. ANG 113th Forensic S&R Team now under the direction of OCME for deployment on decedent retrieval. Currently 10 are assisting. Team is operating regularly assisting Medical Examiner Transport Team.

DOD handling DC’s request for mortuary affairs personnel

Varies Varies

DC has surge capacity with staffing for moving of decedents; but, due to complexity of Death Investigation work there is potential for shortage of Investigator, Pathologist, & mortuary staff to support.



May 4, 2020 DC-7 of 10



by State


Amount in Use

Total in State


Non-PPE Supplies (e.g. Cremation Boxes, Preparation Supplies)

Submitted internal request for 20 stretchers (delivery 5/1). PPE and disinfecting items assigned to OCP for fulfillment. Trailers need shelving and lifts-being manufactured, planned delivery week of 4/27. Refrigerated trailer flooring installed, shelving being built by DPW, expected completion by 5/1. 1k cremation boxes on order (300 due on 4/24, remainder the following week)

N/A N/A Various

None (requests being procured internally)

Notes: DC OCME published a daily sitrep. Per the HHS LNO, “OCME has had previous mass fatality exercises and all hospitals are required to have mass fatality plans. Nursing homes in the district do not have storage capability. All hospital morgues have been contacted and surge plans and numbers verified. Funeral Homes are being advised directly and through a WebEx townhall that they need to strongly encourage families to make prompt decisions so that we can expedite releases. Identified shortcomings are that families cannot be forced to make prompt decisions and to not wait on funerals. Our contracted Crematorium has agreed to store public dispositions while waiting on the required 30 days. Identified shortcoming is the 30-day requirement to hold a body if no next of kin can be identified. OCME’s contracted crematorium reports they can process 22-24 per 24hrs depending on weight. OCME is in the process of contacting a secondary crematory for added resilience.” OCME Investigation Unit is actively tracking hospital and nursing facility COVID deaths to proactively plan for fatality surge. DC is looking into emergency maintenance solutions for the refrigerated trailers.



May 4, 2020 DC-8 of 10



by State


Amount in Use

Total in State




May 4, 2020 DC-9 of 10

9. Testing Sites (Source: R3 GIS Mapbook; R3 EA Testing Site Tracker)

Testing Materials Number Status

Swabs 4,000 Allocated / Dispatched

Vials TBD (Source: FEMA Logistics, received 8:54 AM on 04/30/2020)

TESTING NOTES: (Source: IMAT-A input retrieved 05/03/2020 at 4:00 pm; DC Mayor’s Office)

➢ NSTR



May 4, 2020 DC-10 of 10

10. Defense Coordinating Element (Source: DCE SITREP: DCER3_COVID19_DailySITREP_2MAY20, Received 05/02/2020 2:06 pm)

➢ National Guard Activation Status: Activated; 329 (♦) Personnel. o DCNG does not have SAD status; SMs are automatically on 502(f) when activated

➢ On 2 May, DCE assisted in processing an MA for DC requesting T10 mortuary affairs support. The request includes 4 mortuary affairs specialists and 8 general purpose (GP) forces. After DCE processed the SOW, DCNG agreed to source the general purpose force requirements.

o Draft Mortuary Affairs RRF has been staffed through NORTHCOM and OSD. RRF is with DCHSEMA and FEMA R3 for staffing prior to submission into WebEOC.

➢ MG Jeff Milhorn, the USACE North Atlantic Division Commander, visited the DC Convention Center ACS on 1 May.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 2:00 pm)

IGA ➢ NSTR

Congressional ➢ Open inquiries

• NSTR

12. Regional Financial Summary (Source: Financial SITREP Data as of 4-30-2020, received 05/01/2020 9:52 am)

FEMA-4502-DR-DC FEMA-4502-DR-DC


416X-PUBLIC ASSISTANCE $1 $0

11XX-SALARIES & BENEFITS Total $45,410 $45,409

21XX-TRAVEL Total $84,700 $30,978

22XX-TRANSPORTION Total $129,000 $500

23XX-RENT, COMM, UTILITIES Total $70,000 $0


2501-MISSIONS-FOS Total $0 $0

25XX-OTHER SERVICES Total $20,000 $0

26XX-SUPPLIES & MATERIALS Total $3,000 $0


IMMEDIATE NEEDS ASSISTANCE Total $218,329 $174,658


Total $75,680,900 $55,657,065


May 4, 2020 DE-1 of 8



DELAWARE

1. Hot Issues ➢ On 5/3, The Governor and six other state governors announced a joint multi-state

agreement to develop a regional supply chain for PPE. Other states in the agreement include MA, MD, NJ, NY, PA, and RI. (Governor’s Office)

➢ Beebe Hospital in Sussex County continues to operate near capacity; receiving assistance from HHS and will receive Delaware National Guard staffing on May 11. (IMAT-A)

➢ The State is working on documentation to ask for 100% Federal cost share rather than 75% Federal / 25% State cost share. Currently Public Assistance is working with them. (IMAT-A)

2. State Issues




FEMA Declaration:

FEMA-4526-DR Amendment 001 Individual Assistance limited to the Crisis Counseling Program for all areas in the State of Delaware, 4/30



IMAT-A: Onsite and Virtual Federally supported, Privately managed: 0 (♦0)

NG 502(f) Status: Approved. OSD signed orders for Title 32 status for DENG April 25.

Stay-at-Home Order Stay-at-Home Order for entire state until May 15, 2020, or until “the public health threat is eliminated." Exempts essential activities.

K-12 Schools The Governor, in consultation with superintendents across the state made the decision to close schools through the rest of the academic year.

Brick-and-Mortar Businesses

Non-essential businesses closed until May 15 or “the public health threat is eliminated." Exempts telework. Businesses allowed to stay open must enforce specific social distancing rules. Face masks must be worn at all times in public.

Region 3 Situation Report for Delaware

FOUO- FOR OFICAL USE ONLY

May 4, 2020 DE-2 of 8


Restaurants and bars restricted to delivery and take-out only.


Gatherings restricted to fewer than 10 people until May 15 or “the public health threat is eliminated."

Travel Restrictions

➢ Out-of-state travelers into DE must immediately self-quarantine for 14 days.

➢ Out-of-state workers should telework, if possible, but travel restrictions to assist in the response have been removed.

➢ Face masks must be worn at all times on public transportation.

➢ On 5/3, The Governor and six other state governors announced a joint multi-state agreement to develop a regional supply chain for PPE. Other states in the agreement include MA, MD, NJ, NY, PA, and RI. (Governor’s Office)

➢ On 5/3 the Non-Congregate Shelter (NCS) Program request was extended. An RFI will be going out to validate extending use of NCS for distressed population groups. (IMAT-A)

➢ The Delaware National Guard began a mission on 5/2 to assist Parkview Nursing Home and Rehabilitation Center in Wilmington, DE with patient care. (IMAT-A)

➢ Rallies were held on 5/1 outside the state building in Dover and the Carvel State Office Building in Wilmington. There were about 100 people in Dover and another 75 in Wilmington protesting the Governors’ response to COVID. (IMAT-A)

➢ On 4/30, the Governor issued the 14th modification to his State of Emergency declaration, providing additional protections for Delaware renters during the COVID-19 pandemic, and extending the application deadline for Delaware’s Senior School Property Tax Credit Program until June 1. Delaware’s stay-at-home order, and mandatory quarantine for out-of-state travelers, remain in place. Violations of the emergency declaration, or any of its modifications, constitute a criminal offense. (Governor’s Office)

➢ The State is working on documentation to ask for 100% Federal cost share rather than 75% Federal / 25% State cost share. Currently Public Assistance is working with them. (IMAT-A)

(Source: IMAT-A Inputs, retrieved 4:20 pm on 05/03/2020; DE Governor’s Office)


Date DE

Cumulative DE

Actuals DE %

➢ Currently witnessing a doubling of confirmed cases every 17 (▲2) days (Stay-at-Home Order issued on March 24). Current mortality rate based off confirmed cases is 3.33% (▲.10%)

4/18/2020 2538 215 9%

4/19/2020 2745 207 8%

4/20/2020 2931 186 7%

4/21/2020 3200 269 9%

4/22/2020 3308 108 3%

4/23/2020 3442 134 4%

4/24/2020 3576 134 4%

4/25/2020 4034 458 13%

4/26/2020 4162 128 3%

4/27/2020 4575 413 10%



May 4, 2020 DE-3 of 8

4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A, HHS LNO & DE State Health Operations Center as of 5/3/2020 4:00 pm)

ITEM Total in

State

Total Daily

Usage

Total anticipated

need for next 14-

days


day supply)

State Provided


Total actual federally

requested


received

Gloves

5,074,900

1,660,725

23,250,150 18,175,250

210,000

21,991,600

198,185

Gowns

40,446

67,317

942,438 901,992

-

422,800

32,034

Surgical Masks

401,199

73,014

1,022,196

620,997

6,000

1,831,900

184,500

N-95 Masks

298,088

4,731

66,234 (231,854)

-

37,240

74,885

Face Shields

145,373

1,383

19,362 (126,011)

-

35,000

38,880

Goggles

33,293

1,037

14,518 (18,775)

-

-

-

Coveralls

7,495 -

-

- -

-

3,168

Resource Allocation Strategy Approach TBD (Acute care, hospital emergency departments, intensive care units and usage of strike teams) as of March 25.

