covid-19 clinician support · 12/22/2020 · washington state department of health | 9 k 1 3 5 7 9...

COVID-19 Clinician SupportDecember 22, 2020

1. EPI Report

2. Vaccine Updates

We will have discussion and Q&A throughout the call. Use the “raise hand” function if you have a question

or comment.

Agenda

COVID-19 Epidemiology Update

December 22, 2020

Washington State Department of Health | 2

COVID-19 cases remain very high but appear to be decreasing

Source: https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard

https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard


Percent positivity is decreasing


COVID-19 hospitalizations appear to be flattening




ER visits and admissions for

covid-like Illness have flattened


COVID-19 deaths continue to increase




COVID-19 hospital bed occupancy flattening

Source: https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard

https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard


COVID-19 hospital bed occupancy high throughout the state

Central: King North Central: Chelan, Douglas, Grant, Okanogan

West: Grays Harbor, Lewis, Pacific, Pierce, Thurston counties

South Central: Yakima, Benton, Franklin, Walla Walla, Kittitas




COVID-19 ICU bed occupancy stable




Summary

• COVID-19 activity remains very high

• Case counts and positivity decreasing but hospitalizations are flat

• COVID-19 hospital bed occupancy and ICU occupancy stable

Washington State Department of Health is committed to providing customers with forms

and publications in appropriate alternate formats. Requests can be made by calling

800-525-0127 or by email at [email protected]. TTY users dial 711.

WSHA

December 22, 2020

COVID-19 Vaccine Updates

SHEANNE ALLEN, MPH, MCHES


Workers in sites where direct patient care is being delivered to confirmed or suspected COVID-19 patients

o Example settings: hospital sites managing suspected/confirmed COVID patients; emergency departments; urgent care; clinics (walk-in, respiratory); home; isolation and quarantine facility

o Roles: healthcare providers; tech; security; environmental; non-remote translators; counselors; home health aides, caregivers, and companions; workers performing high risk exposure procedures

Workers exposed to/handling potentially SARS-CoV-2 containing specimens & COVID-19 testing site staff at high risk of exposure to suspected COVID-19 patients

First responders at high risk of exposure to suspected or confirmed COVID-19 patients via high public exposure and procedures

o Frontline emergency workers providing care, transport/ambulatory support, and oversight of any agency (fire, ambulance, hospital)

Workers with elevated risk of acquisition/transmission with populations at higher risk of mortality or severe morbidity

o Examples: staff at long-term care facilities; workers with patients undergoing chemotherapy, dialysis, etc.; home health aides/caregivers/companions

Residents of long-term care facilities and other community-based, congregate living settings where most individuals over 65 years of age are receiving care, supervision, or assistance and are unable to reside independently in the community

Workers administering COVID-19 vaccines

Phase 1aPhase 1a Objectives

• Protect those at highest risk of exposure

• Maintain medical surge response capacity


Allocation Process

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6

Survey LHJs

Survey Providers

DOH Analysis

Develop Rec.

Finalize sites

Place/comm. order


Week 1 (Dec 13-19) Week 2 (Dec 20-26) Week 3 (Dec 27-Jan 1)

• 62,400 doses

• 42 sites

• 27 counties

• Other (e.g., LTCF)

• 172,850 doses

• 200+ sites

• 38 counties


• ~140,000 doses

• ~120 survey respondents

• 38 counties


Allocation Outputs to Date

IN PROCESS


Firs

t d

ose

s p

er

wee

k

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31

50k

100k

150k

200k

22k

* Supply assumptions based upon 2021 supply projections from manufacturers and likely additional supply in spring 2021

300k

33

WA COVID VX FIRST DOSE OPTIMISTIC ROLL-OUT (PRELIMINARY)

500k

Jan Feb Mar Apr May June

Est. max. first d

ose ad

min

istration

per d

ay

26k 60k60k40k

Future points of administration – more and larger volume


• Providers concerned about how to manage unaffiliated workers

• Providers do not want to assess eligibility

• Unaffiliated Phase 1A eligible individuals feel inequitable access and worry will have to compete with next phase

• Growing perception that providers vaccinating staff outside Phase 1A guidance (undermines trust….and we need all the trust we can get)

• Local health jurisdictions lack capacity to organize all unaffiliated workers and match to providers

• Some providers lack staff capacity to administer high volume doses

• We do not know what demand is for Phase 1A to know when we are done

What we hear – Challenges


• First week was limited (~60k) but second week increased volumes (+170k) which represents over half our estimated Phase 1A eligible candidates

• Week 2 – ~10 out of ~100 (10%) provider survey responses indicated willingness to vaccinate unaffiliated workers (mostly in smaller counties)

• Week 3 – 94 out of 123 (76%) provider survey responses indicated willingness to vaccinate unaffiliated workers – but not all provided contact information to enable link

• People want a state-wide system to manage supply and demand as much as possible

What we hear – Opportunities


User added value:

• Assess eligibility

• Provide eligibility confirmation at site

• Help you find where to get vaccinated

Health system added value:

• Removes burden on point of administration

• Assess demand of different groups across zip codes to support planning

PhaseFinder – When is my turn? Where do I go?


