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Coronavirus in Maryland: 5 takeaways from the week

Maryland saw worrying increases in the number of confirmed cases of the coronavirus this week, and hospitalizations have been ticking up slightly.

But the state still recorded its testing positivity rate at 4.57% Thursday, with Johns Hopkins reporting it slightly higher than the recommended 5% threshold at 6.36%. The two entities calculate the positivity rate differently.

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Though the 14-day average of newly reported cases has increased, deaths have stayed fairly level. On Thursday, 585 people were listed as hospitalized for COVID-19, the disease caused by the virus. Hospitalizations are higher than in early July, but still much lower than the peak of 1,707 in May.

At a Wednesday news conference, Gov. Larry Hogan said Maryland is at a critical turning point.

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“We could either continue making progress, continue heading in the right direction, or we could ignore the warnings and spike back up,” the Republican said.

To keep Marylanders up to date with the week’s most pressing takeaways, here are five key points from The Baltimore Sun’s coronavirus coverage.

Hogan expands mask mandate

Hogan expanded April’s executive order on mask wearing to include all indoor public spaces and even outdoor gatherings where social distancing isn’t possible. The previous order applied only to grocery stores, pharmacies and public transit, though several county leaders have already tightened mask restrictions on their own due to local spikes in cases and positivity rates.

Even with this broad measure, which county health officials had previously urged Hogan to consider, the governor said it will be up to local governments to enforce public health orders on wearing masks and limiting capacity at businesses. He said he would not commit state resources, such as state law enforcement officers, to help local governments, nor seek to sanction local jurisdictions that don’t do sufficient enforcement.

Hogan also issued a travel advisory, cautioning people from visiting states that are experiencing surges and have positivity rates higher than 10%. He asked that people who do travel to those states — Alabama, Arizona, Florida, Georgia, Idaho, Louisiana, Nebraska, South Carolina and Texas — to get tested for COVID-19 when they return and quarantine until they get their results back.

Though the state as a whole moved slower than several individual counties, some said the governor’s moves were worth applauding, but urged him to again close nonessential businesses and limit restaurants to takeout service until Maryland’s positivity rate is less than 2% and there’s sufficient testing and contact tracing.

“If we want to prevent a surge of new cases, people should stay home, going out only if they work in an essential service, need to get food and medicine, or to exercise and get fresh air,” Maryland Public Interest Research Director Emily Scarr said in a statement.

For now, Hogan has put on a pause on reopening the state further, and said he would consider doing so if he sees improvement in case counts and positivity rates in certain jurisdictions that are higher than 5%, including Baltimore City and Prince George’s County.

Rocky start to Orioles’ season signals trouble ahead for baseball

Three games into the abbreviated season, the Orioles hit a bump in the road when more than a dozen Miami Marlins players and coaches tested positive for COVID-19 right before the two teams were scheduled to face off Monday in Florida.

The Marlins spent their first series of the season in Philadelphia, and the team’s clubhouse outbreak meant the Phillies had to take a pause on playing, too.

Meanwhile, the Orioles flew back from Miami and had their home opener Wednesday against the New York Yankees, which were supposed to play the Phillies.

Such hurdles and mishaps might be a constant source of stress for Major League Baseball this year as the players and coaches test the productivity of living and playing outside of a “bubble,” or an enclosed space with minimal opportunities for teams to enter and exit. Other leagues such as the NHL, the WNBA and the NBA have rolled out bubble environments for their teams to live and play in. But that concept operates under the looming threat of an outbreak inside the bubble, which could force the entire season to shut down.

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So far, the non-enclosed approach has threatened players’ health and progress on the field as many of them fight for permanent roster spots. It could prove challenging for teams to avoid contracting infections as they travel, especially into states with surges or high positivity rates.

Child care for school-aged children threatens to stall economic recovery

Several child care groups, advocates and business owners have indicated that limited capacity restrictions and overwhelming demand for supervision for school-aged children could threaten Maryland’s economic recovery.

While many child care centers have already gone out of business due to the pandemic, the ones left standing must have smaller class sizes due to state health restrictions. This leaves many families left without options and could force some parents to leave their jobs or attempt to juggle another chaotic school year of watching their children as they work full time.

With several Maryland public school systems starting the year virtually, parents must also secure care for their kids during daytime hours that are usually covered. Caregivers must now also be poised to help children with their virtual schooling — charging hefty prices for such services.

Parents have stressed that securing daytime care for their kids this fall will place undue financial burdens on them, with some expecting to spend thousands of dollars on supervision and schooling help. And as more child care centers going out of business due to low enrollment or financial strains due to the capacity regulations, the world might look very different for working parents once the virus abates.

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State to stop paying for nursing home tests

The Maryland Department will stop paying for weekly coronavirus testing for nursing home staffs on Aug. 15, leaving the facilities forced to foot the bill or risk more outbreaks.

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The facilities, already paying for more cleaning, personal protective gear and hazard pay, have contested that the move leaves them vulnerable. Nursing homes already account for 60% of Maryland’s coronavirus deaths, with more than 2,000 residents and staff dying from COVID-19, according to the state.

Depending on the size of the nursing home, testing all staff can cost thousands of dollars per week, “an unsustainable cost [that] will put at risk the quality care provided to Marylanders most in need,” wrote the state’s three leading industry groups in a letter to Gov. Larry Hogan last week.

The state will work with facilities that cannot afford the testing, Mike Ricci, a spokesman for Hogan, told The Washington Post. “We expect the vast majority of facilities to have plans in place, but there’s a range of options depending on the situation,” he said.

Maryland Health Secretary Robert Neall told the three industry groups in a letter dated Friday that member facilities must “step up and do their part.”

Nursing homes’ revenue is already down below normal as facilities pause from taking in additional residents due to statewide regulations and holds on some elective surgeries. Their failure to pay for testing could also force families to compensate.

Late ICU doctor’s husband: ‘Wear a mask!'

Tributes poured in this week for Dr. Joseph Costa, a Bolton Hill resident and the beloved chief of critical care at downtown Baltimore’s Mercy Medical Center who dedicated his career to treating the sickest patients.

He died of the coronavirus Saturday. He was 56.

Costa’s friends and family remembered him as a “hero” an “egalitarian” who championed the underdog and led with compassion and empathy. Coworkers held a vigil at his bedside as he died, many of them fellow doctors and nurses struggling with working through a global pandemic.

He is survived by his husband, David Hart. He had a message for people learning about his husband’s death: “Wear a mask!”

“I keep thinking, now there is one less ICU doctor to care for pandemic patients in Baltimore,” Hart said. “I get so angry when I see people not wearing masks. It makes me want to take a bar of soap and write on my car’s rearview window that ‘My husband who saved so many lives died of COVID-19.’ "

Masks have proven to mitigate the spread of the disease if worn properly and within six feet of other people. Face coverings should cover the mouth and nose and should be changed or washed frequently.

On Thursday, Mercy’s President and CEO David N. Maine said the hospital would be renaming its ICU in Costa’s memory. The Joseph J. Costa, M.D., Memorial Fund has also been established to provide continued support for patients.

Baltimore Sun reporters Pamela Wood, Jeff Barker, Fred Rasmussen, Lillian Reed, Colin Campbell, Alison Knezevich, Jon Meoli and Daniel Oyefusi contributed to this article.

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