5. Non-Personal Protective Equipment (Source: OPS, Resource Request Forms, WebEOC as of 5/3/2020 4:00 pm)

Request Date/Time Submitted

RRF# Locations Item Status

Medical Staffing 04/22/2020 2628-228800 R3 Approved/Ordered

6. Hospital Capacity & Ventilators (Source: 5/03/2020 – Delaware Hospital Census, ICU, Vents, received 05/03/20 2:54 pm)




Available

Actuals 2,112 (▼13) 491 (▲30) 214 (▲2) 92 (▲18)

➢ As of 04/16/20, “ICU Overflow” has been added to data submitted by Delaware, which provides data on number of ICU beds above the hospital’s traditional ICU bed counts. Only

4/28/2020 4655 80 2%

4/29/2020 4734 79 2%

4/30/2020 4918 184 4%

5/1/2020 5038 120 2%



May 4, 2020 DE-4 of 8

traditional ICU bed counts are included in the above table. Total Overflow ICU beds on 05/03/20 = 166; Total Available Overflow ICU beds = 133.

➢ Beebe Hospital in Sussex County continues to operate near capacity; receiving assistance from HHS and will receive Delaware National Guard staffing on May 11. Will open additional facility (previously built) located approximately 10 miles from the main hospital on May 8; facility has 24 beds. (IMAT-A)

(Source: 5/03/2020 – Delaware Hospital Census, ICU, Vents, received 05/03/20 2:54 pm)

VENTILATORS Total

Ventilators





Actuals 686♦ 669 (▲93) 0♦ 50♦ 0♦

➢ Total ventilators available = 248 ventilators stored at DPH Warehouse + 421 ventilators available at DE hospitals (IMAT-A Planning).

7. Alternate Care Site (ACS) (Source: R3 ACS Ops Tracker, retrieved 05/03/20 8:38 pm; DE IMAT-A Input, retrieved 05/03/20 8:34 pm)


Date

Max # Bed Spaces (Non-

COVID-19)

A.I. DuPont Children’s Hospital Gymnasium

1600 Rockland Road Wilmington, DE 19803

Pending Open As required 38

A.I. DuPont Children’s Hospital Employee Gymnasium

1600 Rockland Road Wilmington, DE 19803

Pending Open As required 29

Governor Bacon Health Center

248 Kent Avenue Delaware City, DE 19706

Open Opened April

28, 2020 30

➢ DE has selected the Governor Bacon Health Center, a state-owned/operated long-term care facility, to serve as a state-administered ACS. (IMAT-A)

o Existing patients at Governor Bacon were moved to the Delaware Hospital for the Chronically Ill in Smyrna in anticipation of admitting COVID-19 patients.

➢ A.I. DuPont can become operational when required. (IMAT-A)



May 4, 2020 DE-5 of 8

8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – DE, Received 4/28/2020 12:43 pm) *No Fatality Management Task Force Updates as of 05/03/2020.

Delaware


by State


Amount in Use

Total in State



Unknown N/A Unknown Unknown None

Refrigerated Storage, including trailers

Surge capability: Morgue Storage Unit: 144 Satellite Morgue (4 large tents with lights, heating, cooling capabilities) Refrigerated transportation trailer: 28

N/A N/A

DFS: 30 Hospitals: 71 Funeral Home capability: 149

None


Unknown N/A N/A N/A None

Non-PPE Supplies (e.g. cremation boxes, preparation supplies)

Unknown N/A N/A N/A None

Notes: Per the HHS LNO “12 crematories exist in DE, capacity unknown. Current inventory of resources is sufficient according to DPH. If inventory is depleted by cross-leveling with health care facilities, gaps may appear.” DE does not anticipate any mortuary affairs shortfalls. Dover AFB is not available for storage or processing of civilian remains.



May 4, 2020 DE-6 of 8

9. Testing Sites (Source: R3 GIS COVID19Mapbook, R3 EA Testing Site Tracker)

Testing Material Number Status


Vials TBD

(Source: FEMA Logistics, received 8:54 AM on 04/30/2020)

TESTING NOTES: (Source: IMAT-A Input, retrieved 4:00 pm, 05/03/2020)

➢ A testing plan has been in the works and should be finalized and put into place the week of 5/4 as a conjunction between the poultry industry and the state. (IMAT-A)

➢ Beebe Hospital and both Bayhealth Hospital held COVID tests (5/2 to 5/4) with the help of DPH. (IMAT-A)

➢ Nanticoke Hospital will host a testing site on 5/5. (IMAT-A)



May 4, 2020 DE-7 of 8

10. Defense Coordinating Element (Source: DCE SITREP: DCER3_COVID19_DailySITREP_2MAY20, Received 05/02/2020 2:06 pm, DE IMAT-A)

➢ National Guard Activation Status: Activated; 98 (♦) Personnel. ➢ 4526DR-DE-DOD-01, T32 Activation for Delaware is approved; all amendments approved

o T32 502(f) Amendments approved to 31 May ➢ JTF Medical continue to augment DE Psychiatric Center staff in support of patient population. ➢ JTF CBRNE continue to support DE Public Health Lab (DPHL) to process and transport

COVID-19 samples in New Castle, Kent, and Sussex counties. ➢ Potential setup and staffing of Mobile Medical Facility (hospital tent) from DENG if determined

there is a need in southern DE. ➢ Parkview Nursing & Rehab in Wilmington has immediate need 3 teams composed of

one (1) RN and two (2) CNAs to cover three shifts daily for two weeks due to staffing shortage.

o DNG began a mission on 5/2 to assist Parkview with patient care. (IMAT-A) o MG Berry, DE TAG concerned with DENG increasing mission sets may not have

the medical personnel to support every request.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 2:00 pm)

IGA ➢ NSTR


• NSTR



May 4, 2020 DE-8 of 8


FEMA-4526-DR-DE FEMA-4526-DR-DE




21XX-TRAVEL Total $84,700 $11,140








IMMEDIATE NEEDS ASSISTANCE Total $0 $0


Total $40,702,816 $4,948,755


May 4, 2020 MD-1 of 10



MARYLAND

1. Hot Issues ➢ Large-scale testing was conducted at Perdue Stadium on Friday, 5/1 and Saturday, 5/2.

(See Section 9 for more information) (IMAT-A) ➢ CDC team arrived in MD and relocated to Salisbury area 5/1 in support of the Eastern

Shore Poultry Task Force. (IMAT-A)

2. State Issues

EOC Status: Full Activation Total Cases: 25,462 (▲3,720) ▲= Difference since May 1 SitRep


1,182 (▲135) ▲= Difference since May 1 SitRep

FEMA Declaration:

FEMA-4491-DR Individual Assistance limited to the Crisis Counseling Program for all areas in the State of Maryland on 4/30


LNO: No (0) Federally supported, Locally managed: 0 (●0)

IMAT-A: Onsite Federally supported, Privately managed: 0 (●0)

NG 502(f) Status: Approved.

Stay-at-Home Order Stay-at-Home Order for the entire state indefinitely, except for essential activities.

K-12 Schools K-12 public schools are closed until May 15. Private schools are to consider closing.

Brick-and-Mortar Businesses

Non-essential businesses closed indefinitely except for telework. Businesses allowed to stay open must enforce specific social distancing and face covering rules.


Restaurants and bars are restricted to delivery and take-out only.

Region 3 Situation Report for Maryland

FOUO- FOR OFFICAL USE ONLY May 4, 2020 MD-2 of 10


Gatherings are indefinitely restricted to less than ten people.

Travel Restrictions

• MD residents are directed that they “should not travel out-of-state unless absolutely necessary”. Residents that do travel out-of-state should self-quarantine for 14 days.

• Non-MD residents and MD residents that have traveled to NY, NJ, or CT, must quarantine in place and limit all contact with others for at least 14 days.

• Riders of public transportation must wear face coverings.

➢ Large-scale testing at Perdue Stadium - Testing Dates: Friday, 5/1 & Saturday, 5/2. See

Section 9 for more information. (IMAT-A) ➢ Wicomico Health Department is aware of communication barriers with non-English speaking

poultry workers and took steps to address including: (IMAT-A) o Messaging via flyers and website in Haitian Creole, Korean, and Spanish o Using pictograms at plants and testing sites o Videos posted on the Wicomico County Health Dept. in multiple languages

➢ On April 27, 2020, Governor’s office officially requested via letter a Cost Share Adjustment by the State of Maryland under FEMA-4491-DR from 75% percent to 100% federal share. This request is in process, as of 5/3/2020. (IMAT-A, Governor’s Office)

(Source: IMAT-A Inputs, accessed 3:30 PM on 05/03/2020; MD Governor’s Office)


➢ Currently witnessing a doubling of confirmed cases every 17 (♦) days (Stay-at-Home Order issued on March 30). Percent of cases per day seem to be trending down as the effects of social distancing take place. Current mortality rate based off confirmed cases is 4.64% (▼.08%).