User experience:

• Not too personal questions

• Multiple languages

• Can complete in advance or at site

• Screen grab, text, or email confirmation to show with ID

PhaseFinder – How it works….

SimpleEquitable

Trust-based

Link to test survey:https://form.jotform.com/203418436942154

https://form.jotform.com/203418436942154


• Time: December 24 – Jan 5

• Objectives:• Support unaffiliated staff to link to vaccination

• Gather feedback

• Target:• Unaffiliated staff who do not like letter

eligibility approach

• Functions:• Qs: age, zip code, healthcare role, LTCF

staff/resident

• Confirmation

• Link to open providers???

PhaseFinder Evolution

CONTAINED PILOT: PHASE 1A ELIGIBLE ONLY BROADER ROLL-OUT

• Time: Jan 6 ->

• Objective: • Support roll-out

• Target:• General public

• Functions:• All Qs (age, zip code, # of co-morbidities, critical

worker or not, role/risk, living situation)

• Confirmation or text/email to alert eligibility

• Link to open providers → Vaccine Finder


Partnership Model

Eligible Indiv

Providers LHJs DOH

• Connect with LHJ to identify role in overarching strategy

• Develop approach to manage unaffiliated individuals (certain hours/day; scheduling system)

• Share contact method for individuals to connect (phone, scheduling system link)

• Explore partnerships to expand volume

• Ensure PhaseFinder available at site for people to confirm eligibility

• Identify which providers can help serve unaffiliated staff equitably

• Review list of open sites to confirm

• Share plan in weekly allocation survey so DOH can allocate more vaccines accordingly

• Share PhaseFinder with target groups (pilot vs. broader launch)

• Procure, design, and launch PhaseFinder

• Share PhaseFinder with target groups (pilot vs broader launch)

• Gather feedback and adapt• Maintain list of open PODs → link

to Vaccine Finder• Manage back-end to monitor use

and trigger eligibility• Provide demand data to support

LHJ planning


Prepare now by reviewing enrollment content

o Provider Agreement

o Provider Profile

o Preparing to Enroll in the COVID-19 Vaccination Program

Online enrollment process will begin November

Provider Enrollment

Provider EnrollmentForms

COVID-19 Vaccination Program Provider Agreement

COVID-19 Vaccination Program Provider Profile Form

https://www.doh.wa.gov/Portals/1/Documents/Pubs/348-768-PreparingEnrollment_COVID19VaccineProvider.pdf


Today 12/22 at 12-1PM

Monday 12/28 at 12-1PM

https://global.gotomeeting.com/join/848481621

You can also dial in using your phone.United States: +1 (571) 317-3122

Access Code: 848-481-621

Office Hours 2020

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fglobal.gotomeeting.com%2Fjoin%2F848481621&data=04%7C01%7Cangela.boyer%40doh.wa.gov%7C34a94d7b8e4b43256f8a08d896db07f2%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637425214756793069%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=EtercZihBoDwpQ5f4H6n0GKtXu5KmHwX6j%2Fjsk5YpVE%3D&reserved=0tel:+15713173122,,848481621


Office Hours Survey

20 respondents

o Weekly- 7

o Bi-weekly 7

Best days

o Wednesday- 11

o Thursday- 11

Best times

o Best times: Lunchtime-13

o Mid-morning (10)

Moderna COVID-19 Vaccine and Updates

KATHY BAY DNP, RN, CENP


Who Can Vaccinate

Washington State Department of Health list available at:

https://www.doh.wa.gov/Portals/1/Documents/Pubs/698-001-ProvidersAuthorizedVaccineAdministration.pdf. Accessed 12-22-2020

https://www.doh.wa.gov/Portals/1/Documents/Pubs/698-001-ProvidersAuthorizedVaccineAdministration.pdf


Guidance from Health Human Services Region 10, FDA and CDC:

Given the public health emergency, it acceptable to use every full dose obtainable (the sixth, or possibly even a seventh) from each vial, pending our administrative solution to the issue. However, since these are preservative free vials, any further remaining liquid that does not constitute a full dose should not be pooled from multiple vials to create one.

