Combating the Novel Coronavirus (COVID-19): Week of Dec. 7
Posted on December 13, 2020
Developments with the novel coronavirus are occurring quickly, as the first shipments of the Pfizer COVID-19 vaccine have gone out and the federal government continues to grapple with legislation to assist American businesses and residents. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.
Healthcare Community Urged to Contact Congress on COVID-19 Relief
As the 116th U.S. Congress is entering its final weeks, a COVID-19 relief package is still being negotiated. A bipartisan group of senators led by Sens. Joe Manchin (D-WV) and Mitt Romney (R-UT) is proposing more than $900 billion in aid for state and local governments, small businesses and healthcare providers. Transportation, unemployment, education, vaccine distribution, and testing and tracing are also included in the package. Funding for healthcare providers includes $35 billion allocated to the Provider Relief Fund (PRF), with $7 billion for rural providers and $1 billion for tribes, tribal organizations, urban Indian health organizations and health service providers to tribes. The plan also includes improvements to PRF reporting guidelines, such as clarification that PRF can be used for staffing, including child care staff, and health systems are allowed flexibility to move targeted PRF distributions within their system. It is possible the bipartisan package could be formally introduced Dec. 14.
Hours before funding for the federal government expired Dec. 11, Congress approved a one-week funding extension to Dec. 18. The extension provides negotiators with several more days to agree to a Continuing Resolution for all government funding and a COVID-19 relief package. Members are asked to contact their U.S. House representative and Michigan Sens. Debbie Stabenow and Gary Peters to encourage the following support for hospitals in the end-of-year package:
- Provide more COVID-19 relief, including additional money for the PRF, federal liability protections, support for front-line healthcare workers, coverage for the uninsured, and accelerated payment forgiveness.
- Eliminate cuts to the Medicaid disproportionate share hospital program in the next fiscal year.
- Extend the congressionally enacted moratorium on the application of the Medicare sequester cuts until the public health emergency ends.
Members are also asked to urge that the following provisions be excluded from any package that reaches the House or Senate for a vote:
- Problematic proposals under consideration related to surprise medical billing, including any “agreement” that takes money from providers without protecting patients.
- Any provisin that would require new, unrealistic and burdensome Occupational Safety and Health Administration standards.
With strong advocacy from the healthcare community, Congress could pass a COVID-19 Relief Package before adjourning for the year. For more information about end-of-year federal activity, members may contact Laura Appel at the MHA.
Pfizer Vaccine Approved and Being Shipped, Priority Groups Finalized
The U.S. Food and Drug Administration (FDA) issued an emergency use authorization determination for the Pfizer COVID-19 vaccine late Dec. 11 and shipments began leaving Kalamazoo Dec. 13.
The Michigan Department of Health and Human Services (MDHHS) had provided additional information about COVID-19 vaccination plans for the state earlier Dec. 11, including priority groups for vaccination administration. The MDHHS slides from the news conference are available online.
The MDHHS is following the recently issued Centers for Disease Control and Prevention recommendations for prioritization of distribution and administration of COVID-19 vaccines. CDC recommendations are based on input from the Advisory Committee on Immunization Practices (ACIP). In addition, multiple health systems and the MHA took part in a stakeholder meeting in November to provide input on Michigan’s priority groups.
- Phase 1A includes paid and unpaid individuals serving in healthcare settings who have direct or indirect exposure to patients or infectious materials and are unable to work from home, as well as residents of long-term care facilities.
- Phase 1B includes some workers in essential and critical industries, including workers with unique skill sets such as nonhospital or nonpublic health laboratories and mortuary services.
- Phase 1C includes people at high risk for severe COVID-19 illness due to underlying medical conditions and people 65 years and older.
- Phase 2 is a mass vaccination campaign for all adults.