Date MD

Cumulative MD

Actuals MD %

4/20/2020 14193 509 4%

4/21/2020 14775 582 4%

4/22/2020 15737 962 7%

4/23/2020 16616 879 6%

4/24/2020 17766 1150 7%

4/25/2020 18581 815 5%

4/26/2020 19487 906 5%

4/27/2020 20113 626 3%

4/28/2020 20849 736 4%

4/29/2020 21642 893 4%

4/30/2020 23472 1730 8%

5/01/2020 24473 1001 4%

5/02/2020 25462 989 4%



4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A, HHS LNO, MD: State Health Operations Center as of 5/3/2020 4:00 pm)

ITEM Total in State

Total Daily

Usage

Total anticipated

need for next 14-

days


day supply)

State Provided


Total actual

federally requested


received

Gloves

465,090

692,381

9,693,334 (9,228,244)

132,900

1,330,540

426,890

Gowns

111,492

323,346

4,526,844 (4,415,352)

55,582

2,966,770

65,922

Surgical Masks

4,908,100

372,858

5,220,012 (311,912)

4,518,250

2,515,500

465,500

N-95 Masks

2,236,010

162,706

2,277,884 (41,874)

23,210

4,071,532

2,229,185

Face Shields

181,434

27,678

387,492 (206,058)

1,151,361

831,595

81,373

Goggles

300 -

-

300

10,734

100,000 -

Coveralls

12,048 -

-

12,048

12,915

1,975

348

Resource Allocation Strategy Prioritization Algorithm (50% Local Health, 40% MD DOH and 10% MD Institute for Emergency Medical Service Systems) as of March 25.

➢ 5/3 - KN05 mask shipment added to N95 total

5. Non-Personal Protective Equipment (Source: R3 Ops: NONPPE Report, Received 5/3/2020 4:00 pm)



Battelle Decon System 04/05/2020 2629-170419 NRCC Complete

Body Bags - 15,000 03/18/2020 2629-109777 NRCC Approved/Ordered

Body Bags - 15,000 03/22/2020 2629-117780 NRCC Approved/Ordered

Emergency Medical Assistance Teams 04/07/2020 2629-178507 R3 Approved/Ordered

FMS - Baltimore 03/20/2020 2629-112501 R3 Complete

Inhalation Water Bags 04/22/2020 2629-229469 R3 Assigned to R3 for Action

Laboratory Support 04/28/2020 2629-245365 R3

On Hold Pending Information from HHS

Medical/Test Supplies 03/22/2020 2629-117743-002 R3 Complete

Medical/Test Supplies 03/31/2020 2629-149454 NRCC Assigned to NRCC for Action





Medical/Test Supplies 04/27/2020 2629-243092 NRCC Assigned to NRCC for Action

Pharmaceuticals 04/03/2020 2629-160919 NRCC On Hold per State

Pharmaceuticals 04/09/2020 2629-187237 NRCC Rejected - SNS Cannot Support



Pharmaceuticals 04/09/2020 2629-187223 NRCC Complete



Pharmaceuticals 04/09/2020 2629-187151 R3 Rejected - SNS Cannot Support







6. Hospital Capacity & Ventilators (Source: COVID-19: Maryland Hospital Status Report, received 05/02/20)




Available

Actuals 3,379 (▲92) 1,601 (▲31) 805 (▲5) 317 (▼38)

(Source: COVID-19: Maryland Hospital Status Report, received 05/02/20)

VENTILATORS Total

Ventilators





Actuals 1,390 (▲91) 715 (▲137) 50♦ 470♦ 1,096♦

NOTES: ➢ Data on ventilators from EMAC & ventilators requested provided by HHS Regional Emergency

Coordinator; data on ventilators from SNS provided by Ventilators Shipped to States report



Battelle Unit Location ➢ 2501 Broening Highway

Baltimore, MD 21224 POC: Todd Gregg, 410-387-3673

o Status: Operational and accepting PPE o Processed 10,749 masks since April 29 o 63 facilities registered (IMAT-A)

7. Alternate Care Site (ACS) (Source: R3 ACS Ops Tracker, retrieved 05/03/20 4:12 pm; MD IMAT-A Inputs, received 05/03/20 3:54 pm)


Date

Max # Bed Spaces (Non-

COVID-19)

Baltimore Convention Center

1 West Pratt Street Baltimore, MD 21201

Open Opened

April 18, 2020 250 (FMS Site)

Washington Adventist Hospital

7600 Carroll Avenue Takoma Park, MD 20912

Pending Buildout TBD 310

Hagerstown Correctional Bldg. 192 (inmates only)

18601 Roxbury Rd. Hagerstown, MD 21746

Pending Buildout TBD TBD

University of Maryland Laurel Medical Center

7300 Van Dusen Road Laurel, MD 20707

Open Opened

April 22, 2020 135

W.L. Gore Building Cecil County, MD Pending Buildout TBD TBD

NOTES: ➢ The W.L. Gore Building in Cecil County has been selected by MD to serve as a state-run ACS;

Durable Medical Equipment sent 05/01/20. (IMAT-A) ➢ Washington Adventist Hospital started construction 04/30/20; will take 4 weeks in 50 bed

increments. (IMAT-A) ➢ Additional ACSs are being scoped, including Chesapeake College (again), Ocean City area (in

case of tourist season population increase), and a site on the lower Eastern Shore (due to the poultry industry’s major COVID-19 outbreak). (IMAT-A)

➢ MD continues to address the COVID-19 threat to corrections facilities; re-scoping is happening for the Hagerstown Correctional Facility Statement of Work. (IMAT-A)

https://goo.gl/maps/F5qKCX57iRzmup4V8

https://goo.gl/maps/F5qKCX57iRzmup4V8



8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – MD.docx, Received 04/23/2020 4:33 pm)* *No Fatality Management Task Force Updates as of 05/03/2020.

Maryland

Item

Amount Procured by State


Amount in Use

Total in State



Unknown 15,000 on site (RRF 2629-109777)

Varies

Varies (Donating 1k to VA; processing request from Nassau Co, NY)

N/A


N/A

N/A [2 Refrigerated Trailers (RRF: 2629-168024-008) returned to FEMA]

Mass Fatality Site is open as of 4/23

Unknown N/A


N/A N/A Varies

OCMD/TMAC/ Approx. 1k licensed funeral directors/morticians within MD

N/A


Unknown N/A N/A Various 6k cremation boxes

Notes: Per the HHS LNO, “current projections indicate that extant capability in the MD mortuary system is capable of normal process final disposition; temporary internment is not anticipated at this time” “Hospitals have been advised to maximize their extant decent storage and larger hospitals have added refrigerated trailers to supplement their internal capacity” “Current mortuary transport services within MD are anticipated to be capable of accommodating the surge…backup National Guard mortuary affairs soldiers are available for a 48-hour stand up should the current mortuary transport system be strained by volume”







TESTING NOTES: (Source: IMAT-A Inputs, retrieved 5:00 PM on 05/03/2020, MD Governor’s Office)

➢ MD DOH will launch a new VEIP COVID testing site in Hagerstown Tuesday 5/5. Active sites include: Glen Burnie (Anne Arundel), Waldorf (Charles), Bel Air (Harford), White Oak (Montgomery), Columbia (Howard), Prince Frederick (Calvert), Owings Mills (Baltimore County) (IMAT-A)



➢ Multi discipline “Go Team” for nursing homes/assisted living facilities have: (IMAT-A) o Visited 37 nursing facilities to date o Have contacted 135 of 227 nursing homes as part of the telephonic assessment

process o Visited lab 5/3 about operations and logistics of long-term care testing; returning

tests to labs; ensuring data makes its way back to case surveillance and investigation

o Standing up “Bridge Team” training on 5/4 for all 24 teams o A plan to ramp up efforts on 5/4 to test all staff and nursing home patients per the

Governor’s order ➢ Amick Farms plans on doing their own testing, and has capability (IMAT-A) ➢ Perdue wants to do their own testing, does not have access to testing, but is planning

on finding access. Perdue is asking employees for details regarding employee’s position in the plant, and if there is any past history of employee being tested, and if those test results were positive or negative compared to current results. (IMAT-A)

➢ Tentative Plans for Mobile Testing Eastern Shore, MD (IMAT-A) o Meeting Monday 5/4 to finalize plans for the rest of the week o Haitian Creole church later in the week o Plants later in the week o One mobile testing per day (1300-1500 or 1500-1700) o Starting either Tuesday 5/5 or Wednesday 5/6. Assess turnout before

determining if needed on Saturday 5/9. ➢ Testing Perdue Stadium - Testing Dates: Friday, 5/1 & Saturday, 5/2 (IMAT-A)

o Currently in possession of 2,000 tests o Able to get 3,000 more if needed within a 24hr request to the lab o Testing is open to all of the community – not just poultry workers, meaning no work ID is

required o According to MDH estimations, we anticipate conducting approximately 320 per day

➢ MD State Lab is expanding courier services and lab hours to support Eastern Shore testing. The White House is rushing tests for a platform that can run 1000 tests a day, should come out in May – asked if State Lab knew other labs that have this platform – there are several in the state. (IMAT-A)

➢ New poultry-related testing sites update: o Perdue Stadium 6400 Hobbs Rd, Salisbury MD 21804, went live on Friday 05/01/2020 o Perdue Farms 521 Willow St., Salisbury, MD 21801, goes live on Tuesday 05/05/2020 o Amick Farms 247 Nealson St, Hurlock, MD 21643, goes live on Tuesday 05/05/2020 or

Wednesday 05/06/2020 TBD. (IMAT-A)