Update at Advisory Committee on Immunization Practices meeting 12-20-2020

Still pending IIS and administrative process for the extra dose; work continues

Possible 6th dose in Pfizer multidose vial


Arabic Burmese

Cherokee Foosun Chuuk (Chuukese)

Chinese, Simplified Chinese Traditional

Deutsch (German) Kreyol Ayisyen (Haitian Creole)

Hindi Hmong

Korean Mam

Polish Porteguese

Russian Spanish

Somali Tagalog

Vietnamese Yiddish

Source: FDA https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine. Accessed 12-20-2020

Pfizer Emergency Use Information Sheet Languages

https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine


Source: Mbaeyi, S. 12/19/2020; Advisory Committee on Immunization Practice meetings available: https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12-19-20.html. Accessed 12/20/2020

https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12-19-20.html

Washington State Department of Health | 25Source: Mbaeyi, S. 12/19/2020; Advisory Committee on Immunization Practice meetings available: https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12-19-20.html. Accessed 12/20/2020



COVID Vaccines

• The mRNA COVID-19 vaccine series consist of two doses administered intramuscularly:

Pfizer-BioNTech (30 µg, 0.3 ml each): three weeks (21 days) apart

or

Moderna (100 µg, 0.5 ml): one month (28 days) apart

• Second doses administered within a grace period of ≤4 days from the recommended date for the second dose are considered valid; however, doses administered earlier do not need to be repeated.

• The second dose should be administered as close to the recommended interval as possible. However, there is no maximum interval between the first and second dose for either vaccine.


Source: Miller, J. 12/19/2020; Advisory Committee on Immunization Practice meetings available: https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12-19-20.html. Accessed 12/20/2020



New

Different COVID-19 Vaccines | CDC

Understanding COVID-19 mRNA Vaccines

Updated

Ensuring COVID-19 Vaccines Work | CDC

Facts about COVID-19 Vaccines

How CDC Is Making COVID-19 Vaccine Recommendations | CDC

Vaccine Education and Training for Healthcare Professionals | CDC

COVID-19 Vaccination Resources

CDC Provider Education Resources

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fdifferent-vaccines.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C1%7C637421027612737235%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=Mjo2teBytV0aLVlPErJLPiqgEuW2ZkoRIy2U6sNU0sA%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fdifferent-vaccines%2Fmrna.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C1%7C637421027612737235%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=hjsWvU%2F%2B62CXA2ijTcEFiSDmp8Kw2b3758U%2BfXZG2NA%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Feffectiveness.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637421027612737235%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=HYaP94uTPM3wtqnLJIhuh0ROMu8o0KNzOTrarRAqt5Y%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fvaccine-benefits%2Ffacts.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637421027612747193%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=W1G9DzvfjdM%2BaYPsnXyHn7nRCZLXOHzslFt3AIHyy1E%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Frecommendations-process.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637421027612747193%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=3CbDLFx04bFJLM2jZEiWF3yteVOSK9XhHBCt8chg0b0%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fed%2Findex.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637421027612757149%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=9H2zurDAZ9FYROXoT7EkHfU%2B7FSbK5xH%2FgL8p3VazEc%3D&reserved=0https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Fvaccination-resources.html&data=04%7C01%7Cmary.huynh%40doh.wa.gov%7C7f403ec4e8b3479d1bde08d8930be987%7C11d0e217264e400a8ba057dcc127d72d%7C0%7C0%7C637421027612757149%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=ru2HEkEZqiOL6TBKBQxKPTsbpIvym7KpDEasxt%2B%2FGwg%3D&reserved=0


• CDC toolkit for healthcare organizations: https://www.cdc.gov/vaccines/covid-19/health0systems-communication-tooklit.html.

• FDA COVID-19 Information: https://www.fda.gov/emergency-preparedness-and-response/counterterrorism-and-emerging-threats/coronavirus-disease-2019-covid-19.

• FDA EUA Guidance: https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization-covid-19euas.

• Pfizer BioNTech Emergency Use Authorization: https://www.fda.gov/media/144414/download.

• Washington State Department of Health ordering and administering provider list: https://www.doh.wa.gov/Portals/1/Documents/Pubs/698-001-ProvidersAuthorizedVaccineAdministration.pdf.

Resources

https://www.cdc.gov/vaccines/covid-19/health0systems-communication-tooklit.htmlhttps://www.fda.gov/emergency-preparedness-and-response/counterterrorism-and-emerging-threats/coronavirus-disease-2019-covid-19https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization-covid-19euashttps://www.fda.gov/media/144414/downloadhttps://www.doh.wa.gov/Portals/1/Documents/Pubs/698-001-ProvidersAuthorizedVaccineAdministration.pdf

To request this document in another format, call 1-800-525-0127. Deaf or hard ofhearing customers, please call 711 (Washington Relay) or email [email protected].

WSHA Vaccine Assistance to DOH• WSHA staff will proactively share status with hospitals• Hospitals can contact WSHA staff regarding: • Weekly allocation of vaccine

• Provider enrollment

• Transfer assistance

• Allocation survey completion

• General process questions• WSHA will answer questions or work with DOH to find answers

• Staff contacts: • Clinical support: Tina Seery, [email protected]

• Logistical support: Josh Russell, [email protected]
mailto:[email protected]:[email protected]