CDC updates COVID-19 quarantine and isolation guidance
Guidance on COVID-19 quarantine and isolation was updated January 4 by the Centers for Disease Control and Prevention (CDC). Under the new guidance, individuals who have been in close contact with someone confirmed to have COVID-19 and fall into one of the following groups should quarantine.
Age 18+ and fully vaccinated but has not received a booster.
Received the single-dose Johnson & Johnson vaccine over two months ago and have not received a booster.
Are unvaccinated or have not completed a primary vaccine series.
During the quarantine period, individuals should
stay home and away from others for at least five days after the last contact with a person who has COVID-19.
If you do not develop symptoms, get tested at least five days after you last had close contact with someone with COVID-19.
For 10 days after exposure watch for fever, cough, shortness of breath or other COVID-19 symptoms. If symptoms are developed individuals should get tested and isolate.
To find a testing or vaccine site location, visit azdhs.gov/covid19/#everyone-home.
Arizona healthcare providers call for help
As COVID-19 cases increased throughout the state and Arizona hospitals encountered a sharp increase in critically ill patients seeking care over the Christmas and New Year holidays, healthcare leaders throughout the state issued a plea for help. “The Arizona health system is teetering on the edge of a crisis,” the letter begins.
The letter, signed by more than 20 AzHHA member hospitals throughout Arizona, explains how residents and visitors alike can help healthcare workers who are stretched thin. Read the letter in English and Spanish and visit SlowTheSpreadAZ.org for more information.
SCOTUS oral arguments on CMS and OSHA vaccine mandates scheduled for tomorrow
The U.S. Supreme Court will hold oral arguments tomorrow on whether to allow the Centers for Medicare & Medicaid Services’ (CMS) and the Occupational Safety and Health Administration’s (OSHA) vaccine mandates to go into effect while legal challenges to the rules are considered by U.S. Courts of Appeal. The CMS mandate applies to healthcare workers while the OSHA mandate applies to workers at places of employment with over 100 employees.
Due to rulings issued by the Eighth Circuit and Fifth Circuit Courts of Appeals, the CMS mandate is currently enforceable in half the country, not including Arizona. In a reversal of its previous position to not enforce its vaccine mandate while it is the subject of judicial review, CMS announced on December 28 it would begin enforcing the mandate in 25 states.
The Sixth Circuit Court of Appeals ruled in December the OSHA vaccine mandate may take effect nationwide, which effectively dissolved the stay of the OSHA mandate the Fifth Circuit Court of Appeals issued in November. OSHA posted an announcement stating it “will not issue citations for non-compliance with any requirements of the ETS before January 10.” OSHA also stated it will not issue citations for non-compliance with the requirement to test unvaccinated employees by February 9 as long as an employer is exercising reasonable, good faith efforts to come into compliance.
In recent weeks, the U.S. Department of Health and Human Services (HHS) has issued several updates to guidance on the use of monoclonal antibody therapies to treat COVID-19. Due to the growth in prevalence of the Omicron variant, which has shown resistance to bamlanivimab/etesevimab and REGEN-COV, HHS announced December 23 that it would pause further allocations of these therapeutics pending updated data from the CDC. However, due to lower frequency of Omicron in some regions and limited supply of alternative treatment options, HHS suggested use of existing supply of bamlanivimab/etesevimab and REGEN-COV in lower-prevalence regions is clinically appropriate.
HHS subsequently announced it would only pause allocations of bamlanivimab/etesevimab and REGEN-COV COVID-19 to regions of the country that have greater than 80% prevalence of the Omicron variant based on CDC data. On December 31, HHS announced all states and territories could continue to order both bamlanivimab/etesevimab and REGEN-COV based on allocated amounts for clinically appropriate use. Before HHS’ announcement, the National Institutes of Health published clinical guidelines.
The Arizona Department of Health Services (ADHS) is urging providers to continue to administer bamlanivimab/etesevimab and REGEN-COV until the alternative monoclonal therapeutic sotrovimab, which has shown to be more effective against the Omicron variant, is more widely available. For more information from ADHS on monoclonal antibodies, including where to find treatment, click here.
COVID-19 antiviral prioritization
The Arizona Vaccine and Antiviral Prioritization Advisory Committee (VAPAC) is scheduled to meet January 7 to discuss the prioritization of COVID-19 antivirals, Paxlovid and Molnupiravir, which are currently in limited supply nationwide. ADHS recently sent preliminary guidance to providers, which will be formalized pending approval from VAPAC. More information may be requested by emailing the ADHS COVID-19 Therapeutics Team at [email protected].