➢ National Guard Activation Status: Activated; 1,338 (♦) Personnel. ➢ 4491DR-MD-DOD-01, T32 Activation for Maryland approved; all amendments approved ➢ USACE build out of Hagerstown Correctional Facility is expected to be complete 4 May. ➢ Regarding MD’s request to MRNMMC to provide 100k isolation gowns for distro to local

hospitals, DCE has coordinated the request with Defense Health Agency who has no objections to the transfer. DCE coordinating with DOD LNOs at the NRCC for a decision on whether DOD would authorize the transfer vs redistributing this excess PPE throughout DOD medical facilities / organizations.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 at 2:00 pm)

IGA ➢ NSTR


• NSTR

➢ Closed inquiries

• Sen. Cardin: Inquired what type of state and local reimbursements are available from FEMA? Questions pertained to reimbursement for testing supplies since MEMA is acquiring these commercially. Sen. Cardin’s office is looking to see if it is possible for localities to be reimbursed quickly. The inquiry was sent to the Recovery/PA program area. PA Fact Sheet and appropriate guidance was provided. Specifically, proper PA eligibility was discussed. Closed 4/30




FEMA-4491-DR-MD FEMA-4491-DR-MD


416X-PUBLIC ASSISTANCE $1,618,348 $618,347


21XX-TRAVEL Total $84,700 $14,760

22XX-TRANSPORTION Total $3,000,500 $500



2501-MISSIONS-FOS Total $750,000 $0






Total $126,645,077 $43,588,049


May 4, 2020 PA-1 of 10



PENNSYLVANIA

1. Hot Issues ➢ In a press briefing on 5/1, the Governor announced the partial reopening of 24 counties

beginning May 8. (see Section 2 for more details) (Governor’s Office)

➢ The Temple ACS location discharged its final patient on 5/3. Temple ACS location will stand down the week of 5/4 and go into a standby status, anticipated to remain idle until 7/1. (IMAT-A and PA SEPLO SitRep 20200502)

2. State Issues



2,418 (▲223) ▲= Difference since May 1 SitRep

FEMA Declaration:

FEMA-4506-DR Amendment 001 Individual Assistance limited to the Crisis Counseling Program for all areas in the Commonwealth of Pennsylvania, 4/30


LNO: Yes (1) Federally supported, Locally managed: 1 (♦0)


NG 502(f) Status: Approved. PANG has indicated their intent to request an extension for 502f status through 6/30. (DCE SitRep)

Stay-at-Home Order

Stay-at-Home Order for the entire commonwealth until May 8. Philadelphia’s Stay-at-Home Order in effect indefinitely. Both exempt essential activities. Starting on May 8, the order may be lifted/relaxed slowly for some counties, following a tiered 3-phase approach. Starting Friday, May 1, golf courses, marinas, guided fishing trips, and privately-owned campgrounds may reopen statewide and are required to follow updated life-sustaining business guidance.

K-12 Schools Public, private and charter schools closed for the remainder of the 2019-20 academic year.

https://www.fema.gov/disaster/notices/dr-4506-pa-amendment-001

https://www.governor.pa.gov/process-to-reopen-pennsylvania/

Region 3 Situation Report for Pennsylvania


May 4, 2020 PA-2 of 10


Non-essential businesses closed indefinitely, except telework. Some non-essential businesses in certain counties may be allowed to reopen on May 8, following a tiered 3-phase approach. Construction will resume commonwealth-wide on May 1. Businesses allowed to stay open must enforce specific social distancing and face mask rules.


Restaurants and bars are restricted to delivery and take-out only. Workers and customers must follow specific social distancing and face mask rules. Starting on May 8, the restrictions may be lifted/relaxed slowly for some counties, following a tiered 3-phase approach.


Gatherings of 10 or more people are strongly discouraged. Starting on May 8, the guidance or rules for gatherings may be relaxed in some counties, following a tiered 3-phase approach.

Travel Restrictions

Non-essential travel prohibited. Starting Friday, May 1, golf courses, marinas, guided fishing trips and privately-owned campgrounds may reopen statewide and are required to follow updated life-sustaining business guidance.

➢ In a press briefing on 5/1, the Governor announced the reopening of 24 counties beginning May 8. The counties are Bradford, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Elk, Erie, Forest, Jefferson, Lawrence, Lycoming, McKean, Mercer, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga, Union, Venango, and Warren. On Monday, May 4, the administration will release guidance for businesses permitted to reopen on May 8 in these 24 counties. (Governors Office)

o Work & Congregate Setting Restrictions ▪ Telework Must Continue Where Feasible ▪ Businesses with In-Person Operations Must Follow Business and Building

Safety Orders ▪ Child Care Open Complying with Guidance ▪ Congregate Care and Prison Restrictions in Place ▪ Schools Remain Closed for In-Person Instruction

o Social Restrictions ▪ Stay at Home Order Lifted for Aggressive Mitigation ▪ Large Gatherings of More than 25 Prohibited ▪ In-Person Retail Allowable, Curbside and Delivery Preferable ▪ Indoor Recreation, Health and Wellness Facilities and Personal Care

Services (such as gyms, spas, hair salons, nail salons and other entities that provide massage therapy), and all Entertainment (such as casinos, theaters) Remain Closed

▪ Restaurants and Bars Limited to Carry-Out and Delivery Only ➢ The Temple ACS location discharged its final patient on 5/3. Temple ACS location will

stand down the week of 5/4 and go into a standby status, anticipated to remain idle until 7/1. (IMAT-A and PA SEPLO SitRep 20200502)






May 4, 2020 PA-3 of 10

➢ On 4/30, The Governor’s office is allowing golf courses, marinas and private campgrounds to re-open 5/1/20. State parks will remain closed until 5/14/20. Businesses must adhere to all CDC Guidelines. It was also announced that hospitals may resume elective surgeries, procedures, and admissions. (IMAT-A)

➢ State currently leaning forward on planning efforts for potential future surge in the fall. PA currently has a draft Mobile Community Testing Plan for surge capabilities. The plan will be a rapid deployment concept to be stood up within 24 hours with a planned operation period of 24 hours. Multiple applications are being explored including drive through, walk-up and support to Long-Term Care (LTC) facilities. (IMAT-A)

(IMAT-A Inputs, accessed 3:45 pm 05/03/2020, PA Governor’s Office, PA SEPLO SitRep 20200402 12pm)


➢ Currently witnessing a doubling of confirmed cases every 23 (▲2) days (commonwealth-wide Stay-at-Home Order issued April 1). Percent of cases per day seem to be trending down as the effects of social distancing take place. Current mortality rate based off confirmed cases is 5.01% (♦).

4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A, HHS LNO, PA: State Health Operations Center as of 5/3/2020 4:00 pm)

ITEM Total in

State

Total Daily

Usage

Total anticipated

need for next 14-days


day supply)

State Provided


Total actual federally

requested


received

Gloves -

456,784

6,394,976

(6,394,976)

363,000

4,436,984

473,725

Gowns -

130,416

1,825,824

(1,825,824)

55,698

1,212,173

86,304

Surgical Masks

-

189,802

2,657,228

(2,657,228)

386,000

869,210

328,500

N-95 Masks

1,346,665

134,468

1,882,552

(535,887)

1,839,000

615,292

112,250

Date PA Cumulative PA Actuals PA %

4/19/2020 32384 1215 4%

4/20/2020 33232 948 3%

4/21/2020 34528 1296 4%

4/22/2020 35684 1156 3%

4/23/2020 37053 1369 4%

4/24/2020 38652 1599 4%

4/25/2020 40049 1397 4%

4/26/2020 41165 1116 3%

4/27/2020 42050 885 2%

4/28/2020 43264 1214 3%

4/29/2020 44366 1102 3%

4/30/2020 45763 1397 3%

5/1/2020 46971 1208 3%

5/2/2020 48305 1334 3%



May 4, 2020 PA-4 of 10

Face Shields

-

273,004

3,822,056

(3,822,056)

62,400

2,414,433

110,880

Goggles -

1,230

17,220

(17,220)

- - -

Coveralls -

84,776

1,186,864

(1,186,864)

3,408

699,090

480

Resource Allocation Strategy Tiered Approach (Long term care, health care, quarantine and isolation facilities, homeless and congregate living) as of March 28.

➢ State provided resources are as of April 9. The state is procuring; however, delivery dates are projected and are outside 3-4 weeks.

➢ The “Total in State” numbers represent what is in the warehouse; minus the items that, although still in the warehouse, are committed for distribution to a specific site and no longer counted as on hand inventory.” per IMAT A Planner (Read) and TL (Cribben).

N95s Gowns Procedure

Masks Gloves

Face Shields

Hand Sanitizer

Body Bags Coveralls

1,165,248 54,280 236,020 212,200 88,200 178,664 2,484 83,461

(Source: PA DOH SITREP 5/2/2020; Received 5/3/2020)

➢ The Dept of Health SitRep numbers are provided by DOH Logistics Section and represent all PPE items currently in the warehouse at the moment the SitRep is prepared, per IMAT A Planner (Read) and TL (Cribben).