The MDHHS vaccination plan includes additional prioritization guidance within these categories. It was stressed that vaccination in these phases will likely overlap. The timing of the start of vaccination in a phase is dependent on guidance from the CDC and the ACIP, the supply of vaccine from the manufacturer, how vaccine is allocated from the federal level to Michigan and the capacity to administer the vaccine to populations.
The MHA will continue to provide updates on vaccine distribution as they become available. Members who receive updates directly from the MDHHS are encouraged to share that information with the MHA for vetting or broader distribution. Members with questions and information may contact Ruthanne Sudderth at the MHA.
MDHHS “Pause” Extended to Dec. 20
The MDHHS announced Dec. 7 that it was extending to Dec. 20 its Nov. 18 emergency order limiting indoor gatherings and requiring mask wearing. Previously set to expire at midnight Dec. 8, the extended order slightly relaxes some of the previous order’s restrictions; for example, it allows for in-person instruction of certain trade/vocational programs, with protections in place.
The MDHHS announcement comes on the heels of the MHA’s Dec. 7 letter, published on behalf of MHA-member chief medical officers, urging the state to continue some degree of protection so that the slight progress in hospitalizations achieved since Nov. 18 does not regress. The MHA also issued a statement recognizing the order extension following the MDHHS announcement and has conducted media interviews with outlets from across the state. Links to some of the media coverage is available in a related article.
Data Tracking COVID-19 Patients, New Reporting Requirements
- Hospitals have asked for clarification on how to count patients who are no longer in COVID-19 isolation for reporting into the state’s EMResource portal or the national TeleTracking portal. According to guidance from the U.S. Department of Health and Human Services (HHS), COVID-19 patients should continue to be counted in the COVID-19 daily census and COVID-19 ICU census regardless of their isolation status or change in location (e.g. transferred out of a COVID-19 unit). Once a patient has been identified as COVID-19-positive, they should always be counted in your daily COVID-19 census until discharged or expired. Only the data field that pertains to hospital onset COVID-19 patients should take into account the change in COVID-19 isolation status.
- The HHS recently released new COVID-19 reporting guidance for hospitals. The influenza data fields will be mandatory (except psychiatric and rehabilitation facilities) starting Dec. 18. In addition, beginning Jan. 8, 2021, new therapeutic fields will be mandatory each Wednesday. These fields will be designated with generic identifiers (currently using only the letters A and B) to provide flexibility to the HHS on new therapeutics. Therapeutic A has been designated for Casirivimab/Imdevimab and therapeutic B has been designated for Bamlanivimab data collection.
Members with questions on data should contact Jim Lee at the MHA.
COVID-19 Webinar Series Available for All Hospitals
A weekly Mi-COVID19 webinar series began Dec. 9 that aims to continue collaboration and share COVID-19-related lessons learned with stakeholders and experts across multiple disciplines to support Michigan hospitals and providers in caring for COVID-19 patients. The series is hosted by the Mi-COVID19 Initiative, part of the Michigan Hospital Medicine Safety Consortium.
These webinars will be held from noon to 1 p.m. each Wednesday and are currently scheduled through Feb. 24. Webinar topics and registration information are available online.
CME/CE credit is being offered for each webinar. The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Michigan Medical School designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
For information on future webinars, webinar recordings and COVID-related resources, visit the Mi-COVID19 Initiative webpage. To share COVID-19-related resources, contact the Mi-COVID19 leadership team.
An additional series of education webinars for providers on COVID-19 vaccine is available from the MDHHS. Three 30-minute presentations will be offered from noon to 12:30 p.m. on the following dates and can be joined via the appropriate link:
- Dec. 14: An Update on the Pfizer COVID-19 Vaccine
- Dec. 21: An Update on the Moderna COVID-19 Vaccine
- Dec. 22: Talking Points for Common COVID-19 Vaccine Concerns
No registration is required for these three webinars, and no continuing education credits are offered. Recordings will be made available for those who are unable to attend.
Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC). Members with MHA-specific questions should contact the following MHA staff members:
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