BALTIMORE, MD — New orders were issued by Gov. Larry Hogan Wednesday in an effort to expand health-care services as the number of new coronavirus cases continues to climb. He expanded telehealth services and designated disabilities services personnel as health-care providers. Maryland's hospital regulatory agency is also working to obtain federal money to help pay for the expected increase in patients and treatment costs.

As of Wednesday morning, Maryland had a total of 1,985 confirmed cases of coronavirus, an increase of 325 cases, which is the largest one-day increase to date. The Maryland Department of Health said there have been 13 additional deaths as a result of the pandemic, bringing the state's total to 31 deaths.

There are now more than 4,000 COVID-19 cases in the National Capital Region of Maryland, the District of Columbia and Virginia.

A statewide stay-at-home order was put in place Monday after the number of deaths from the new coronavirus in Maryland tripled over the weekend, from five Saturday to 15 on Sunday.

Maryland officials ordered schools closed on March 16, non-essential services were ordered closed March 23, and a stay-at-home order was issued March 30. Hogan has not banned travel, although he said anyone who has been outside of the state should self-quarantine for 14 days.

When Hogan issued the stay-at-home order he said Maryland faces "a deadly public health crisis. We are no longer asking or suggesting that Marylanders stay home. We are directing them to do so," Hogan said.

2 New Orders From Governor

Hogan issued two emergency orders that expand telehealth services and designate disabilities services personnel as health-care providers.

"As our state faces new and unprecedented challenges, we need to be adaptive, innovative, and inclusive in our response," Hogan said in a statement. "The orders I have issued today help ensure that Marylanders of all ages and abilities can continue receiving essential services throughout this public health crisis."

EXPANDING TELEHEALTH SERVICES IN MARYLAND: Hogan issued an executive order that amends the previous May 20 order regarding telehealth by expanding these services beyond audio-only methods. With this order, healthcare providers may engage in asynchronous telehealth services, such as email, provided that any and all telehealth practices are clinically appropriate, properly documented, and otherwise comply with proper standards of care. These telehealth services are also eligible for reimbursement by Medicaid. Read the amended executive order.

HEALTH CARE DESIGNATION FOR DISABILITIES SERVICE PERSONNEL: Hogan issued an executive order ensuring that workers who provide important support services to the disabled will be treated as health care providers under the recently-enacted Families First Coronavirus Response Act. This order officially recognizes the essential function of services for the disabled—including in-home care, interpreting services, social services, and support systems for substance abuse and mental illness—and designates those who provide these services as essential health care providers. Read the executive order.

All of Hogan's emergency orders and proclamations are available here. For health resources, including case counts and clinician guidance, visit coronavirus.maryland.gov.

These social distancing measures and other steps can help minimize the spread of the coronavirus:

• Stay at home as much as possible. If you must go out, maintain a 6-foot distance from others.
• Wash your hands often with soap and warm water for at least 20 seconds on both sides and between your fingers.
• Use an alcohol-based hand sanitizer with at least 60 percent alcohol if soap and water are not available.
• Avoid touching your eyes, nose and mouth.
• Avoid people who are ill.
• Disinfect high-contact surfaces, such as door knobs and tables.

The Center for Disease Control and Prevention recommends, if you think you have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, call a healthcare provider for medical advice.

The Maryland Department of Health has shared this overview of the virus and how to be safe:

What are risk factors for serious illness from COVID-19?
Older people, age 60 and above, and those with pre-existing medical conditions have a higher risk
for serious illness from COVID-19. Examples of pre-existing medical conditions include: cancer,
diabetes, heart disease or other conditions impacting the immune system's ability to fight germs.
How does COVID-19 spread?
COVID-19 is thought to be able to spread like the cold or flu through:
• coughing and sneezing, which creates respiratory droplets
• close personal contact, such as touching or shaking hands
• touching an object or surface with the virus on it
What are the symptoms of COVID-19?
• Fever
• Coughing
• Shortness of breath
• In more severe cases, pneumonia (infection in the lungs)
What should I do if I think I am sick with COVID-19?
If you become sick with fever, cough or have difficulty breathing, contact your health care
provider, especially if you are over 60 years of age or have pre-existing medical conditions. If you
do not have a health care provider, contact your local health department.
Follow these steps:
• Call your health care provider, local health department or emergency room before you go
• Tell them about your symptoms, any recent travel and close contacts (such as people in
your household)
• Wear a mask, if one is available
If someone has COVID-19, what will happen to them?
The vast majority of people recover from this infection. Most people will have mild or moderate
symptoms. Most people may be advised to recover at home and isolate themselves from others.
These individuals should call their physicians or health care practitioners if their symptoms get
worse.
Some COVID-19 infections can lead to serious illness, and in some cases death. If someone has a
more serious illness from COVID-19, they may be admitted to the hospital.

Hospital Preparations, Costs, Funding

As Maryland prepares for a potential novel coronavirus outbreak, hospitals will play a crucial role in treating patients that contract the virus. The state's hospital cost and quality regulatory agency, the Maryland Health Services Cost Review Commission, is working on approaches to ensure hospitals have the funding needed to expand capacity so that residents have access to critical emergency and intensive inpatient services.

Hospitals across Maryland are reviewing emergency plans and preparing additional testing space, beds, and equipment to be able to screen and treat patients with the acute respiratory symptoms associated with the coronavirus.Read more at Patch