5. Non-Personal Protective Equipment (Source: R3 Ops: NONPPE Report, Received 5/3/2020 4:00 pm)



ACS Staffing 04/06/2020 2630-173297 NRCC Approved/Ordered

Battelle Decon System 04/05/2020 2630-171066 R3 Complete

Blankets - 10,000 04/02/2020 2630-154971-004 NRCC Complete

Body Bags - 7,500 04/02/2020 2630-154978 NRCC Complete

Cots - 400 04/02/2020 2630-154971-001 R3 Cancelled

Cots - 50 04/02/2020 2630-154971-002 R3 Cancelled

DOD Medical Personnel 04/15/2020 2630-209549 R3 Approved/Ordered

FMS - 2 04/03/2020 2630-158013 R3 Assigned to DOD for Action

FMS - Glen Mills 03/23/2020 2630-119722 NRCC Complete

FMS - Philadelphia 03/22/2020 2630-119779 NRCC Complete

Meals - 291,270 03/28/2020 2630-134411 NRCC Complete


Medical Staffing 04/21/2020 2630-227033 NRCC Assigned to NRCC for Action

Medical/Test Supplies 03/17/2020 2630-117032-002 NRCC Complete

Medical/Test Supplies 03/22/2020 2630-115580-001 NRCC Assigned to NRCC for Action



May 4, 2020 PA-5 of 10




Pharmacy Cache - 1 03/27/2020 2630-132668 NRCC On Hold by HHS

Qualitative Fit Test Kits 03/06/2020 2630-117562 R3 Assigned to R3 for Action


USACE Support for ACS Task Force

03/18/2020 2595-109523 R3 Approved/Ordered

6. Hospital Capacity & Ventilators (Source: 5.2 PA PPE Burn Rate and Beds COVID-19, received 05/03/2020 6:54 am)




Available

Actuals 19,859♦ 7,247 (▼175) 4,503♦ 1,391 (▼43)

(Source: PA Department of Health’s Hospital Preparedness Dashboard as of 05/03/20 5:21 pm)

VENTILATORS Total

Ventilators





Actuals 5,344 (▲4) 3,947 (▲16) ♦ ♦ 0♦

NOTES: ➢ Data on Total Ventilators & Ventilators Available provided by the PA Hospital Preparedness

Dashboard; all other data provided by the Region 3 NONPPE Report Battelle Unit Location

➢ 54 Conchester Road Glen Mills, PA 19346 POC: Tim Sevinson, 717-756-5038

o Status: Operational as of Afternoon 5/1 o Approximately 141 vendors have registered for participation (IMAT-A)

https://www.arcgis.com/apps/opsdashboard/index.html#/85054b06472e4208b02285b8557f24cf



May 4, 2020 PA-6 of 10

7. Alternate Care Sites (ACS) (Source: R3 ACS Ops Tracker, retrieved 04/30/2020 10:16 pm; PA IMAT-A Input, retrieved 05/03/20 6:35 pm)

Site Address/BLDG

Number Site Status Operational Date

Max # Bed Spaces (Non-COVID-19)

Glen Mills School 185 Glen Mills Rd. Glen Mills, PA 19342

Pending Open TBD 265

Temple University - Liacouras Center

1776 N. Broad St. Philadelphia, PA

Open Opened on April

13, 2020

221 beds; possible addt’l 250

State-provided

David Lawrence Convention Center

1000 Duquesne Blvd. Pittsburgh, PA


East Stroudsburg University

200 Prospect St. East Stroudsburg, PA 18301


NOTES: ➢ Temple Univ. Liacouras Center ACS discharged its final patient; there are currently 0 (▼3)

patients as of 5/3. Temple ACS will stand down the week of 5/4 and go into a “warm” status. (IMAT-A)

➢ The Glen Mills and East Stroudsburg University ACS sites are not open but are on standby; operational and ready to receive and treat patients on short notice. (IMAT-A)

➢ USACE and PA have come to a tentative agreement to have USACE do the buildout of the five (5) ACS previously identified. - Ellwood, St. Luke’s Hospital, Sunbury Community Hospital, York Memorial Hospital & Lancaster General Hospital. State legal currently working on use agreements; these locations are in a holding pattern. Other locations are being utilized prior to these 5 identified USACE/State locations.

➢ DOD Medical Task Force arrived and is on the ground for mission assignment. The 85-member team is supporting the Temple ACS location several hospitals within the Philadelphia Region; 33 PAX at the Temple ACS-CSF as of 5/3. (IMAT-A)

➢ State currently leaning forward on ACS planning efforts for potential surge in the fall. (IMAT-A)



May 4, 2020 PA-7 of 10

8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – PA.docx, Received 04/28/2020 3:26 pm)* *No Fatality Management Task Force Updates as of 05/03/2020.

Pennsylvania


by State


Amount in Use

Total in State



Unknown 7,500 Varies Varies N/A (Has 2,848 in excess)


1139 (morgues), 192 (PSCA assets), BEMS has regionally-staged cooling tents

N/A

PEMA relocated trailers to Delaware County

33 refrigerated trailers, 23 staged at FIG. The Coroners Association has 4 trailers and the PANG in Pittsburgh has an additional 2 trailers. There is also an option for 15 trailers used for food storage to be utilized.

N/A (hospital storage but not nursing home storage)


Pennsylvania State Coroners Association, National Guard assets

N/A PANG assets supporting SEPA

Varies N/A


Unknown N/A Unknown Varies N/A

Notes: PEMA created the Fatality Management Response in a Pandemic Environment: Concept of Operations Plan and Action Steps Plan Based on COVID-19 Pandemic 2020. The Medical Examiner/Coroner is responsible for managing mass fatalities. The surge trigger is a CDC death rate of 2.4 deaths per day per 100,000 population. The state is not looking at temporary internment as an option. PA has identified a delay in the processing of death certificates and has requested volunteers to help decrease the processing time.



May 4, 2020 PA-8 of 10





TESTING NOTES: (Source: IMAT-A Inputs accessed 3:45 PM on 05/03/2020)

➢ Two state supported testing sites are open (Mohegan Sun and Montgomery County Community College. (IMAT-A)



May 4, 2020 PA-9 of 10


➢ National Guard Activation Status: Activated; 1220 (▲2) Personnel. ➢ 4506DR-PA-DOD-01, Dover AFB as a FEMA FSA approved; extended to 25 May ➢ 4506DR-PA-DOD-04, T32 Activation for Pennsylvania approved; all amendments approved

o T32 502(f) approved to 31 May, no additional funding; additional 150 personnel approved (900 total)

o PANG has indicated their intent to request an extension for 502(f) status through 30 Jun 2020

➢ 4506DR-PA-DOD-05, Med Aug for medical support to ACS in East PA approved o MATO 1: Identified the Temple University ACS as the primary work site o MATO 2: Adds additional work sites at five local hospitals

➢ UAMTF 352-1 is developing a demobilization plan with Philadelphia OEM. Tentative plan is to begin demob on 12 May following the Temple ACS shut down. Anticipate UAMTF SMs supporting local hospitals to demob at the same time; pending approval by PEMA.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 2:00pm)

IGA ➢ NSTR


• NSTR



May 4, 2020 PA-10 of 10


FEMA-4506-DR-PA FEMA-4506-DR-PA ALLOCATIONS OBLIGATIONS

416X-PUBLIC ASSISTANCE $6,359,926 $6,359,925


21XX-TRAVEL Total $113,800 $75,905

22XX-TRANSPORTION Total $1,078,600 $7,812

23XX-RENT, COMM, UTILITIES Total $514,125 $380,606


2501-MISSIONS-FOS Total $800,000 $77,822

25XX-OTHER SERVICES Total $631,000 $376,034





Total $98,705,089 $60,372,529


VA-1 of 9

May 4, 2020



VIRGINIA

1. Hot Issues ➢ As of 5/1 VDEM is recommending cancelling plans for the Alternate Care Facilities

(ACFs) in northern Virginia and Richmond. (IMAT-A)

2. State Issues




FEMA Declaration:

FEMA-4512-DR Amendment 001 Individual Assistance limited to the Crisis Counseling Program for all areas in the Commonwealth of Virginia, 4/30




NG 502(f) Status: Approved. VANG is drafting letter requesting T32 502f status continuation through 12/31. (DCE SitRep)

Stay-at-Home Order

Stay-at-Home order for the entire commonwealth until June 10, except for essential activities. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth). Hospitals and dentists will be allowed to resume non-emergency procedures as of midnight Thursday, April 30.

K-12 Schools Schools closed for remainder of the 2019-20 academic year. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth).


Non-essential businesses must follow a 10-patron limit and social

https://www.fema.gov/disaster/notices/dr-4512-va-amendment-001

https://www.governor.virginia.gov/newsroom/all-releases/2020/april/headline-856337-en.html





Region 3 Situation Report for Virginia


May 4, 2020 VA-2 of 9

distancing rules, until May 8. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth).


Restaurants and Bars restricted to delivery and take-out only until May 8. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth).


Gatherings outside the home restricted to fewer than 10 people until May 8. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth). May General and Special Elections delayed by two weeks, from May 5, 2020 to May 19, 2020. June primary elections from June 9, 2020 to June 23, 2020.

Travel Restrictions

• No residents should travel out-of-state unless necessary.