Changes to EMResource
ADHS is rolling out revisions to EMResource to streamline reporting and provide additional functionality. The event “Update 3” will be removed and the rescinded Executive Order related statuses will be disabled. The event “Update 1 COVID-19: Status & Bed Poll” will be modified to only include status types that are part of the most current Enhanced Surveillance Advisory (ESA) required reporting elements, see Executive Order 2021-21. All status types in the event “Update 1: COVID-19 PPE, Staffing, & Supply Updates” will only be required to be filled out by request.
ADHS is also revising data definitions, which can be found here. Questions about the definitions or data in EMResource may email [email protected]. Members of the AzCHER team at AzHHA are also available to field questions.
CDC’s ACIP recommends booster dose for children 12-17
The CDC’s Advisory Committee on Immunization Practices endorsed yesterday a single booster dose of the Pfizer COVID-19 vaccine for children ages 12-17 at least five months after receiving a second dose. Just three days ago, the U.S. Food and Drug Administration authorized a single booster dose of the Pfizer COVID-19 vaccine for children ages 12-15.
Arizona state legislative session and member update call start next week
We’re off to the races on Monday, January 10 as the 2nd Regular Session of the 55th Legislature convenes for business this year. As of today, there is still one vacancy remaining, as former Senator Jamescita Peshlakai (D-LD7) resigned her position to accept a role with the Department of the Interior. The Coconino County Board of Supervisors has not named a replacement. Over 100 bills have already been pre-filed, and if that number is any indication, we can anticipate a long session just like the 2021 session, which lasted 171 days. Many repeat themes from the 2021 session are also emerging—bills on election procedure, school choice and education issues, healthcare mandates and finally quite a few placeholder bills with no substantive content. AzHHA’s top legislative priority as identified by our Public Policy Committee and Board of Directors is delivering solutions to help with the healthcare workforce crisis facing Arizona’s hospitals and healthcare system.
Of interest to the hospital community, the House Health Committee has some new faces, including Representative Beverly Pingerelli (R-LD21) and former Health Committee member Rep. Pamela Powers Hannley (D-LD9), as well as a new Vice-Chair in Rep. Steve Kaiser (R-LD15). The Senate Health Committee also has one new member in recently appointed Senator Raquel Terán (D-LD30). In addition to opening day festivities on Monday, Governor Doug Ducey will also deliver his final State of the State address to a joint session of the legislature.
AzHHA will begin its weekly Legislative Update calls on Friday, January 14 at 1:30 p.m. Members will receive a meeting invitation soon.
CDC updates strategies to mitigate healthcare personnel staffing shortages
Just before the holidays, the CDC updated its strategies to mitigate healthcare personnel staffing shortages. In a Health Alert Network message, the CDC recommended healthcare personnel
get all doses of COVID-19 vaccines, including booster doses.
increase patient outreach efforts to recommend, encourage and offer COVID-19 vaccination and boosters.
recommend that all healthcare personnel who are immunocompromised continue to practice all prevention measures to protect themselves against COVID-19.
when spending time in community settings, take all recommended steps to protect yourself and others from COVID-19 infection to decrease the risk of spreading the virus.
Free COVID-19 testing supplies for RHCs
The U.S. Department of Health and Human Services announced Medicare-certified Rural Health Clinics are eligible to order free COVID-19 self-testing supplies. Click here to apply. Questions may be emailed to [email protected].
Quality improvement funding opportunity
Diagnostic errors are the most common, catastrophic and costly of all causes of preventable medical harm. In fact, according to the Society to Improve Diagnosis in Medicine (SIDM), errors in diagnosis are the most frequent cause of medical error reported by patients.
In efforts to identify, develop, and test interventions SIDM has launched the DxQI Seed Grant Program aimed at improving diagnostic quality and reducing harm from diagnostic error. Approximately 20 grantees will be awarded up to $50,000 for their quality improvement projects. Learn more and apply at improvediagnosis.org/dxqi/.
February 7 - Developing a Telemedicine Program
This course is ideal for individuals or groups who have some telehealth experience and are interested in expanding their services. It is also a great course for those new to telehealth who are interested in gaining a deeper understanding of the growing industry. The course fee is waived for Arizona, New Mexico, Utah, Colorado and Nevada residents. Register here.
Introduction to POLST
Interested in learning how to use the Arizona POLST form with your patients? The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST, Physician Orders for Life-Sustaining Treatment, in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. To register for a workshop, click on a date below.
In the News
Arizona Reports Over 7,000 More COVID-19 Cases, 154 Deaths
U.S. News and World Report
CDC Advisers Endorse First Covid-19 Boosters for 12- to 15-Year-Olds
Wall Street Journal