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AzHHA Member Advisory - COVID-19: December 15

The Arizona Department of Health Services (ADHS) is reporting Arizona could receive about 380,000 doses of vaccine by the end of the month, with a similar allocation next month to cover the required “booster shot.”

Arizona COVID-19 data 

Arizona continues to see an alarming trend in COVID-19 cases and hospitalizations according to the weekly forecast model by Joe Gerald, M.D., Ph.D., a researcher at the University of Arizona’s Zuckerman College of Public Health. As of December 11, COVID-19 hospitalizations were 41%, a 21% increase from last week. Intensive care bed utilization was 45%, a 14% increase from the previous week. As of December 14, Arizona Rt was 1.21, the highest in the nation as measured by Rt.live.

Vaccine update 

With the Food and Drug Administration’s granting emergency use authorization (EUA) to Pfizer, Inc. for its BNT162b2 mRNA COVID-19 vaccine, Arizona has received its first shipment of the vaccine, which is being distributed to Maricopa and Pima Counties. The FDA is scheduled to review the Moderna vaccine application this week, and if approved, Arizona could begin receiving this second vaccine by the end of the week.

The Arizona Department of Health Services (ADHS) is reporting Arizona could receive about 380,000 doses of vaccine by the end of the month, with a similar allocation next month to cover the required “booster shot.” ADHS also reports the state’s allocation could increase next month to vaccinate additional healthcare workers and long-term care residents under phase 1A of the state plan.

Local public health departments have jurisdiction for developing vaccination plans within each county, and healthcare providers should be reaching out to them to learn more. ADHS will be developing a communications plan in collaboration with local public health, AzHHA and other stakeholders. For more information on the state plan and links to helpful resources, visit the ADHS COVID vaccine webpage.

As required by the EUA, Pfizer has also made public fact sheets for providers and patients

Post Vaccine Considerations

On December 13, the Centers for Disease Control and Prevention (CDC) posted Post Vaccine Considerations for Healthcare Personnel. This document provides guidance for healthcare facilities to appropriately evaluate and manage healthcare personnel with post-vaccination signs and symptoms, such as fever, fatigue, headache, chills, myalgia, and arthralgia. “The approach described in this document is intended to reduce the risks for disruptions in care and pathogen (e.g., SARS-CoV-2) transmission resulting from:

  • unnecessarily excluding HCP with only post-vaccination signs and symptoms from work, and
  • inadvertently allowing HCP with SARS-CoV-2 or another transmissible infection to work.”

The guidance also outlines considerations to minimize the impact of post-vaccination signs and symptoms on healthcare staffing.

Maricopa County issues vaccine “pre-screen survey”

The Maricopa County Department of Public Health (MCDPH) is in the final planning stages for providing the COVID-19 vaccine to people who are at the highest risk of contracting COVID-19 based on their occupational and individual risk factors. The first allocation of vaccine doses will be prioritized to individuals in Phase 1A: those working in a healthcare setting, especially those with the most potential exposure to COVID-19, as well as residents and staff of long-term care facilities.  

If you are a healthcare worker in Maricopa County, public health requests that you complete this pre-screen survey as the first step to scheduling an appointment. Your response will help MCDPH determine your eligibility and connect you with your assigned regional vaccine provider, based on the location of your primary worksite. More information is available at Maricopa.gov/COVID19vaccine1A.

CNOs Discuss Staffing Challenges

AzHHA holds ongoing CNO (Chief Nursing Officer) meetings to discuss COVID-19 challenges and the sharing of resources. There have been concerns around the ability to meet requirements for acuity staffing, especially in the ICU, when the hospital is at capacity and cannot obtain additional staffing or transfer patients. Guests at the December 4 CNO meeting were from ADHS Licensing and Certification and they provided some clarity on this topic:  

ADHS Response: The rules provide that the hospital determines the patient needs and adjust the number and type of personnel to meet those needs. There is no exception to this rule, nor can ADHS waive this rule. There is also no exception to or ability to waive the ICU ratios. The department recognizes, however, that the hospital's acuity plan may be impossible to implement due to circumstances beyond the hospital's control. For example, acuity may increase unexpectedly during a shift requiring an increase in staffing or it may be impossible for the hospital to locate additional staff. In these situations, the hospital is required to implement its acuity policy according to the situation creating the increased staffing requirement. Hospital policies and procedures are required to address how patients' needs for nursing services will be met in these circumstances and the hospital is required to document the implementation of these policies and procedures. See ADHS Substantive Policy SP-027-DLS-OMF.

If your CNO is not participating in these meetings contact Vicki Buchda, Director Care Improvement at vbuchda@azhha.org for a meeting invite.

PR peer group

AzHHA also convenes Arizona healthcare public relations professionals for virtual collaboration and communication coordination. If your hospital or healthcare professional would like to join this week’s scheduled call, contact Holly Ward at communications@azhha.org.  

New data reporting

The Department of Health and Human Services (HHS) last week updated its guidance to hospitals on the reporting of COVID-19-related data. The guidance includes two key changes stemming from the Centers for Medicare & Medicaid Services’ December 2 interim final rule expanding the requirement for hospitals to report to new sets of COVID-19 data: influenza data and COVID-19 therapeutic data, specifically Bamlanimivab and Casirivimab/Imdevimab (also known as Regeneron). ADHS has already incorporated the flu data fields into EMResource and has begun transmission to HHS. The therapeutic data fields should be complete by the end of the week.

ADHS last week also added new voluntary “surge” data fields to EMResource. While responding to these data fields is voluntary, the department will be relying on this information to assess resource and waiver requests. AzHHA has requested ADHS clarify the purpose of these new data fields as well as defining some of the terminology.