• Those who have traveled out-of-state should self-quarantine for 14 days. (See Governor’s April 24 “Forward Virginia” phased approach to re-opening the Commonwealth)

➢ As of 5/1 VDEM is recommending cancelling plans for the Alternate Care Facilities (ACFs) in northern Virginia and Richmond. (IMAT-A)

➢ Poultry Working Group met on 5/1. IMAT-A representative fully integrated. The group changed their name to “Poultry Plant Working Group.” (IMAT-A)

(Source: VA IMAT-A Inputs, retrieved 4:00 PM on 05/03/2020; Governor’s Office)


➢ Currently witnessing a doubling of confirmed cases every 16 (♦) days (Stay-at-Home Order was issued on March 31). Current mortality rate based off confirmed cases is 3.53% (▲.06%).

Date VA

Cumulative VA

Actuals VA %

4/20/2020 9630 640 7%

4/21/2020 10266 636 7%

4/22/2020 10998 732 7%

4/23/2020 11594 596 5%

4/24/2020 12366 772 7%

4/25/2020 12970 604 5%

4/26/2020 13535 565 4%

4/27/2020 14339 804 6%

4/28/2020 14961 622 4%

4/29/2020 15846 885 6%

4/30/2020 16901 1055 7%

5/01/2020 17731 830 5%

5/02/2020 18671 940 5%












May 4, 2020 VA-3 of 9

4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A, HHS LNO to VDEM and VEST as of 5/3/2020 4:00 pm)

ITEM Total in

State Total Daily

Usage

Total anticipated

need for next 14-

days


day supply)

State Provided


Total actual

federally requested


received

Gloves

5,536,515

248,500

3,479,000 2,057,515

599,800

-

386,976

Gowns

44,976

66,383

929,362 (884,386)

233,949

96,293

82,620

Surgical Masks

2,451,317

372,432

5,214,048 (2,762,731)

318,508

-

510,221

N-95 Masks

1,116,136

155,231

2,173,234 (1,057,098)

477,551

174,162

390,208

Face Shields

85,466

208,926

2,924,964 (2,839,498)

240,700

304,740

101,035

Goggles

196,581

8,054

112,756 83,825

10,006

53,778 -

Coveralls

27,171

13,289

186,046 (158,875)

-

224,685

2,057

Resource Allocation Strategy Prioritization (60% Healthcare Facilities, 20% Local Health Districts, 15% EMS, and 5% to be held in reserve) as of March 24.

➢ With coordination between FEMA/HHS/VA to get a justifiable RRF we started using a calculator to adjust for missing PPE data. As the survey results become more accurate, we will be using PPE burn rate averages in place of the previous calculated results. The Total in State column is determined via the daily surveyed medical facilities on hand PPE in addition to total combined VDH/VDEM on hand warehouse inventory per IMAT A rep.

➢ State provided resources do not represent cumulative ordered PPE, but daily amounts ordered. Updated amounts only display on previous day close of business. If no PPE ordered then previously ordered amounts show, see date in source. No updates on Sat/Sun.

5. Non-Personal Protective Equipment (Source: R3 Ops: NONPPE Report, received 5/3/2020 4:00 pm; VA IMAT-A Inputs)



Battelle Decon System 04/07/2020 2631-178556 NRCC Complete

Battelle Decon System 04/07/2020 2631-178513 NRCC Approved/Ordered

Battelle Decon System 04/07/2020 2631-178496 NRCC Approved/Ordered



Medical/Test Supplies 03/22/2020 2631-117417 NRCC Complete

Pharmaceuticals 04/24/2020 2631-235766 NRCC Approved/Ordered



May 4, 2020 VA-4 of 9



Pharmacy Cache - 1 04/06/2020 2631-176252 NRCC On Hold - none available




6. Hospital Capacity & Ventilators (Source: RE: Virginia Roll Up Report 5/3/2020, received 05/03/20 9:58 am)




Available

Actuals 11,569♦ 3,554 (▲149) 1,774♦ 597 (▼111)

(Source: RE: Virginia Roll Up Report 5/3/2020, received 05/03/20 9:58 am)

VENTILATORS Total

Ventilators





Actuals 2,953 (▼29) 2,361♦ ♦ ♦ 0♦

➢ Data on ventilators from EMAC, ventilators from SNS, and ventilators requested per the Region 3 NONPPE Report

Battelle Unit Locations

1. 821 Southgate Drive Blacksburg, VA 24061 POC: Jason Eaton, 804-674-2400

o Status: Arrived 4/29, 80% offloaded as of May 1

2. 2401 G Avenue Newport News, VA 23602 POC: Jason Eaton, 804-674-2400

o Status: Expected delivery May 2

3. 10300 Courthouse Road Chesterfield, VA 23832 POC: Robert Paxton, 804-629-4031

o Status: Expected delivery May 4 VEST is currently developing plans for how the masks will be collected and transported to the Battelle Units. (IMAT-A)



May 4, 2020 VA-5 of 9

7. Alternate Care Site (ACS) (Source: R3 ACS Ops Tracker, retrieved 05/03/20 9:08 pm; IMAT-A Inputs, received 05/03/2020 8:59 pm)



(Non-COVID-19)

Hampton Roads Convention Center

1610 Coliseum Drive Hampton, VA 23666

Site Approved 04/01/2020

ON HOLD

560 (♦)

Richmond Convention Center

Richmond Convention Center 403 N 3rd Street Richmond, VA 23219


758 (♦)

Dulles Expo Center 4320 Chantilly Shopping Center Chantilly, VA 20151


483 (♦)

➢ Virginia continues to use the title Alternate Care Facilities (ACF) in lieu of ACS. (IMAT-A) ➢ Facilities are on hold indefinitely but preparations are being made for final lease

signing/contract execution (NOTE: As of 5/1, VDEM recommending cancelling plans for the ACFs in Northern Virginia and Richmond). Modeling data suggests that statewide hospital bed capacity will be sufficient in the immediate future; therefore, VA placed the 3 ACFs on hold and is planning a 3-pronged approach for Medical Surge to cover multiple scenarios:

1. Support and equip existing facilities; 2. Continue to plan for 3 large ACFs (listed above) up to point of contract execution; 3. Begin planning for smaller, more agile ACF units that can be stood up based on need

(200-bed “pop-up” facilities that can be stood-up quickly by VAARNG). o As of 5/1, ACF task force has identified five locations for potential “pop up”

ACFs; there is a bid out for 100 beds at each location: ▪ Greensville ▪ St Brides CC ▪ Beaumont - Powhatan ▪ North Housing - Powhatan ▪ Green Rock CC

o Next steps needed for ACFs to become operational: ▪ Site surveys ▪ VANG standing by for manpower requests ▪ Facilities will need to determine infrastructure needs ▪ Determine where the supplies are going to be delivered and stored. (IMAT-A)



May 4, 2020 VA-6 of 9

8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – VA (April 29).docx, Received 04/28/2020 3:39 pm)* *No Fatality Management Task Force Updates as of 05/03/2020.

Virginia


by State


Amount in Use

Total in State



Receiving 1,000 as a donation from Maryland. 4885 large, 421 bariatric, 1053 pediatric

N/A Varies Varies N/A


The state has the ability to contract for refrigerated trucks. The state is also identifying cold-storage centers.

N/A Varies 585 spaces,

up to 659 emergency

N/A


Virginia Funeral Directors Association (VFDA) Disaster Response Team. Additional staff from DMORT, VFDA, private sector, military and VDH may be sought for WMD events.

N/A Varies Varies N/A


Unknown N/A Unknown Unknown N/A

Notes: VA is in the process of forming a state-wide Fatality Management Task Force and is submitting a survey to be filled out. 50 funeral homes completed the survey. The Office of Chief Medical Examiner (OCME) is broken out into four districts (Northern, Western, Central, Tidewater). Per Appendix 8 (Pandemic Influenza Plan 2020) of the VDEM Emergency Response Plan: The capacity of existing hospital and funeral home morgues within the state would likely be exceeded in the first few weeks of the initial wave of pandemic activity. The decedent’s next of kin has authority on final disposition of the body (VA §32.1 – 283); however, if the Virginia State Health Commissioner, in consultation with the Governor, deems remains are hazardous and a risk to public health, the Commonwealth will be responsible for the handling, identification, and disposition of the remains (VA §32.1 – 288.1). Unclaimed bodies are remains that are not claimed by next of kin after 10 days. In these circumstances, a court order defines that law enforcement of the decedent’s locality of residence has legal authority of the remains and can make decisions on final disposition.



May 4, 2020 VA-7 of 9



Swabs 15,000 VDEM confirmed receipt (IMAT-A)

Vials TBD (Source: FEMA Logistics, received 8:54 AM on 04/30/2020, IMAT-A 05/01/2020 at 5:24 PM)

TESTING NOTES: Source: (IMAT-A inputs 05/03/2020 at 4:00 PM; 03May2020VESTSituationReport,pdf.

➢ Testing is now top priority of Governor to fully support the “Forward Virginia” Blueprint. (IMAT-A)

➢ VA National Guard has been trained to conduct testing (IMAT-A) ➢ The Virginia National Guard is actively deploying and supporting testing missions at

congregate and community settings throughout the state. (VEST)



May 4, 2020 VA-8 of 9

➢ FEMA is providing Virginia with 235,000 swabs and 176,250 transport media for testing in May. These totals will be distributed in weekly shipments. (VEST)

➢ An update on statewide testing efforts occurred during the Governor’s press briefing on Friday, 5/1. (VEST Report)


➢ National Guard Activation Status: Activated; 497 (▲9) Personnel. ➢ 4512DR-VA-DOD-01, T32 Activation for Virginia approved; all amendments approved.

o T32 502(f) Amendment approved to 31 May, no additional funding o Virginia National Guard is drafting letter requesting T32 502(f) status continuation

through 31 December 2020 ➢ The VANG’s Chemical Biological Radiological Nuclear High Yield Explosive Response

Force Package (CERFP) working with VDH to test first long-term care facility; lessons learned will be applied to train the teams.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 at 2:00 pm)

IGA ➢ NSTR


• NSTR ➢ Closed inquiries

• Sen. Cline: Inquired regarding guidance on how the Ronald McDonald House (RMH) could obtain a thermal scan thermometer in order to re-open. The staffer and RMH were referred to VDEM. Closed 4/30



May 4, 2020 VA-9 of 9


FEMA-4512-DR-VA FEMA-4512-DR-VA




21XX-TRAVEL Total $84,700 $8,286








IMMEDIATE NEEDS ASSISTANCE Total $0 $2,386


Total $225,994,998 $176,328,169

13. Miscellaneous ➢ COL Suzanne Hiscock (AFEPLO) and LT Thomas Teuschl (NEPLO) have both

demobilized from IMAT-A as of Friday 5/1. (IMAT-A) ➢ PAGS supporting Virginia State Feeding TF call on Monday 5/4. (IMAT-A) ➢ 73 RPAs submitted (expect this to rise after Applicant briefings). (IMAT-A)

➢ VA participated in a crisis counseling call on 5/1. (IMAT-A)

May 4, 2020 WV-1 of 8



WEST VIRGINIA

1. Hot Issues ➢ Governor announced on 4/29 that his “Stay at Home” executive order will be replaced

by a “Safer at Home” order effective Monday, 5/4. The order allows the opening of some businesses and personal services. Restaurants can offer outdoor meals and healthcare services can also resume. It also recommends that the elderly and at-risk persons remain at home as much as possible. (IMAT-A and Governor’s Office)

2. State Issues




FEMA Declaration: FEMA-4517-DR Community Based Test Sites (CBTS)

LNO: Yes (1) Federally supported, Locally managed: 0 (♦0)


NG 502(f) Status: Approved. Governor requested an extension through 8/15. (DCE SitRep)

Stay-at-Home Order

Stay-at-Home Order for the entire state, until May 4, except for essential activities. Starting May 4, Safer at Home Guidelines apply. Travel for resumption of elective procedures at hospitals and dental and occupational therapy services allowed starting 4/30.

K-12 Schools

Public and private schools closed for the remainder of the 2019-20 academic year. Starting 4/30, daycare services across the state will be able to resume, provided that enhanced testing procedures are put in place at each of these facilities.


Across the entire state, non-essential businesses closed, except for telework, home-based, and businesses closed to public with fewer than 6 employees onsite. In 12 counties, all businesses must require employees to work from home to the maximum extent possible, and businesses allowed to stay open must enforce specific social distancing rules. Resumption of elective procedures at hospitals and dental and occupational therapy services is allowed starting 4/30. Starting May 4 as part of the Safer at Home order, small businesses may reopen if <10 employees and limited customer contact and interaction.

https://governor.wv.gov/Pages/Safer-at-Home.aspx

https://governor.wv.gov/News/press-releases/2020/Pages/COVID-19-UPDATE-Gov.-Justice-announces-that-





Region 3 Situation Report for West Virginia


May 4, 2020 WV-2 of 8


Restaurants and bars restricted to delivery and take-out only. Starting May 4 as part of the Safer at Home order, outdoor dining will be allowed.


Gatherings outside the home restricted to fewer than 10 people across the state. In 13 counties, gatherings are limited to 5 or fewer people. Starting May 4 as part of the Safer at Home order, allowable group size increases to 25.

Travel Restrictions

➢ Non-essential out-of-state visitors must self-quarantine for 14 days. ➢ State Police may monitor roads for travelers from areas of COVID-19

community spread. ➢ In 1 county (Hampshire), hotels, motels, and similar short-term rental

properties are barred from allowing guests to book a reservation of fewer than 14 days except in extenuating circumstances.

➢ Governor announced on 4/29 that his “Stay at Home” executive order will be replaced by a “Safer at Home” order effective Monday, 5/4. The order allows the opening of some businesses and personal services. Restaurants can offer outdoor meals and healthcare services can also resume. It also recommends that the elderly and at-risk persons remain at home as much as possible. (IMAT-A and Governor’s Office)

➢ Union representing federal correctional officers picketed Saturday, 5/2, in Morgantown over the transfer of inmates to COVID-19 quarantine sites at Federal Correctional Center in Gilmer, and the potential transfer to another quarantine site at FCC Hazelton. (IMAT-A)

➢ WVNG and WV Department of Education have distributed approximately 1.35 million meals to school children statewide. (IMAT-A)

➢ FEMA VAL assisting DHSEM with request for approximately 150k shelf stable meals for multiple counties throughout the state. (IMAT-A)

➢ WVNG and WVU has verified new HVAC sanitation technique has been verified as being 99.99% effective. Technique will continue to be tested and modified to determine effective future sanitation capabilities. (IMAT-A)

➢ First phase of Governor’s reopening plan begins with the resumption of elective procedures at hospitals and dental and occupational therapy services, starting 4/30. (IMAT-A and Governor’s

Office Press Release) (WV IMAT-A Input, retrieved 5:30 pm on 05/03/2020)





May 4, 2020 WV-3 of 8


➢ Currently witnessing a doubling of confirmed cases every 24 (▲2) days (Stay-at-Home Order issued on March 25) Percent of cases per day seem to be trending down as the effects of social distancing take place. Current mortality rate based off confirmed cases is 4.20% (▲.09%).

4. Personal Protective Equipment (Source: Input from PPE-Vent Data by IMAT-A and HHS LNO to WV: WVNG Warehouse Report and WV Hospital Assoc. Report; retrieved at 4:00 pm on 5/3/20)

ITEM Total in

State

Total Daily

Usage

Total anticipated

need for next 14-

days


day supply)

State Provided


Total actual

federally requested


received

Gloves

2,408,928

771,999

10,807,995

(9,639,382)

3,403,346

14,480,763

231,206

Gowns

9,697

33,977

475,682

(465,510)

39,166

1,081,528

45,773

Surgical Masks

615,831

95,466

1,336,518

(677,473)

643,520

1,170,808

320,539

N-95 Masks

207,313

28,778

402,898

(202,328)

306,737

453,999

96,101

Face Shields

225,215 - - -

211,458

229,427

81,459

Goggles

8,540

2,394

33,517

(24,072)

9,837

92,877 -

Coveralls

11,121 - - -

16,650

90,068

1,832

Resource Allocation Strategy

Prioritization (35% to hospitals, 40% to local health departments (EMS/Primary Care/Home Health), 15% to nursing homes and long-term care facilities, and 10% surge for WV DHHR as of March 31.

➢ The lack of data for face shields and coveralls is due to lack of reporting in these two categories from the WVNG and WV Hospital Association. (PPE Report)

Date WV

Cumulative WV

Actuals WV %

4/20/2020 908 18 2%

4/21/2020 929 21 2%

4/22/2020 963 34 4%

4/23/2020 981 18 2%

4/24/2020 1010 29 3%

4/25/2020 1044 34 3%

4/26/2020 1053 9 1%

4/27/2020 1077 24 2%

4/28/2020 1095 18 2%

4/29/2020 1109 14 1%

4/30/2020 1125 16 1%

5/01/2020 1169 44 4%

5/02/2020 1191 22 2%



May 4, 2020 WV-4 of 8

➢ Per IMAT-A counterpart, the daily usage and 14-day projections will be updated once a week when the hospitals are required to respond to the survey sent out by the WV Hospital Association. Additionally, the ‘State Provided’ column has not been provided by the state. The WV IMAT-A is working actively with the WVNG and WV Hospital Association. (PPE Report)

5. Non-Personal Protective Equipment (Source: R3 Ops: NONPPE Report, received 5/3/2020 4:00 pm)




Medical/Test Supplies 03/25/2020 2632-125635-001 NRCC Approved/Ordered

Medical/Test Supplies 03/25/2020 2632-125635-003 NRCC Complete

Medical/Test Supplies 03/27/2020 2632-131260-002

NRCC Assigned to NRCC for Action

Oximeters - 1,000 03/27/2020 2632-131651 R3

On Hold Pending Need Assessment

Pharmaceuticals 04/17/2020 2632-215137-001 NRCC Complete

Pharmaceuticals 04/17/2020 2632-215137-002-001 NRCC Assigned to HHS for Action

Thermometers - 96 04/01/2020 2632-150785 R3 On Hold Pending Need Assessment

6. Hospital Capacity & Ventilators (Source: RE: West Virginia Hospital Bed and Ventilator Count, received 05/03/2020 2:06 pm)




Available

Actuals 6,764 (▼47) 3,572 (▼96) 749 (▼18) 254 (▼13)

(Source: RE: West Virginia Hospital Bed and Ventilator Count, received 05/03/2020 2:06 pm)

VENTILATORS Total

Ventilators





Actuals 794 (▲27) 598♦ ♦ ♦ 75♦

➢ Data on ventilators from EMAC, ventilators from SNS and ventilators requested is per the Region 3 NONPPE Report

➢ Ventilators requested are currently on hold by HHS, pending allocation decision.



May 4, 2020 WV-5 of 8

7. Alternate Care Site (ACS) (Source: R3 ACS Ops Tracker, retrieved 05/03/2020 8:25 pm; WV IMAT-A Input, retrieved 05/03/20 8:26 pm)



(Non-COVID-19)

Charleston St. Francis Hospital 333 Laidley St. Charleston, WV 25301

Open Opened on 04/10/2020

75

➢ St. Francis is open / operational but has not treated any patients as of May 3. (IMAT-A)

➢ FEMA is coordinating with DHHR to use the emergency room of Fairmont Hospital as ACS. DHHR signed MOU with WVU Health; DHHR and FEMA/DHSEM PA setting up call to discuss potential eligibility. (IMAT-A)

➢ Sharpe Hospital in Weston is now operational as an ACS specifically for the treatment of psychiatric patients who’ve tested positive for COVID-19. Capacity is 16-18 beds. (IMAT-A)

8. Fatality Management (Source: Fatality Management Task Force: FMTF Tracker – WV.docx, Received 04/19/2020 4:40 am)* *No Fatality Management Task Force Updates as of 05/03/2020.

West Virginia


by State


Amount in Use

Total in State



7,000 (20,000 phased in over next ~month - is not COVID-specific, based on a regular contractual agreement with vendor)

N/A Varies 7,000 N/A


N/A N/A

(2) 20 pax trailers in use in Charleston (non-COVID related)

4 total, (2) 20 pax non-COVID & (2) 20 pax in reserve located in S. Charleston & Beckley

N/A


N/A N/A Unknown 300 funeral homes

N/A


Varies N/A Varies Varies Transportation (see notes)

Notes: WV is operating in a 38-40% non-COVID surge. Per the WV Supplement to Mass Fatality Annex, for a vast majority of cases involving COVID-19, the Office of the Chief Medical Examiner (WVOCME) would not assume jurisdiction, and therefore would be considered a



May 4, 2020 WV-6 of 8

West Virginia


by State


Amount in Use

Total in State


subject matter expert in assisting with proper movement and temporary storage of decedents. OCME recommended that 75% capacity of their facility could be used as a possible initial or subsequent trigger point. OCME processes approx. 24 cases a day with a capacity for 48. Long-term storage is not an expected shortfall. WVOCME maintains mobile refrigerated mortuary storage units for use as needed, but this temporary storage asset is currently limited to a capacity of 40 decedents total. The decision to make required changes to funeral services is outside the scope of the WVOCME mission. Portable cold storage capacity and exceeding surge capacity by the WVOCME will require additional asset requests through WVDHHR Health Command. The WVOCME maintains a list of transportation vendors that are utilized to conduct decedent transportation on a daily basis for the normal WVOCME daily caseload. If the reporting entity indicates the requirement for transportation exceeds the entity capacity, such report shall be referred to Health Command for proper investigation as quickly as possible.



May 4, 2020 WV-7 of 8





TESTING NOTES: (Source: IMAT-A Inputs, retrieved 5:20 pm on 05/03/2020)

➢ NSTR (IMAT-A)


➢ National Guard Activation Status: Activated; 701 (▼5) Personnel. ➢ 4517DR-WV-DOD-01, T32 Activation for West Virginia approved; all amendments approved

o 502(f) Amendment approved to 31 May, no additional funding.



May 4, 2020 WV-8 of 8

o WV has indicated their intent to request an extension for 502(f) status through 15 Aug 2020. If approved, this extension would give 165 WVNG a two-week extension (June 1 to 14) to allow for quarantine as needed. The remaining 300 WVNG would be extended until 15 AUG on 502(f) status to continue supporting COVID 19 response.

➢ WVNG will assist with testing since they have the first National Guard mobile testing laboratory certified through DOD.

11. External Affairs Report (Source: R3 EA Report, received 5/1/2020 2:00 pm) IGA

➢ NSTR


• NSTR



FEMA-4517-DR-WV FEMA-4517-DR-WV


416X-PUBLIC ASSISTANCE $198,456 $198,456


21XX-TRAVEL Total $84,700 $20,185








IMMEDIATE NEEDS ASSISTANCE Total $13,912,478 $13,364


Total $44,960,191 $8,791,331


Appendixes

• ASPR SITUATION REPORT

Region III COVID-19 Profile:

Cases, deaths, county hotspots, testing, ED

analysis, ventilator use, hospital capacity, and

KCER

May 1, 2020

UNCLASSIFIED//FOR OFFICIAL USE ONLY


2Saving Lives. Protecting Americans.

Summary• The 7-day death rate* for Region III rose since yesterday’s report by

approximately 8%

• 7-day death rate* rose from 50 to 54 per million population

• The 7-day death rate for each state in Region III rose in the same period

• A few counties in Virginia have had >100% increase in cases between 27Apr and 30Apr:

• Salem city had 136% increase (n=15)

• Northampton county had 129% increase (n=36)

• Roanoke city had 121% increase (n=40)

• The percent of new tests that are positive within the last 7 days varies within Region III

• High: Delaware, 21.4%; District of Columbia, 22.1%; Maryland, 19.9%; Pennsylvania, 15.8%; Virginia, 17.1%

• Low: West Virginia, 1.2%

• Maryland has increased its testing by 131% in the last 7 days compared to the previous 7 days



Note: All data are subject to reporting inconsistencies.

* A 7-day case or death rate is less sensitive to inconsistencies in reporting and will increase or decrease as the direction of the trend might change











































(Source: USAFacts)







(Source: USAFacts)






























• Presented hospital regions are selected from the top 100 hospital regions across the country, and may change over time

HospitalRegion RecentAvg RecentAvgPer100k JanFebAvg JanFebAvgPer100k Ratio

PA_Philadelphia 28.6 1.8 9.9 0.6 2.9

DE_Kent 3.3 1.8 1.2 0.7 2.8

VA_Manassas 5.3 12.7 2.2 5.2 2.5

VA_Alexandria 6.7 4.2 2.7 1.7 2.5

MD_Wicomico 3.0 2.9 1.3 1.3 2.3

MD_Harford 2.1 0.8 1.0 0.4 2.1

VA_Arlington 2.9 1.2 1.4 0.6 2.1

VA_Northampton 3.7 31.7 1.8 15.6 2.0

DC_District of Columbia 32.9 4.7 17.1 2.4 1.9

PA_Westmoreland 2.6 0.7 1.4 0.4 1.9

PA_Monroe 2.4 1.4 1.4 0.8 1.8

WV_Ohio 8.9 21.2 5.0 12.0 1.8

PA_Montgomery 8.9 1.1 5.3 0.6 1.7

PA_Butler 1.6 0.8 1.0 0.5 1.6

MD_Allegany 2.0 2.8 1.3 1.8 1.6

MD_Prince Georges 15.1 1.7 10.1 1.1 1.5

PA_Chester 4.7 0.9 3.2 0.6 1.5

MD_Carroll 6.0 3.6 4.2 2.5 1.4

MD_Montgomery 32.6 3.1 23.8 2.3 1.4

MD_Howard 3.9 1.2 2.9 0.9 1.3

VA_Fairfax_County 15.0 1.3 11.4 1.0 1.3

PA_Franklin 2.9 1.8 2.2 1.4 1.3

TOP HOSPITAL REGIONS WITH EMERGENCY DEPT VISITS (RATIO WITH JAN-FEB AVG)Data pulled from CDC ESSENCE on 04/30/2020; covering 04/20/2020 - 04/27/2020

Data has a 2-day lag to allow hospitals time to report, reducing inaccuracy

ED Visit Count - visits to a hospital emergency dept - Essence query is for number of ED patients with fever, cough, and short, difficult breath

ED Visit Count Per 100k - ED visit count per 100k population

Hospital Region -- NSSP is a collection of zip codes that closely approximate county boundaries in the vast majority of places. Certain cities are pulled from their

surrounding counties and made their own region.








Daily status of dialysis beneficiaries impacted by COVID-19KCER data, as of 30Apr2020, Region III

• KCER data may be inconsistently reported across facilities, resulting in interpretability issues (e.g., negative

counts)



COVID-19 Positive (+) Patients and Staff COVID-19 PUI TestingTested Negative (-) for

COVID-19COVID-19 Positives (+) that have Recovered

COVID-19 Positives (+) Deaths

State Patients

Patients admitted to hospital/ receiving

treatment in hospital

Patients receiving treatment in

outpatient facility

Home patients self-monitoring and

continuing home therapy Staff Patient PUIs Staff PUIs

Patients tested

negativeStaff tested

negativeRecovered

PatientsRecovered

StaffPatient Deaths Staff Deaths

Washington DC 65 33 17 1 0 44 0 30 0 2 1 4 0

Delaware 38 12 3 0 1 28 9 41 4 0 0 0 0

Maryland 256 77 117 10 35 235 50 224 58 29 0 34 0

Pennsylvania 461 159 121 18 49 343 120 431 114 55 7 47 0

Virginia 127 44 53 3 20 162 61 218 54 17 1 18 0

West Virginia 7 1 1 0 1 19 4 54 7 1 0 1 0

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